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Yoon S, Ploss A, Hutzel M, Webb R, Hatfield A, Lee JY, Munshi A, Radney A, McClellan J. Parenting attitudes and behaviors among parents involved with the child welfare system and affected by substance use disorders. CHILD ABUSE & NEGLECT 2024; 149:106657. [PMID: 38262180 DOI: 10.1016/j.chiabu.2024.106657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/13/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Co-occurring parental substance use and child maltreatment is a serious concern in the U.S child welfare system. OBJECTIVE The aim of the study was to examine parenting attitudes and practices among parents who participated in Ohio START (Sobriety, Treatment, And Reducing Trauma), a statewide initiative that provides support to families affected by co-occurring parental substance use and child maltreatment. PARTICIPANTS AND SETTING Study 1 involved quantitative data collected from 73 enrolled parents through pre-test and post-test telephone surveys. Study 2 (parent interviews) involved qualitative data collected through in-depth interviews with 34 enrolled parents. METHODS The paired-sample t-test and the McNemar test were conducted in Study 1 and thematic analysis was conducted in Study 2. RESULTS Quantitative analysis indicated significant improvements in parental expectations of children (t = -3.42, p = .001, Cohen's d = -0.40), parent-child family roles (t = -5.74, p < .001, Cohen's d = -0.67), and children's power and independence (t = -3.42, p = .001, Cohen's d = -0.40). Qualitative analysis revealed six themes related to changes in parenting after participation in Ohio START: (1) Being present for children, (2) Engaging in activities with children, (3) Enjoyment in providing care to children, (4) Maintaining employment for financial stability, (5) Better emotion regulation and stress management, and (6) a sense of pride. CONCLUSIONS Our findings demonstrate positive changes in parenting attitudes and practices among parents who participated in Ohio START and provide further support for the potential merits of this model and its continued expansion throughout Ohio.
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Affiliation(s)
- Susan Yoon
- College of Social Work, The Ohio State University, Columbus, OH, USA; Department of Social Welfare, College of Social Sciences, Ewha Womans University, Seoul, South Korea.
| | - Alexa Ploss
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Margaret Hutzel
- Voinovich School of Leadership and Public Service, Ohio University, Athens, OH, USA
| | - Robin Webb
- Voinovich School of Leadership and Public Service, Ohio University, Athens, OH, USA
| | - Ally Hatfield
- Voinovich School of Leadership and Public Service, Ohio University, Athens, OH, USA
| | - Joyce Y Lee
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Additti Munshi
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Angelise Radney
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Jen McClellan
- Public Children Services Association of Ohio (PCSAO), Columbus, OH, USA
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Bunger AC, Chuang E, Girth AM, Lancaster KE, Smith R, Phillips RJ, Martin J, Gadel F, Willauer T, Himmeger MJ, Millisor J, McClellan J, Powell BJ, Saldana L, Aarons GA. Specifying cross-system collaboration strategies for implementation: a multi-site qualitative study with child welfare and behavioral health organizations. Implement Sci 2024; 19:13. [PMID: 38347639 PMCID: PMC10863233 DOI: 10.1186/s13012-024-01335-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/28/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Cross-system interventions that integrate health, behavioral health, and social services can improve client outcomes and expand community impact. Successful implementation of these interventions depends on the extent to which service partners can align frontline services and organizational operations. However, collaboration strategies linking multiple implementation contexts have received limited empirical attention. This study identifies, describes, and specifies multi-level collaboration strategies used during the implementation of Ohio Sobriety Treatment and Reducing Trauma (Ohio START), a cross-system intervention that integrates services across two systems (child welfare and evidence-based behavioral health services) for families that are affected by co-occurring child maltreatment and parental substance use disorders. METHODS In phase 1, we used a multi-site qualitative design with 17 counties that implemented Ohio START. Qualitative data were gathered from 104 staff from child welfare agencies, behavioral health treatment organizations, and regional behavioral health boards involved in implementation via 48 small group interviews about collaborative approaches to implementation. To examine cross-system collaboration strategies, qualitative data were analyzed using an iterative template approach and content analysis. In phase 2, a 16-member expert panel met to validate and specify the cross-system collaboration strategies identified in the interviews. The panel was comprised of key child welfare and behavioral health partners and scholars. RESULTS In phase 1, we identified seven cross-system collaboration strategies used for implementation. Three strategies were used to staff the program: (1) contract for expertise, (2) provide joint supervision, and (3) co-locate staff. Two strategies were used to promote service access: (4) referral protocols and (5) expedited access agreements. Two strategies were used to align case plans: (6) shared decision-making meetings, and (7) sharing data. In phase 2, expert panelists specified operational details of the cross-system collaboration strategies, and explained the processes by which strategies were perceived to improve implementation and service system outcomes. CONCLUSIONS We identified a range of cross-system collaboration strategies that show promise for improving staffing, service access, and case planning. Leaders, supervisors, and frontline staff used these strategies during all phases of implementation. These findings lay the foundation for future experimental and quasi-experimental studies that test the effectiveness of cross-system collaboration strategies.
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Affiliation(s)
- Alicia C Bunger
- Division of General Internal Medicine, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.
| | - Emmeline Chuang
- School of Social Welfare, University of California Berkeley, Berkeley, CA, USA
| | - Amanda M Girth
- John Glenn College of Public Affairs, The Ohio State University, Columbus, OH, USA
| | | | - Rebecca Smith
- Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Jared Martin
- Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, CA, USA
| | - Fawn Gadel
- Public Children Services Association of Ohio, Columbus, OH, USA
| | | | | | | | - Jen McClellan
- Public Children Services Association of Ohio, Columbus, OH, USA
| | - Byron J Powell
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, St. Louis, MO, USA
- Center for Dissemination & Implementation, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA
- Division of Infectious Diseases, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Lisa Saldana
- Lighthouse Institute, Chestnut Health Systems, Eugene, OR, USA
| | - Gregory A Aarons
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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Ali MM, Ghertner R. Is buprenorphine treatment availability associated with decreases in substantiated cases of child maltreatment? J Subst Abuse Treat 2022; 139:108780. [DOI: 10.1016/j.jsat.2022.108780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/04/2022] [Accepted: 03/30/2022] [Indexed: 11/17/2022]
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Huebner RA, Hall MT, Walton MT, Smead E, Willauer T, Posze L. The Sobriety Treatment and Recovery Teams program for families with parental substance use: Comparison of child welfare outcomes through 12 months post-intervention. CHILD ABUSE & NEGLECT 2021; 120:105260. [PMID: 34391128 DOI: 10.1016/j.chiabu.2021.105260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 07/07/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The 2018 Family First Prevention Services Act (FFPSA) shifted child welfare funding to interventions proven effective in preserving families with parental substance use and child welfare involvement. The Sobriety Treatment and Recovery Teams (START) program serves this population with FFPSA aligned goals. OBJECTIVE This study was the first to test the sustained effects of START from the initial CPS report through 12-months post-intervention. PARTICIPANTS AND SETTING Children (n = 784) receiving START services in four sites were compared to 784 children receiving child welfare treatment as usual (TAU). METHODS Using child welfare administrative data, children in START were matched to children in TAU using propensity score matching. Outcomes were tested during the intervention period, and at six- and 12-months post-intervention using comparative statistics and multilevel logistic regression. RESULTS The odds of START children being placed in out-of-home care (OOHC) during the intervention period were half those of children in TAU (20.3% vs. 35.2%, p < .001, OR = 0.47, 95% CI [0.37, 0.59]). When placed in OOHC, START children were more likely to be reunified with their parents (p = .042, OR = 1.44, 95% CI [0.99, 1.62]). At 12-months post-intervention, 68.5% of START and 56.0% of TAU-served children remained free from both OOHC placement and child abuse and neglect (after multilevel clustering adjustment: p < .001, OR = 1.85, 95% CI [1.41, 2.43]). CONCLUSION The primary impact of START was significantly reduced rates of OOHC placement, with results sustained through 12-months post-intervention and after accounting for family clusters and site differences.
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Affiliation(s)
- Ruth A Huebner
- Kentucky Department of Community Based Services, Retired Professor Eastern Kentucky University, United States of America.
| | - Martin T Hall
- Kent School of Social Work, University of Louisville, Louisville, KY, United States of America.
| | - Mathew T Walton
- Office of Health Data and Analytics, Division of Analytics, Frankfort, KY 40621, United States of America.
| | - Erin Smead
- University of Kentucky College of Social Work, Department for Community Based Services, United States of America.
| | - Tina Willauer
- National START Training and Technical Assistance Program, Children and Family Futures, Inc., Lake Forest, CA 92630, United States of America.
| | - Lynn Posze
- National START Training and Technical Assistance Program, Children and Family Futures, Inc., Lake Forest, CA 92630, United States of America.
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