Evaluation of two implementation strategies in 51 child county public service systems in two states: results of a cluster randomized head-to-head implementation trial

Autor: Patricia Chamberlain, C. Hendricks Brown, Courtenay Padgett, Wei Wang, Gracelyn Cruden, Lisa Saldana
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Child Welfare
Health Informatics
California
law.invention
Health administration
Foster Home Care
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Nursing
law
Health care
Outcome Assessment
Health Care
Milestone (project management)
Medicine
Cluster Analysis
Humans
0501 psychology and cognitive sciences
Operations management
030212 general & internal medicine
Community Health Services
Child
Health policy
Ohio
Medicine(all)
Patient Care Team
business.industry
Health Policy
Research
05 social sciences
Health services research
Public Health
Environmental and Occupational Health
Health Plan Implementation
Multidimensional Treatment Foster Care
Stages of Implementation Completion
General Medicine
Mental health
Implementation
Public service
Clinical Competence
business
Delivery of Health Care
050104 developmental & child psychology
Zdroj: Implementation Science : IS
ISSN: 1748-5908
Popis: Background Much is to be learned about what implementation strategies are the most beneficial to communities attempting to adopt evidence-based practices. This paper presents outcomes from a randomized implementation trial of Multidimensional Treatment Foster Care (MTFC) in child public service systems in California and Ohio, including child welfare, juvenile justice, and mental health. Methods Fifty-one counties were assigned randomly to one of two different implementation strategies (Community Development Teams (CDT) or independent county implementation strategy (IND)) across four cohorts after being matched on county characteristics. We compared these two strategies on implementation process, quality, and milestone achievements using the Stages of Implementation Completion (SIC) (Implement Sci 6(1):1–8, 2011). Results A composite score for each county, combining the final implementation stage attained, the number of families served, and quality of implementation, was used as the primary outcome. No significant difference between CDT and IND was found for the composite measure. Additional analyses showed that there was no evidence that CDT increased the proportion of counties that started-up programs (i.e., placed at least one family in MTFC). For counties that did implement MTFC, those in the CDT condition served over twice as many youth during the study period as did IND. Of the counties that successfully achieved program start-up, those in the CDT condition completed the implementation process more thoroughly, as measured by the SIC. We found no significant differences by implementation condition on the time it took for first placement, achieving competency, or number of stages completed. Conclusions This trial did not lead to higher rates of implementation or faster implementation but did provide evidence for more robust implementation in the CDT condition compared to IND implementation once the first family received MTFC services. This trial was successful from a design perspective in that no counties dropped out, even though this study took place during an economic recession. We believe that this methodologic approach of measurement utilizing the SIC, which is comprised of the three dimensions of quality, quantity, and timing, is appropriate for a wide range of implementation and translational studies. Trial registration Trial ID: NCT00880126 (ClinicalTrials.gov). Electronic supplementary material The online version of this article (doi:10.1186/s13012-014-0134-8) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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