TY - JOUR
T1 - Evaluation of two implementation strategies in 51 child county public service systems in two states
T2 - results of a cluster randomized head-to-head implementation trial
AU - Brown, C. Hendricks
AU - Chamberlain, Patricia
AU - Saldana, Lisa
AU - Padgett, Courtenay
AU - Wang, Wei
AU - Cruden, Gracelyn
N1 - Funding Information:
This research was supported by the following grants: R01 MH076158, NIMH, U.S. PHS (PI: Chamberlain); R01 MH076158-05S1, P30 DA023920, P50 DA035763, NIDA, U.S. PHS (PI: Chamberlain); P30 DA027828, NIDA, U.S. PHS (PI: Brown); K23 DA021603, NIDA, R01 MH0977748 NIMH, U. S. PHS (PI: Saldana); The Children’s Bureau, Department of Health and Human Services, and the WT Grant Foundation. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.
PY - 2014
Y1 - 2014
N2 - 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).
AB - 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).
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U2 - 10.1186/s13012-014-0134-8
DO - 10.1186/s13012-014-0134-8
M3 - Article
C2 - 25312005
AN - SCOPUS:84964697246
SN - 1748-5908
VL - 9
SP - 134
JO - Implementation science : IS
JF - Implementation science : IS
ER -
