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Article
Publication date: 19 August 2019

Rebecca Lengnick-Hall, Karissa Fenwick, Michael S. Hurlburt, Amy Green, Rachel A. Askew and Gregory A. Aarons

Researchers suggest that adaptation should be a planned process, with practitioners actively consulting with program developers or academic partners, but few studies have…

Abstract

Purpose

Researchers suggest that adaptation should be a planned process, with practitioners actively consulting with program developers or academic partners, but few studies have examined how adaptation unfolds during evidence-based practice (EBP) implementation. The purpose of this paper is to describe real-world adaptation discussions and the conditions under which they occurred during the implementation of a new practice across multiple county child welfare systems.

Design/methodology/approach

This study qualitatively examines 127 meeting notes to understand how implementers and researchers talk about adaptation during the implementation of SafeCare, an EBP aimed at reducing child maltreatment and neglect.

Findings

Several types of adaptation discussions emerged. First, because it appeared difficult to get staff to talk about adaptation in group settings, meeting participants discussed factors that hindered adaptation conversations. Next, they discussed types of adaptations that they made or would like to make. Finally, they discussed adaptation as a normal part of SafeCare implementation.

Research limitations/implications

Limitations include data collection by a single research team member and focus on a particular EBP. However, this study provides new insight into how stakeholders naturally discuss adaptation needs, ideas and concerns.

Practical implications

Understanding adaptation discussions can help managers engage frontline staff who are using newly implemented EBPs, identify adaptation needs and solutions, and proactively support individuals who are balancing adaptation and fidelity during implementation.

Originality/value

This study’s unique data captured in vivo interactions that occurred at various time points during the implementation of an EBP rather than drawing upon data collected from more scripted and cross-sectional formats. Multiple child welfare and implementation stakeholders and types of interactions were examined.

Details

Journal of Children's Services, vol. 14 no. 4
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 15 July 2019

Gregory A. Aarons, Rachel A. Askew, Amy E. Green, Alexis J. Yalon, Kendal Reeder and Lawrence A. Palinkas

The purpose of this paper is twofold: first, to identify the types of adaptations made by service providers (i.e. practitioners) during a large-scale US statewide…

Abstract

Purpose

The purpose of this paper is twofold: first, to identify the types of adaptations made by service providers (i.e. practitioners) during a large-scale US statewide implementation of SafeCare®, an evidence-based intervention to reduce child neglect; and second, to place adaptations within a taxonomy of types of adaptations.

Design/methodology/approach

Semi-structured interviews and focus groups were conducted with 138 SafeCare providers and supervisors. Grounded theory methods were used to identify themes, specific types of adaptations and factors associated with adaptation.

Findings

Adaptations were made to both peripheral and core elements of the evidence-based practice (EBP). The taxonomy of adaptations included two broad categories of process and content. Process adaptations included presentation of materials, dosage/intensity of sessions, order of presentation, addressing urgent concerns before focusing on the EBP and supplementing information to model materials. Content adaptations included excluding parts of the EBP and overemphasizing certain aspects of the EBP. Adaptations were motivated by client factors such as the age of the target child, provider factors such as a providers’ level of self-efficacy with the EBP and concerns over client/provider rapport. Client factors were paramount in motivating adaptations of all kinds.

Research limitations/implications

The present findings highlight the need to examine ways in which adaptations affect EBP implementation and sustainment, client engagement in treatment, and client outcomes.

Practical implications

Implementers and EBP developers and trainers should build flexibility into their models while safeguarding core intervention elements that drive positive client outcomes.

Originality/value

This study is unique in examining and enumerating both process and content types of adaptations in a large-scale child neglect implementation study. In addition, such adaptations may be generalizable to other types of EBPs.

Details

Journal of Children's Services, vol. 14 no. 2
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 9 December 2014

Megan Finno-Velasquez, Danielle L. Fettes, Gregory A. Aarons and Michael S. Hurlburt

The purpose of this paper is to examine the experiences of Latino clients following a naturalistic cultural adaptation made to SafeCare, an evidence-based home visiting…

Abstract

Purpose

The purpose of this paper is to examine the experiences of Latino clients following a naturalistic cultural adaptation made to SafeCare, an evidence-based home visiting intervention designed to address specific linguistic and cultural issues affecting the Latino community during implementation in San Diego County, California.

Design/methodology/approach

Hierarchical linear models examined whether Latino clients experienced differences in perceptions of SafeCare delivery, working relationship with the home visitor and satisfaction with services when compared with non-Latino clients and whether language of service delivery and provider-client ethnic match were related to Latino clients’ experiences of the intervention.

Findings

Overall, across several different dimensions, there was no decrement in experience with SafeCare for Latino clients compared to non-Latino ones, implying that adaptations made locally adequately engaged Latino and Spanish-speaking clients in services without compromising perceived adherence to the programme model.

Research limitations/implications

Because this was a non-experimental study, conclusions could not be drawn as to whether the locally adapted SafeCare would fare better in Latino client ratings than SafeCare unadapted. However, the findings are important because they contradict concerns that EBPs may not be relevant to diverse client groups, and support the idea that when adaptations are made, it is possible to maintain adherence at the same level of adherence as when the programme is delivered in its non-adapted form.

Originality/value

The study explicitly documents and generates knowledge around an organic adaptation made in a community to an evidence-based intervention for a client group about whom there has been documented concern regarding the relevance of and engagement in services.

Details

Journal of Children's Services, vol. 9 no. 4
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 11 February 2021

Ashwini Tiwari, Daniel Whitaker and Shannon Self-Brown

Two common methods in community settings of assessing program fidelity, a critical implementation component for program effectiveness, are video and audio recordings of…

Abstract

Purpose

Two common methods in community settings of assessing program fidelity, a critical implementation component for program effectiveness, are video and audio recordings of sessions. This paper aims to examine how these two methods compared when used for a home-based behavioral parenting-training model (SafeCare®).

Design/methodology/approach

Twenty-five SafeCare video-recorded sessions between home visitors and parents were scored by trained raters either using the video or audio-only portions of recordings. Sessions were coded using fidelity checklists, with items (n = 33) classified as one of two fidelity aspects, content [delivery of program components (n = 15)], or process [communication and rapport building (n = 11)]. Seven items were considered to overlap between constructs. Items were coded as having been done or not done appropriately. Coders rated items as “technological limitation” when scoring methods hindered coding. Analyses compared percent agreement and disagreement between audio and video coders.

Findings

Overall agreement between coders was 72.12%. Levels of agreement were higher for content items (M = 80.89%, SD = 19.68) than process items (58.54%, SD = 34.41). Disagreements due to technology limitations among audio coders were noted among 15 items; particularly, higher levels of disagreement were seen among process items (42.42%) than content items (9.64%).

Originality/value

Compared to video, fidelity monitoring via audio recordings was associated with some loss of process-related fidelity. However, audio recordings could be sufficient with supplements such as participant surveys, to better capture process items. Research should also examine how content and process fidelity relate to changes in family behavior to further inform optimal fidelity monitoring methods for program use.

Details

Journal of Children's Services, vol. 16 no. 2
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 14 June 2018

Lara M. Gunderson, Cathleen E. Willging, Elise M. Trott Jaramillo, Amy E. Green, Danielle L. Fettes, Debra B. Hecht and Gregory A. Aarons

Evidence-based interventions (EBIs) for human services unfold within complicated social and organizational circumstances and are influenced by the attitudes and behaviors…

Abstract

Purpose

Evidence-based interventions (EBIs) for human services unfold within complicated social and organizational circumstances and are influenced by the attitudes and behaviors of diverse stakeholders situated within these environments. Coaching is commonly regarded as an effective strategy to support service providers in delivering EBIs and attaining high levels of fidelity over time. The purpose of this paper is to address a lacuna in research examining the factors influencing coaching, an important EBI support component.

Design/methodology/approach

The authors use the Exploration, Preparation, Implementation, and Sustainment framework to consider inner- and outer-context factors that affect coaching over time. This case study of coaching draws from a larger qualitative data set from three iterative investigations of implementation and sustainment of a home visitation program, SafeCare®. SafeCare is an EBI designed to reduce child neglect.

Findings

The authors elaborate on six major categories of findings derived from an iterative data coding and analysis process: perceptions of “good” and “bad” coaches by system sustainment status; coach as peer; in-house coaching capacity; intervention developer requirements vs other outer-context needs; outer-context support; and inner-context support.

Practical implications

Coaching is considered a key component for effective implementation of EBIs in public-sector systems, yet is under-studied. Understanding inner- and outer-context factors illuminates the ways they affect the capacity of coaches to support service delivery.

Originality/value

This paper demonstrates that coaching can accomplish more than provision of EBI fidelity support. Stakeholders characterized coaches as operating as boundary spanners who link inner and outer contexts to enable EBI implementation and sustainment.

Details

Journal of Children's Services, vol. 13 no. 1
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 19 December 2016

Amy E. Green, Guy Cafri and Gregory Aarons

The concerns that implementing a new structured innovation with increased oversight may lead to reduced job autonomy and poorer work attitudes. These concerns have been…

Abstract

Purpose

The concerns that implementing a new structured innovation with increased oversight may lead to reduced job autonomy and poorer work attitudes. These concerns have been cited as a barrier to evidence-based treatment (EBT) implementation. However, previous research found lower turnover among child welfare providers implementing an EBT with fidelity monitoring compared to those administering services as usual (SAU). The authors hypothesized that changes in job autonomy, job satisfaction, and organizational commitment would be no worse among providers in EBT conditions and fidelity monitoring conditions compared to SAU and no monitoring conditions.

Design/methodology/approach

Survey data were collected from 208 service providers over four waves at six month intervals as part of a 2 (EBT vs SAU) by 2 (fidelity monitoring vs no monitoring) hybrid effectiveness-implementation trial. Superiority testing was conducted to determine whether there were significant differences over time on the outcomes as a function of experimental condition. Non-inferiority testing examined whether the EBT condition is not inferior to SAU and monitoring not inferior to no monitoring on the outcomes.

Findings

No evidence of superiority was found for any conditions over time on the outcomes. Non-inferiority testing indicates EBT is not inferior to SAU and monitoring is not inferior to no monitoring on the outcomes.

Originality/value

This study provide empirical quantitative data regarding job attitudes and job autonomy perceptions over time following EBT implementation. In light of the current findings, concerns regarding the impact of EBT implementation on provider job perceptions should be minimized.

Details

Journal of Children's Services, vol. 11 no. 4
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 20 June 2016

Tara Flemington and Jennifer Anne Fraser

Nurse home visiting programmes designed to reduce the likelihood of child maltreatment in families at risk have been widely implemented in Australia and overseas. The…

Abstract

Purpose

Nurse home visiting programmes designed to reduce the likelihood of child maltreatment in families at risk have been widely implemented in Australia and overseas. The purpose of this paper is to examine the intensity and duration of maternal involvement in a nurse home visiting programme to prevent child maltreatment.

Design/methodology/approach

A retrospective, longitudinal design was employed. The clinical records of 40 mothers who had received nurse home visits following the birth of a new baby for at least six months, and had provided consent for their details to be accessed for research purposes, were selected for analysis. The influence of antenatal characteristics and well-being on maternal involvement in a nurse home visiting programme was examined using reliability of change indices.

Findings

Mothers with impaired family functioning reporting they experienced violence at home were more likely to leave the programme early and received fewer than the prescribed number of home visits compared to mothers who had been enroled into the programme for other complex psychosocial needs. At the same time, mothers enroled on the basis of impaired psychological functioning and who did not report violence in the home remained, and received more than the prescribed number of home visits over the course of their involvement.

Originality/value

Results showed that domestic violence increased the risk of poor engagement with a targeted nurse home visiting programme. At the same time, home visitors responded to complex individual and family needs by increasing the number of home visits accordingly. This theoretically based pilot research has helped to disentangle antecedents of maternal involvement and the subsequent impact on programme outcomes. Further investigation using a larger study sample is needed.

Details

Journal of Children's Services, vol. 11 no. 2
Type: Research Article
ISSN: 1746-6660

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Content available
Article
Publication date: 19 July 2011

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489

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 6
Type: Research Article
ISSN: 0952-6862

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Content available
Article
Publication date: 9 December 2014

Nick Axford and Michael Little

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314

Abstract

Details

Journal of Children's Services, vol. 9 no. 4
Type: Research Article
ISSN: 1746-6660

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Book part
Publication date: 30 September 2020

Damian Kedziora

In the past few decades, service offshoring industry has been developing globally, and in the past few years its dynamic growth has been observed in Central and Eastern…

Abstract

In the past few decades, service offshoring industry has been developing globally, and in the past few years its dynamic growth has been observed in Central and Eastern Europe (CEE). Intensive process migrations have been influenced by the primary goal of minimizing operational expenses, at the same time improving service efficiency and gaining access to wide talent pools. The chapter summarizes current state and key development trends of the offshore service delivery sector in the CEE region. Moreover, it aims at contributing to the understanding of corporate culture at the CEE service delivery organizations, which has been the dominant factor influencing their effectiveness and quality of delivery. The exploratory, pilot study conducted at the sample of three organizations from three countries in the region was supposed to examine the organizational culture at CEE nearshore delivery centres, by applying analysis based on seven factors, broken into 26 cultural artefacts. With minor exceptions, the results highlight positive perception of key organizational culture's elements across employees (e.g. communication, goal setting, team work, reward orientation, innovativeness standards). The only negatively assessed element is the performance standards, including their clear definition, coaching for personal improvement of employees and emphasizing good performance of the organizations. The quantitative study is limited to only three sample companies from three countries, therefore extending the research scope is recommended, as well as exploring the link of national culture elements to the employees' perception of organizational relations and culture.

Details

Understanding National Culture and Ethics in Organizations
Type: Book
ISBN: 978-1-83867-022-1

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