Maltreated children involved with child welfare have 2.5 times greater risk for developing mental health problems than children in the general population. There have been few successful implementations of evidence-based practices (EBPs) that reduce child maltreatment (CM) and mental health risk in child welfare, and the barriers to successful implementation are well documented. The Job-Demands Resource Model (JD- R) is a useful approach for considering how to enhance the uptake of EBPs in demanding, chaotic, and under- resourced environments, such as child welfare. JD-R suggests that employees who perceive high job demands and low resources may experience negative job performance and resist change, but that high job demands can be buffered by high levels of perceived resources. This proposal focuses on the development and pilot testing of an innovative-technology enhanced implementation approach, which will increase the resources offered to child welfare providers during implementation, while also reducing associated demands, with the goal of improving provider fidelity and implementation success. Building on seed grant funding, we propose to develop and test a computer-mediated approach for SafeCare, an EBP targeting CM prevention. Following development and validation of the computer-mediated approach (first part of Year1), a feasibility trial will be conducted with 30 newly trained SafeCare providers who will be randomly assigned to either Implementation as usual (IAU-SC) or Technology-Enhanced SafeCare Implementation (TE-SC). Providers assigned to IAU-SC will deliver SafeCare as designed. Providers assigned to TE-SC will bring computers to sessions and utilize the installed software to assist in the delivery of SafeCare to parents. During the feasibility trial, providers will serve two families each (N=60). Provider outcomes of interest are SafeCare fidelity, perceptions of job demands and resources during EBP implementation, and feasibility/satisfaction ratings for the TE-SC software. Parent and child behavior change, and parent satisfaction, will also be measured in the two implementation conditions. These data will form the basis for an R01 application that will examine the impact of the technology-enhanced implementation approaches on program effectiveness, training costs, and provider fidelity with additional EBPs. Thus, this project is the first step towards an innovative implementation approach that can enhance the reach of EBPs, and consequently, make a positive public health impact on CM and related mental health consequences.

Public Health Relevance

This project will develop and test an innovative technology-based approach for implementing an evidence-based practice (EBP) in child welfare. Specifically, a computer-mediated approach will be developed to assist child welfare providers with delivery of SafeCare to families, with the goal of improving provider fidelity and implementation success. A randomized feasibility trial will be conducted to test the technology-based approach against the standard SafeCare implementation approach. Results in favor of the technology-based approach could alter the paradigm for EBP implementation in child welfare and enhance the public health impact of EBPs targeting child maltreatment and related mental health consequences.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Exploratory/Developmental Grants (R21)
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Study Section
Dissemination and Implementation Research in Health Study Section (DIRH)
Program Officer
Chambers, David A
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Georgia State University
Schools of Public Health
United States
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