Abstract
In this chapter, we describe the scale-up and impact of a linked multilevel intervention in a public child welfare system. Linked multilevel interventions are interventions with multiple components that target one or more levels within the systems. In health care, multilevel interventions are gaining traction, but there are few references to multilevel interventions in the child welfare despite obvious parallels. Families with children in the child welfare system face challenges across multiple life domains, and the systems designed to serve those families are administratively and financially interdependent. Single prong interventions that address one level of the service system while ignoring the interdependencies may be less effective. In this chapter, we describe one attempt to align the interdependencies in ways that improve the chances an intervention will have its intended effect.
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Notes
- 1.
This chapter is based on an evaluation report prepared for the public child welfare agency that developed the linked interventions. Additional information about those reports is available from the authors. In addition, see Chamberlain, Feldman, Wulczyn, Saldana, and Forgatch (2016).
- 2.
Although the public agency implemented both KEEP and PTC as a paired intervention – KEEP targets foster parents and PTC was focused on bio-parents – we limit our discussion of the interventions to KEEP in order to better focus on the multilevel, linked nature of the intervention. We speculate that the expected, at-scale effect of the EB intervention depends on its alignment with the other forces in the so-called system that affect performance and outcomes. This is similar to the EPIS model of EB implementation (Aarons, Hurlburt, & Horwitz, 2011), but it differs in important ways. In the EPIS model, the issue is how various multilevel factors affect the implementation of an EBP. In our case, the multiple levels are conceptualized as part of the intervention itself.
- 3.
For more information about KEEP, see http://www.cebc4cw.org/program/keeping-foster-and-kin-parents-supported-and-trained/. For more information about PTC, see http://www.cebc4cw.org/program/parenting-through-change/
- 4.
For information on the Title IV-E Waiver program, please see http://www.acf.hhs.gov/programs/cb/programs/child-welfare-waivers (accessed on July 7, 2016).
- 5.
Foster parent training is required for all foster parents on an ongoing basis. In this respect, each of the participating provider agencies had a process in place for training foster parents. The content of the training offered by KEEP, though, was different than what was being offered by the agencies prior to the Project.
- 6.
McHugo et al. (2007).
- 7.
At the time of the second survey, 34% of responding case planners reported a caseload between 12 and 14 active cases.
- 8.
On a number of occasions, during meetings with the public agency leadership, we were reminded by the public agency that the Project was “so much more” than KEEP or any single EBI. To the public agency, the Project was the bundle of interventions, structural and practice changes in their entirety.
- 9.
The interpretation of odds ratios is as follows: Odds ratios greater than 1 imply faster rates of exit to permanency; odds ratios of less than 1 imply slower permanency rates relative to the relevant reference group. For example, males leave care at a rate that is about 3% faster (1.028) than the rate reported for females.
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Wulczyn, F., Feldman, S. (2020). The Scale-Up of Linked Multilevel Interventions: A Case Study. In: Albers, B., Shlonsky, A., Mildon, R. (eds) Implementation Science 3.0. Springer, Cham. https://doi.org/10.1007/978-3-030-03874-8_11
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