Abstract
This study describes development in federally funded systems of care. Data for this study were collected using the System of Care Assessment that rated grantees’ enactment of system of care principles in the infrastructure and service delivery domains. Data were collected by trained raters who conducted several site visits over the funding period. This study described system development over time across 61 sites and tested whether gains were statistically significant. Latent profile analysis was used to explore whether sites could be meaningfully grouped based on their baseline service delivery domain scores. Differences across groups were tested in terms of community, system, and client characteristics. Differential growth across groups was also examined. Overall, systems of care developed over time in both the infrastructure and service delivery domains. Although infrastructure scores were generally lower than service delivery scores, greater gains were seen for the infrastructure domain. Three groups of sites were identified that could be distinguished in terms of degree of development overall, and for specific system of care principles. The groups of sites differed in terms of community factors, system features, and client characteristics. In addition, repeated measures analyses found differential growth in system development over time across groups.
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References
Ackoff, R., & Rovini, S. (2003). Redesigning society. Standford, CA: Stanford Business Books.
Behrens, T. R., & Foster-Fishman, P. G. (2007). Developing operating principles for systems change. American Journal of Community Psychology, 39, 411–414.
Bickman, L., & Heflinger, C. A. (1995). Seeking success by reducing implementation and evaluation failures. In L. B. Bickman & D. Rog (Eds.), Children’s mental health services: Research, policy and evaluation (pp. 171–205). Thousand Oaks, CA: Sage.
Brannan, A. M. (2003). Ensuring effective mental health treatment in real-world settings and the critical role of the family. Journal of Child and Family Studies, 12, 1–10.
Brannan, A. M., Baughman, L. N., Reed, E. D., & Katz-Leavy, J. (2002). System of care assessment: Cross-site comparison of findings. Children Services: Social Policy, Research, and Practice, 5, 37–56.
DuPlessis, H. M., Inkelas, M., & Halfon, N. S. (1998). Assessing the performance of community systems for children. Health Services Research, 33, 1111–1142.
Fiorelli, J. S., & Margolis, H. (1993). Managing and understanding large systems change: Guidelines for executives and change agents. Organizational Development Journal, 11, 1–13.
Foster-Fishman, P. G., & Droege, E. (2010). Locating the system in system of care. Evaluation and Program Planning, 33, 11–13.
Foster-Fishman, P. G., Nowell, B., & Yang, H. (2007). Putting the system back into systems change: A framework for understanding and changing organizational and community systems. American Journal of Community Psychology, 39, 197–215.
Friedman, S. R., Reynolds, J., Quan, M. A., Call, S., Crusto, C. A., & Kaufman, J. S. (2007). Measuring changes in interagency collaboration: An examination of the Bridgeport Safe Start initiative. Evaluation and Program Planning, 30, 294–306.
Heflinger, C. A., & Northrop, D. A. (2000). What happens when capitated behavioral health comes to town? Transition from the Fort Bragg Demonstration to a managed capitated behavioral health contract. Journal of Behavioral Health Services and Research, 27, 390–405.
Hernandez, M., Gomez, A., Lipien, L., Greenbaum, P. E., Armstrong, K. H., & Gonzalez, P. (2001). Using the system of care practice review in the national evaluation: Evaluating the fidelity of practice to system of care principles. Journal of Emotional and Behavioral Disorders, 9, 43–52.
Hernandez, M., & Hodges, S. (2003). Building upon the theory of change for systems of care. Journal of Emotional and Behavioral Disorders, 11, 19–26.
Hodges, S., Ferriera, K., Israel, N., & Mazza, J. (2010). Systems of care, featherless bipeds, and the measure of all things. Evaluation and Program Planning, 33, 4–10.
Hodges, S., Friedman, R. M., & Hernandez, M. (2008). Integrating the components into an effective system of care: A framework for putting the pieces together. In B. A. Stroul & G. Blau (Eds.), The system of care handbook: Transforming mental health services for children, youth, and families (pp. 71–94). Baltimore, MD: Brookes Publishing.
Holden, E. W., Santiago, R. L., Manteuffel, B. A., Stephens, R., Brannan, A. M., Soler, R., et al. (2003). Systems of care demonstration projects: Innovation, evaluation and sustainability. In A. Pumariega & N. Winters (Eds.), Handbook of community systems of care: The new child and adolescent community psychiatry (pp. 432–458). San Francisco, CA: Jossey-Bass.
Huang, L., Stroul, B., Friedman, R., Mrazek, P., Friesen, B., Pires, S., et al. (2005). Transforming mental health care for children and their families. American Psychologist, 60, 615–627.
Kreger, M., Brindis, C. D., Manuel, D. M., & Sassourbre, L. (2007). Lessons learned in systems change initiatives: Benchmarks and indicators. American Journal of Community Psychology, 39, 301–320.
Midgley, G. (2000). Systemic intervention: Philosophy, methodology, and practice. New York: Kluwer.
Morrissey, J. P. (1992). An interorganizational network approach to evaluating children’s mental health service systems. In L. Bickman & D. J. Rog (Eds.), Evaluating mental health services for children. New directions for program evaluation (Vol. 54, pp. 85–98). Ann Arbor, MI: Jossey-Bass, Inc.
Morrissey, J. P., Johnsen, M. C., & Calloway, M. (1997). Evaluating performance and change in mental health systems serving children and youth: Interorganizational network analysis. Journal of Mental Health Administration, 24(1), 4–7.
Muthen, B. O. (2001). Latent variable mixture modeling. In G. A. Marcoulides & R. E. Schumacker (Eds.), New directions and techniques in structural equations modeling. Mahway, NJ: Lawrence Erlbaum Associates.
Muthén, L., & Muthén, B. (2001). Mplus user’s guide, Version 2.12. Los Angeles, CA: Muthén & Muthén.
Ning, Y., & Finch, S. J. (2004). The likelihood ratio test with the Box-Cox transformation for the normal mixture problem: Power and sample size study. Communications in Statistics Simulations and Computations, 33, 553–565.
Parson, B. A. (2007). The state of methods and tools for social systems change. American Journal of Community Psychology, 39, 405–409.
Raffery, A. E., & Dean, N. (2006). Variable selection for model-based clustering. Journal of the American Statistical Association, 101, 168–178.
Senge, P. M. (1990). The fifth discipline. New York: Doubleday.
Sheehan, A., Manteuffel, B., Stormann, C., & King, T. (2008). Evaluation and continuous quality improvement. In B. A. Stroul & G. M. Blau (Eds.), The system of care handbook: Transforming mental health services for children, youth, and families (pp. 329–358). Baltimore, MD: Paul H. Brookes Publishing Co. Inc.
Stroul, B., Blau, G., & Sondheimer, D. (2008). Systems of care: A strategy to transform children’s mental health care. In B. Stroul & G. Blau (Eds.), The system of care handbook: Transforming mental health services for children, youth, and families (pp. 3–24). Baltimore, MD: Paul H. Brookes Publishing Co. Inc.
Stroul, B., & Friedman, R. (1986, revised edition). A system of care for severely emotionally disturbed children and youth. Washington, DC: CASSP Technical Assistance Center.
Tonidandel, S., & Overall, J. E. (2004). Determining the number of clusters by sampling with replacement. Psychological Methods, 9, 238–249.
Vermunt, J. K., & Magidson, J. (2002). Latent class cluster analysis. In Applied latent class analysis (pp. 89–106). Cambridge: Cambridge University Press.
Vinson, N. B., Brannan, A. M., Baughman, L. B., Wilce, M., & Gawron, T. (2001). The system of care model: Implementation in 27 sites. Journal of Emotional and Behavioral Disorders, 9, 30–41.
Washington Department of Health (2004). WWAMI: Rural Health Research Center. http://depts.washington.edu/uwruca/ downloaded August 2, 2011.
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Brannan, A.M., Brashears, F., Gyamfi, P. et al. Implementation and Development of Federally-Funded Systems of Care Over Time. Am J Community Psychol 49, 467–482 (2012). https://doi.org/10.1007/s10464-011-9472-8
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DOI: https://doi.org/10.1007/s10464-011-9472-8