Advertisement

Journal of Child and Family Studies

, Volume 24, Issue 4, pp 979–991 | Cite as

Psychometrics, Reliability, and Validity of a Wraparound Team Observation Measure

  • Eric J. Bruns
  • Ericka S. Weathers
  • Jesse C. Suter
  • Spencer Hensley
  • Michael D. Pullmann
  • April Sather
Original Paper

Abstract

Wraparound is a widely-implemented team-based care coordination process for youth with serious emotional and behavioral needs. Wraparound has a positive evidence base; however, research has shown inconsistency in the quality of its implementation that can reduce its effectiveness. The current paper presents results of three studies used to examine psychometrics, reliability, and validity of a measure of wraparound fidelity as assessed during team meetings called the Team Observation Measure (TOM). Analysis of TOM results from 1,078 team observations across 59 sites found good overall internal consistency (α = 0.80), but constrained variability, with the average team rated as having 78 % of indicators of model adherent wraparound present, 11 % absent, and 11 % not applicable. A study of N = 23 pairs of raters found a pooled Kappa statistic of 0.733, indicating substantial inter-rater reliability. Higher agreement was found between external evaluators than for pairs of raters that included an external evaluator and an internal rater (e.g., supervisor or coach). A validity study found no correlation between the TOM and an alternate fidelity instrument, the Wraparound Fidelity Index (WFI), at the team level. However, positive correlations between mean program-level TOM and WFI scores provide support for TOM validity as a summative assessment of site- or program-level fidelity. Implications for TOM users, measure refinement, and future research are discussed.

Keywords

Wraparound Children Fidelity Observation Reliability 

Notes

Acknowledgments

This study was supported in part by grant R34 MH072759 from the National Institute of Mental Health. We would like to thank our national collaborators and the dozens of trained TOM observers in these wraparound initiatives nationally. Thanks also to the wraparound initiatives in Clark County, Nevada and King County, Washington for their collaboration on the inter-rater reliability studies.

References

  1. Aspland, H., & Gardner, F. (2003). Observational measures of parent child interaction. Child and Adolescent Mental Health, 8, 136–144.CrossRefGoogle Scholar
  2. Bruns, E. J. (2008). Measuring wraparound fidelity. In E. J. Bruns & J. S. Walker (Eds.), The resource guide to wraparound. Portland, OR: National Wraparound Initiative, Research and Training Center for Family Support and Children’s Mental Health.Google Scholar
  3. Bruns, E. J., Burchard, J., Suter, J., & Force, M. D. (2005). Measuring fidelity within community treatments for children and families. In M. Epstein, A. Duchnowski, & K. Kutash (Eds.), Outcomes for children and youth with emotional and behavioral disorders and their families (Vol. 2). Austin, TX: Pro-ED.Google Scholar
  4. Bruns, E. J., Burchard, J. D., Suter, J. C., Leverentz-Brady, K. M., & Force, M. M. (2004). Assessing fidelity to a community-based treatment for youth: The wraparound fidelity index. Journal of Emotional & Behavioral Disorders, 12(2), 79.CrossRefGoogle Scholar
  5. Bruns, E. J., Pullmann, M. P., Brinson, R. D., Sather, A., & Ramey, M. (2014). Effectiveness of wraparound vs. case management for children and adolescents: Results of a randomized study. Manuscript submitted for publication.Google Scholar
  6. Bruns, E. J., & Sather, A. (2007). User’s manual to the wraparound team observation measure. Seattle, WA: University of Washington, Wraparound Evaluation and Research Team, Division of Public Behavioral Health and Justice Policy.Google Scholar
  7. Bruns, E. J., & Sather, A. (2013). Team Oversation Measure (TOM) manual for use and scoring. Wraparound fidelity assessment system (WFAS). Seattle, WA: University of Washington School of Medicine, Division of Public Behavioral Health and Justice Policy.Google Scholar
  8. Bruns, E. J., Sather, A., & Pullmann, M. D. (2010). The wraparound fidelity assessment system-psychometric analyses to support refinement of the wraparound fidelity index and team observation measure. Paper presented at the the 23rd Annual Children’s Mental Health Research and Policy Conference, Tampa, FL.Google Scholar
  9. Bruns, E. J., Sather, A., Pullmann, M. D., & Stambaugh, L. F. (2011). National trends in implementing wraparound: results from the state wraparound survey. Journal of Child and Family Studies, 20(6), 726–735. doi: 10.1007/s10826-011-9535-3.CrossRefGoogle Scholar
  10. Bruns, E. J., & Suter, J. C. (2010). Summary of the wraparound evidence base. In E. J. Bruns & J. S. Walker (Eds.), The resouce guide to wraparound. National Wraparound Initiative: Portland, OR.Google Scholar
  11. Bruns, E. J., Suter, J. C., Force, M. M., Sather, A., & Leverentz-Brady, K. M. (2009). Wraparound Fidelity Index 4.0: Manual for training, administration, and scoring of the WFI 4.0. Seattle: Division of Public Behavioral Health and Justice Policy, University of Washington.Google Scholar
  12. Bruns, E. J., Suter, J. C., & Leverentz-Brady, K. M. (2006). Relations between program and system variables and fidelity to the wraparound process for children and families. Psychiatric Services, 57(11), 1586–1593. doi: 10.1176/appi.ps.57.11.1586.CrossRefPubMedGoogle Scholar
  13. Bruns, E. J., Walker, J. S., Bernstein, A., Daleiden, E., Pullmann, M. D., & Chorpita, B. F. (2013). Family voice with informed choice: coordinating wraparound with research-based treatment for children and adolescents. Journal of Clinical Child & Adolescent Psychology. (Online First Publishing),. doi: 10.1080/15374416.2013.859081.Google Scholar
  14. Bruns, E. J., Walker, J. S., & The National Wraparound Initiative Advisory Group. (2008). Ten principles of the wraparound process. In E. J. Bruns & J. S. Walker (Eds.), Resource guide to wraparound. Portland, OR: National Wraparound Initiative, Research and Training Center for Family Support and Children’s Mental Health.Google Scholar
  15. Bruns, E. J., Walker, J. S., Zabel, M., Estep, K., Matarese, M., Harburger, D., et al. (2010b). The wraparound process as a model for intervening with youth with complex needs and their families. American Journal of Community Psychology, 46(3–4), 314–331. doi: 10.1007/s10464-010-9346-5.CrossRefPubMedCentralPubMedGoogle Scholar
  16. Burchard, J. D., Bruns, E. J., & Burchard, S. N. (2002). The wraparound process. In B. J. Burns, K. Hoagwood, & M. English (Eds.), Community-based interventions for youth (pp. 69–90). New York: Oxford University Press.Google Scholar
  17. Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66(1), 7–18.CrossRefPubMedGoogle Scholar
  18. Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20(1), 37–46.CrossRefGoogle Scholar
  19. Cooper, J. L., Aratani, Y., Knitzer, J., Douglas-Hall, A., Masi, R., Banghart, P., et al. (2008). Unclaimed children revisited: The status of children’s mental health policy in the United States. New York: National Center for Children. in Poverty.Google Scholar
  20. Cox, K., Baker, D., & Wong, M. A. (2010). Wraparound retrospective: Factors predicting positive outcomes. Journal of Emotional & Behavioral Disorders, 18(1), 3–13.CrossRefGoogle Scholar
  21. De Vries, H., Elliott, M. N., Kanouse, D. E., & Teleki, S. S. (2008). Using pooled kappa to summarize interrater agreement across many Items. Field Methods, 20(3), 272–282.CrossRefGoogle Scholar
  22. Eames, C. C., Daley, D. D., Hutchings, J. J., Hughes, J. C., Jones, K. K., Martin, P. P., et al. (2008). The leader observation tool: A process skills treatment fidelity measure for the incredible years parenting programme. Child: Care, Health and Development, 34(3), 391–400. doi: 10.1111/j.1365-2214.2008.00828.x.Google Scholar
  23. Effland, V. S., Walton, B. A., & McIntyre, J. S. (2011). Connecting the dots: Stages of implementation, wraparound fidelity and youth outcomes. Journal of Child and Family Studies, 20(6), 736–746. doi: 10.1007/s10826-011-9541-5.CrossRefGoogle Scholar
  24. Epstein, M. H., Jayanthi, M., McKelvey, J., Frankenberry, E., Hary, R., Potter, K., et al. (1998). Reliability of the wraparound observation form: An instrument to measure the wraparound process. Journal of Child and Family Studies, 7, 161–170.CrossRefGoogle Scholar
  25. Epstein, M. H., & Sharma, J. M. (1998). Behavioral and emotional rating scale: A strength-based approach to assessment. Austin, TX: PRO-ED.Google Scholar
  26. Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.Google Scholar
  27. Glisson, C., & Hemmelgarn, A. (1998). The effects of organizational climate and interorganizational coordination on the quality and outcomes of children’s service systems. Child Abuse and Neglect, 22(5), 401–421. doi: 10.1016/S0145-2134(98)00005-2.CrossRefPubMedGoogle Scholar
  28. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.Google Scholar
  29. Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174.CrossRefPubMedGoogle Scholar
  30. Lyons, J. S., Weiner, D. A., & Lyons, M. B. (2004). Measurement as communication in outcomes management: The child and adolescent needs and strengths (CANS). The Use of Psychological Testing for Treatment Planning and Outcomes Assessment, 3, 461–476.Google Scholar
  31. Miles, P., Brown, N., & The National Wraparound Initiative Implementation Work Group. (2011). The wraparound implementation guide: A handbook for administrators and managers. Portland, OR: National Wraparound Initative.Google Scholar
  32. Mitchell, P. F. (2011). Evidence-based practice in real-world services for young people with complex needs: New opportunities suggested by recent implementation science. Children and Youth Services Review, 33, 207–216. doi: 10.1016/j.childyouth.2010.10.003.CrossRefGoogle Scholar
  33. Nordness, P. D., & Epstein, M. H. (2003). Reliability of the wraparound observation form-second version: An instrument designed to assess the fidelity of the Wraparound approach. Mental Health Services Research, 5, 89–96.CrossRefPubMedGoogle Scholar
  34. Proctor, E. K., Landsverk, J., Aarons, G. A., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy In Mental Health, 36(1), 24–34.CrossRefPubMedGoogle Scholar
  35. Pullmann, M., Bruns, E. J., & Sather, A. (2013). Evaluating fidelity to the wraparound service model for youth: Application of item response theory to the wraparound fidelity index. Psychological Assessment, 25(2), 583–598.CrossRefPubMedCentralPubMedGoogle Scholar
  36. Sather, A., & Bruns, E. J. (2008). Wraparound fidelity index 4.0: Interviewer training toolkit. Seattle: Division of Public Behavioral Health and Justice Policy, University of Washington.Google Scholar
  37. Schoenwald, S. K. (2011). It’s a bird, it’s a plane, it’s … fidelity measurement in the real world. American Journal of Orthopsychiatry, 76, 304–311.Google Scholar
  38. Schoenwald, S. K., Garland, A. F., Chapman, J. E., Frazier, S. L., Sheidow, A. J., & Southam-Gerow, M. A. (2011). Toward the effective and efficient measurement of implementation fidelity. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 32–43.CrossRefPubMedCentralPubMedGoogle Scholar
  39. Singh, N. N., Curtis, W. J., Wechsler, H. A., Ellis, C. R., & Cohen, R. (1997). Family friendliness of community-based services for children and adolescents with emotional and behavioral disorders and their families: An observational study. Journal of Emotional and Behavioral Disorders, 5(2), 82–92. doi: 10.1177/106342669700500203.CrossRefGoogle Scholar
  40. Snyder, E. H., Lawrence, N., & Dodge, K. A. (2012). The impact of system of care support in adherence to wraparound principles in child and family teams in child welfare in North Carolina. Children and Youth Services Review, 34(4), 639–647.CrossRefPubMedCentralPubMedGoogle Scholar
  41. Stroul, B. A. (2002). Issue brief—system of care: A framework for system reform in children’s mental health. Washington, DC: Georgetown University Child Development Center, National Technical Assistance Center for Children’s Mental Health.Google Scholar
  42. Stroul, B. A., & Friedman, R. M. (1986). A system of care for severely emotionally disturbed children and youth. Tampa, FL: University of South Florida, Tampa Research Training Center for Improved Services for Seriously Emotionally Disturbed Children and Georgetown Univ. Child Development Center, Washington D. C. Cassp Technical Assistance Center.Google Scholar
  43. Suter, J. C., & Bruns, E. J. (2009). Effectiveness of the wraparound process for children with emotional and behavioral disorders: A meta-analysis. Clincial Child and Family Psychology Review, 12(4), 336–351.CrossRefGoogle Scholar
  44. United States Public Health Service (USPHS). (1999). Mental health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.Google Scholar
  45. van Dijk, J. (1990). Delphi method as a learning instrument: Bank employees discussing an automation project. Technological Forecasting and Social Change, 37, 399–407.CrossRefGoogle Scholar
  46. VanDenBerg, J., Bruns, E., & Burchard, J. (2003). History of the wraparound process. Focal Point: A National Bulletin on Family Support and Children’s Mental Health: Quality and Fidelity in Wraparound, 17(2), 4–7.Google Scholar
  47. Vetter, J. & Strech, G (2012, March). Using the ohio scales for assessment and outcome measurement in a statewide system of care. Paper presented at the 25th Annual Children’s Mental Health Research and Policy Conference, Tampa, FL.Google Scholar
  48. Walker, J. S., & Bruns, E. J. (2006). Building on practice-based evidence: Using expert perspectives to define the wraparound process. Psychiatric Services, 57, 1579–1585.CrossRefPubMedGoogle Scholar
  49. Walker, J. S., Bruns, E. J., Conlan, L., & LaForce, C. (2011). The National Wraparound Initiative: A community-of-practice approach to building knowledge in the field of children’s mental health. Best Practices in Mental Health, 7(1), 26–46.Google Scholar
  50. Walker, J. S., Bruns, E. J., & Penn, M. (2008a). Individualized services in systems of care: The wraparound process. In B. A. Stroul & G. M. Blau (Eds.), The system of care handbook: Transforming mental health services for children, youth, and families. Baltimore, MD: Paul H. Brookes Publishing Company.Google Scholar
  51. Walker, J. S., Bruns, E. J., & The National Wraparound Initiative Advisory Group. (2008b). Phases and activities of the wraparound process. In E. J. Bruns & J. S. Walker (Eds.), Resource guide to wraparound. Portland, OR: National Wraparound Initiative, Research and Training Center for Family Support and Children’s Mental Health.Google Scholar
  52. Webster-Stratton, C., & Hancock, L. (1998). Training for parents of young children with conduct problems: Contents, methods and therapeutic processes. In G. E. Schaefer & J. M. Breismeister (Eds.), Handbook of parent training (pp. 98–152). New York: Wiley.Google Scholar
  53. Williams, N. J., & Glisson, C. (2013). Testing a theory of organizational culture, climate and youth outcomes in child welfare systems: A united states national study. Child Abuse & Neglect (Online first publication),. doi: 10.1016/j.chiabu.2013.09.003.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Eric J. Bruns
    • 1
  • Ericka S. Weathers
    • 1
  • Jesse C. Suter
    • 2
  • Spencer Hensley
    • 1
  • Michael D. Pullmann
    • 1
  • April Sather
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesUniversity of Washington School of MedicineSeattleUSA
  2. 2.Center on Disability and Community InclusionUniversity of VermontBurlingtonUSA

Personalised recommendations