Delivering Evidence-Based Parenting Services to Families in Child Welfare Using Telehealth

利用远程医疗为儿童福利家庭提供循证育儿服务

• 批准号: 10633017
• 负责人: MONICA L OXFORD
• 金额: $ 66.25万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-15 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10633017
• 关键词: 2019-nCoV; Address; Adherence; Administrator; Age; Attention; COVID-19; COVID-19 pandemic; Caregivers; Caring; Child; Child Care; Child Rearing; Child Welfare; Communities; Control Groups; Cost Analysis; Cost-Benefit Analysis; Data; Development; Drops; Economics; Effectiveness; Eligibility Determination; Emotional; Enrollment; Evidence based program; Failure; Family; Foundations; Funding; Health Personnel; Health Services; Health Services Accessibility; Home; Home visitation; Household; Interruption; Investigation; Knowledge; Learning; Measures; Mental Health; Methodology; Modeling; Monitor; Natural experiment; Noise; Occupations; Outcome; Parent-Child Relations; Parents; Persons; Policy Maker; Procedures; Protocols documentation; Provider; Randomized, Controlled Trials; Reporting; Risk; Sampling; Schools; Service delivery model; Services; Social Change; Social Work; Source; System; Technology; Time; United States; Universities; Washington; Work; Youth; arm; care systems; child protective service; cost effective; cost effectiveness; design; distraction; dosage; effectiveness evaluation; effectiveness testing; evidence base; externalizing behavior; family support; foster care; improved; innovation; maltreatment; member; online delivery; pandemic disease; prevention service; programs; provider adherence; randomized controlled design; response; safety net; satisfaction; school closure; service delivery; service providers; service utilization; social; telehealth; treatment as usual; welfare; wireless fidelity

ABSTRACT The severe acute respiratory syndrome coronavirus 2 (denoted COVID-19) pandemic has shaken the foundation of services delivered to vulnerable families involved with or monitored by the child protective/welfare system. COVID-19 has changed the landscape of how children and families interact with the vital services provided by the child welfare system. Home visitation, which includes a bedrock of essential and transformative parenting support services for families involved with child welfare, was no longer safe or viable in the presence of COVID-19. The pandemic shredded safety nets. It made evident to providers, administrators, and policymakers how fragile our child protective system is. Under this strained state, child welfare agencies and mental health providers innovated service delivery systems. In Washington State, the Department of Children, Youth, and Families (DCYF) worked with local service agencies providing evidence-based programs to revise program protocols. Provider teams and program developers worked together to transition in-person services to remote platforms by developing and delivering telehealth services to families. The pandemic created the conditions for a natural experiment in service delivery in Washington State. The natural experiment proved that telehealth services are a viable service delivery system; thousands of child welfare involved families were served via telehealth. We do not know, however, if these services were effective, or which families had the technological capacity to engage, or for those who did engage were they able to complete the program. Did online home visiting produce the expected outcomes? While online delivery was an innovation driven by the necessity in response to COVID-19, many questions remain. The potential is high, but little is known about telehealth in child welfare. This proposal is a three-arm effectiveness trail of an evidence-based home visiting program: 1) delivered online, 2) delivered in-person, and 3) usual care. We will assess the effectiveness of Promoting First Relationships (PFR: a 10-week model) to improve observed parent-child interaction and caregivers’ knowledge of social and emotional development in a sample of 358 caregivers with children under age 18 months at enrollment. We will also assess if PFR reduces child externalizing behavior and reduces out of home placements of the child into foster care. We will assess the cost-effectiveness of providing PFR via telehealth. We will address the degree to which families in Child Protective Services (CPS) have the technology needed to engage with telehealth services, as well as family satisfaction and compliance. Finally, we will measure service providers’ fidelity to the PFR model and their adherence to delivering PFR via telehealth. The proposed study leverages a longstanding partnership between the University of Washington and Washington State DCYF, overseeing services in child welfare to answer these questions.

抽象的 严重急性呼吸综合征冠状病毒 2（称为 COVID-19）大流行动摇了 为涉及儿童或受儿童监督的弱势家庭提供服务的基础 COVID-19 改变了儿童和家庭与社会互动的方式。 儿童福利系统提供的重要服务，其中包括基本服务和基本服务。 为涉及儿童福利的家庭提供变革性育儿支持服务，不再安全或可行 在 COVID-19 的存在下，供应商、管理人员都清楚地看到了这一点。 政策制定者们在这种紧张的状态下，我们的儿童保护体系是多么脆弱。 在华盛顿州，精神卫生部门创新了服务提供系统。 儿童、青少年和家庭 (DCYF) 与当地服务机构合作提供循证计划 修订项目协议。提供商团队和项目开发人员共同努力，亲自进行过渡。 通过为家庭开发和提供远程医疗服务来向远程平台提供服务。 华盛顿州提供服务的自然实验的条件自然实验得到了证明。 远程医疗服务是一个可行的服务提供系统； 然而，我们不知道这些服务是否有效，也不知道哪些家庭拥有这些服务。 参与的技术能力，或者对于那些参与的人来说，他们是否能够完成该计划。 在线家访能产生预期的结果吗？而在线交付是由 应对 COVID-19 的必要性，仍然存在许多问题，潜力很大，但人们对此知之甚少。 该提案是基于证据的家访的三臂有效性试验。 计划：1) 在线提供，2) 亲自提供，3) 常规护理的有效性。 促进第一关系（PFR：10 周模型），以改善观察到的亲子互动和 358 名 1 岁以下儿童的照护者样本中，照护者对社交和情感发展的了解程度 入组时 18 个月大时，我们还将评估 PFR 是否会减少儿童的外化行为并减少外化行为。 我们将评估通过 PFR 提供的成本效益。 我们将解决儿童保护服务 (CPS) 中的家庭拥有该技术的程度。 最后，我们将参与远程医疗服务以及家庭满意度和合规性。 衡量服务提供商对 PFR 模型的忠诚度以及他们通过远程医疗提供 PFR 的坚持程度。 拟议的研究利用了华盛顿大学和华盛顿之间的长期合作伙伴关系 国家 DCYF 负责监督儿童福利服务来回答这些问题。