Project Details
RRTC for Children's Mental Health Study 2: Holistic Approaches to Studying Community-based Systems of Care
Description
PURPOSE:
The purpose of this project is to identify strategies that local communities undertake in implementing community-based systems of care and provide greater understanding of how factors affecting system implementation contribute to the development of local systems of care for children with serious emotional disturbance and their families. The study is currently investigating:
· Fundamental mechanisms of system implementation
· How factors contributing to system implementation interact to produce well functioning systems serving children with serious emotional disturbance and their families
· How system implementation factors are used in specific or unique combinations to develop local systems of care
· How local context influences system-of-care development
· What structures and processes contribute to the implementation of systems of care
· If system of care implementation is marked by identifiable change agents or triggering conditions
· What conditions support or impede the development of systems of care
METHODS:
The investigation uses a multiple-site embedded case study design to investigate howcommunities operationalize and implement strategies that contribute to the development ofcommunity-based systems of care for children with SED and their families. Each year, a national nomination process is conducted to identify established systems of care. A site selection process involving document review and key stakeholder interviews is used to identify participating sites. Case study data is then collected using semi-structured interviews with administrators, managers, direct service staff and families; direct observation; document review; and a review of aggregate outcome data. A brief description of these methods follows.
· Document review is used to provide organizational-level data related to system implementation as well as system-of-care development in a historical context. Documents include any materials related to goals and intent of the system, legislative history, regulations or guidelines, budget justifications, monitoring reports, annual reports, and reports of accomplishments.
· System implementation factor brainstorming and rating is conducted in order to identify local factors believed to be critical to system-of-care implementation. This process consists of identifying system implementation factors, then rating the identified factors on a five-point scale with regard to both their importance and effectiveness in local efforts to develop systems of care.
· Key stakeholder interviews are conducted in person and by telephone for the purpose of understanding personal perceptions and beliefs about the process of system-of-care implementation and the role of the identified implementation factors in local system development and their relationship with one another.
· Direct observation of service delivery structures and processes are conducted for the purpose of observing aspects of system implementation in action.
· Aggregate outcome data is reviewed for the purpose of establishing progress toward system goals and better understanding linkages between specific strategies and outcomes. A total of 8 communities will be selected for this study. The first four years of the study consist of data collection and preliminary analysis of data, and the development and dissemination of site-based reports and issue briefs on lessons learned from successful systems. The fifth year of the study will consist of in depth cross-site data analysis and summary and dissemination of findings.
RESULTS:
It is expected that the results of this study will help both established and potential systems of care to identify strategies for successful system implementation within their local contexts. Findings of each phase will be shared with professional and family audiences through workshops, presentations, issue briefs, newsletter articles and published papers. This effort will be extended to cross-site findings as results become available.
Related News Articles
New Issue Briefs Feature Lessons Learned from Established Systems of Care