TEAMS R34 #1 After-Action Reviews in Child Welfare Services (R34-1)

University of California San Diego

Status: Enrolling

Conditions: Children, Adult; Mental Health Issue

Treatments: Behavioral: After-Action Review

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05629013

P50MH126231-01A1 (U.S. NIH Grant/Contract)

803821

Details and patient eligibility

About

This project proposes to improve successful mental health service linkage in Child Welfare Services (CWS) by adapting and testing the After Action Review (AAR) team effectiveness intervention to augment the Child Family Team (CFT) services intervention. Despite being both required and a collaborative approach to service planning, CFT meetings are implemented with questionable fidelity and consistency, rarely including children and families as intended. By inclusion of child and family voice, the AAR-enhanced CFT should lead to increased fidelity to the CFT intervention and greater levels of parental satisfaction with the service and shared decision-making, thus resulting in enhanced follow-through with Action Plans and linkage to mental health care for children.

Full description

The proposed project will address the following aims:

Aim 1. Conduct a qualitative needs assessment targeting the ongoing implementation of the CFT services intervention in a large, publicly funded, CWS. A qualitative inquiry consisting of interviews and focus groups with key stakeholders will result in the preparation of an action plan to address identified gaps between the current and desired CFT services intervention outcomes.

Aim 2. Adapt and tailor the AAR implementation strategy to address the CFT services intervention needs.

Aim 3. Assess mechanisms of the AAR team effectiveness intervention for CFT implementation.

Enrollment: 320 estimated patients

Sex: All

Ages: 6+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Inclusion Criteria for CWS leaders and/or caseworkers

1. (For leaders) Employed as one of several CWS leadership positions: CWS Director, CWS Deputy Director, CWS Regional Manager; (For caseworkers) Employed as a caseworker in one of the two participating regions for the proposed study.
2. Plans to remain employed for at least six months beyond study initiation
3. Speaks English or Spanish

Inclusion Criteria for formal and informal CFT members

1. Member of CFT with one of the participating CWS caseworkers. CFT members can include mental health services provider, Court Appointed Special Advocate (CASA), educational representative, and other supports
2. Speaks English or Spanish

Inclusion Criteria for parents/caregivers with active CWS cases

1. Parent/caregiver of child aged 6-17 with an open CWS case
2. Initial CFT meeting for open CWS case has not yet been held (Aim 3)
3. Speaks English or Spanish

Inclusion Criteria for children with active CWS cases (for mental health service linkage data extraction only*)

1. Child aged 6-17 with an open CWS case
2. Mental health services need/s (identified by the CWS caseworker via CANS screening in advance of the initial CFT meeting, during which consensus is reached regarding the Action Plan and service referral)

Exclusion criteria

Individuals who do not meet inclusion criteria are not eligible to participate in this study.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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320 participants in 2 patient groups

Child Family Team (CFT) as Usual

No Intervention group

Description:

The CFT is a family meeting model that is an existing mechanism being implemented systemwide in San Diego County Child Welfare Services (CWS). Each child or youth is required to have a CFT meeting within sixty days of entering the CWS to identify areas of behavioral, emotional, or social needs, and to complete an initial case Action Plan.

Child Family Team (CFT) with After Action Review (AAR)

Experimental group

Description:

CFT is being augmented with the after-action review.

Treatment:

Behavioral: After-Action Review