Cathleen E Willging1, Elise M Trott1, Danielle Fettes2, Lara Gunderson1, Amy E Green2, Roseann Myers3, Michael S Hurlburt4, Gregory A Aarons2. 1. Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, Albuquerque, NM, USA. 2. Child and Adolescent Services Research Center, University of California, San Diego, CA, USA. 3. County of San Diego Health and Human Services Agency, Child Welfare Services, San Diego, CA, USA. 4. School of Social Work, University of Southern California, San Diego, CA, USA.
Abstract
OBJECTIVE: We examine how frontline workers and supervisors delivering a research supported intervention (RSI) to reduce child neglect negotiated system-related challenges, the pragmatics of RSI implementation, and their professional identities and relationships with clients. METHODS: We conducted semi-structured interviews, small group discussions, and focus groups with frontline workers and supervisors in one large county over two time periods. We used iterative coding to analyze qualitative data. RESULTS: Frontline workers navigated several aspects of RSI implementation and sustainment: (1) contract requirements and information dissemination, (2) fidelity, (3) competing demands and crises, (4) structure versus creativity, and (5) relationships with clients. CONCLUSIONS: Workers dynamically negotiated multiple system- and provider-level (or outer- and inner-contextual) demands influencing RSI provision for clients with complex service needs. Results affirm the need to attend to the unintended consequences of implementing new contract, reimbursement, and other system organizational processes and to address the "committed work" supporting RSI delivery.
OBJECTIVE: We examine how frontline workers and supervisors delivering a research supported intervention (RSI) to reduce child neglect negotiated system-related challenges, the pragmatics of RSI implementation, and their professional identities and relationships with clients. METHODS: We conducted semi-structured interviews, small group discussions, and focus groups with frontline workers and supervisors in one large county over two time periods. We used iterative coding to analyze qualitative data. RESULTS: Frontline workers navigated several aspects of RSI implementation and sustainment: (1) contract requirements and information dissemination, (2) fidelity, (3) competing demands and crises, (4) structure versus creativity, and (5) relationships with clients. CONCLUSIONS: Workers dynamically negotiated multiple system- and provider-level (or outer- and inner-contextual) demands influencing RSI provision for clients with complex service needs. Results affirm the need to attend to the unintended consequences of implementing new contract, reimbursement, and other system organizational processes and to address the "committed work" supporting RSI delivery.
Authors: Gregory A Aarons; Danielle L Fettes; Michael S Hurlburt; Lawrence A Palinkas; Lara Gunderson; Cathleen E Willging; Mark J Chaffin Journal: J Clin Child Adolesc Psychol Date: 2014-03-10
Authors: Cathleen E Willging; Lara Gunderson; Amy E Green; Elise Trott Jaramillo; Laura Garrison; Mark G Ehrhart; Gregory A Aarons Journal: Hum Serv Organ Manag Leadersh Gov Date: 2018-07-18
Authors: Lara M Gunderson; Cathleen E Willging; Elise M Trott Jaramillo; Amy E Green; Danielle L Fettes; Debra B Hect; Gregory A Aarons Journal: J Child Serv Date: 2018