scholarly journals MacKillop Family Services’ Family Preservation and Reunification Response for Vulnerable Families—Protocol for an Effectiveness-Implementation Study

2021 ◽  
Vol 18 (19) ◽  
pp. 10279
Author(s):  
Heather Morris ◽  
Melissa Savaglio ◽  
Nick Halfpenny ◽  
Renee O’Donnell ◽  
Alesia Pileggi ◽  
...  
Keyword(s):  
Scale Up ◽  
Strong Support ◽  
Family Preservation ◽  
Family Services ◽  
Family Outcomes ◽  
Implementation Evaluation ◽  
Paired Samples ◽  
Out Of Home Care ◽  
Vulnerable Families ◽  
Barriers To Implementation

International evidence supports the effect of intensive family preservation and reunification services in preventing children’s placement in out-of-home care (OOHC). Evidence within Australia is scarce. This protocol paper describes a hybrid effectiveness-implementation evaluation of the Victorian Family Preservation and Reunification (FPR) Response implemented by MacKillop Family Services. Participants include families engaged in the program and staff involved in program delivery. A pre-post study design will be used to assess the effectiveness of the FPR in improving family outcomes from intake to closure, including: (i) parenting knowledge, skills, and capability; (ii) family safety and home environment; (iii) child development, adolescent behaviour, education attendance and attachment; (iv) connection to services; and (v) prevention of children from entering or re-entering OOHC. Interviews and focus groups will be conducted with staff to evaluate the program’s fidelity, reach, feasibility, acceptability, and enablers and barriers to implementation. Quantitative data will be analysed using descriptive statistics and a series of paired-samples t-tests and F tests to examine changes in outcomes over time; thematic analysis will be used for qualitative data. If the FPR can yield significant improvements in families’ outcomes, this would provide strong support for its scale-up across Australia, to better support vulnerable families.

Evaluation of a Newborn Screen for Predicting Out-of-Home Placement

2011 ◽  
Vol 16 (4) ◽  
pp. 239-249 ◽  
Author(s):  
Marni D. Brownell ◽  
Mariette Chartier ◽  
Robert Santos ◽  
Wendy Au ◽  
Noralou P. Roos ◽  
...  
Keyword(s):  
At Risk ◽  
Home Care ◽  
Predictive Validity ◽  
Discharge Data ◽  
Out Of Home Care ◽  
Social Risks ◽  
Vulnerable Families ◽  
Newborn Screen ◽  
Out Of Home Placement ◽  
Home Placement

A newborn screen designed to predict family risk was examined to: (a) determine whether all families with newborns were screened; (b) evaluate its predictive validity for identifying risk of out-of-home placement, as a proxy for maltreatment; (c) determine which items were most predictive of out-of-home placement. All infants born in Manitoba, Canada from 2000 to 2002 were followed until March 31, 2004 ( N = 40,886) by linking four population-based data sets: (a) newborn screening data on biological, psychological, and social risks; (b) population registry data on demographics; (c) hospital discharge data on newborn birth records; (d) data on children entering out-of-home care. Of the study population, 18.4% were not screened and 3.0% were placed in out-of-home care at least once during the study period. Infants not screened were twice as likely to enter care compared to those screened (4.9% vs. 2.5%). Infants screening at risk were 15 times more likely to enter care than those screening “not at risk.” Sensitivity and specificity of the screen were 77.6% and 83.3%, respectively. Screening efforts to identify vulnerable families missed a substantial portion of families needing support. The screening tool demonstrated moderate predictive validity for identifying children at risk of entering care in the first years of life.

scholarly journals “The right time is just after birth”: Acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers

2020 ◽  
Author(s):  
Emma Sacks ◽  
Philisiwe Khumalo ◽  
Bhekisisa Tsabedze ◽  
William Montgomery ◽  
Nobuhle Mthethwa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Point Of Care ◽  
Scale Up ◽  
Testing Machine ◽  
Strong Support ◽  
Return Of Results ◽  
Care Workers ◽  
Birth Testing ◽  
The Right

Abstract Background: Testing for HIV at birth has the potential to identify infants infected in utero , and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over two years. Methods: In order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N=28), health care workers (N=14), and policymakers (N=10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type. Results: Responses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups. Conclusions: There is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.

scholarly journals 9.G. Workshop: Evaluation of scale-up of health systems interventions: what and how? Lessons for scale-up projects

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Small Group ◽  
Health Information ◽  
Large Scale ◽  
Scale Up ◽  
Health Information Systems ◽  
Scaling Up ◽  
Evaluation Methods ◽  
Cost Evaluation ◽  
Research Projects ◽  
Implementation Evaluation

Abstract Objectives Non-communicable diseases (NCD) are a major challenge for health systems across the globe. Although effective interventions for prevention, detection and control exist, these do not reach all people in need, especially the poor and most vulnerable. Scale-up strategies are developed to increase universal access to those interventions, addressing demand-side and supply-side barriers and to facilitate integration in the health system. While there are useful frameworks to conceptualise and operationalise scale-up of NCD interventions, there is a knowledge gap on what and how to evaluate. This session addresses that knowledge gap, presenting evaluation methods for scale-up from four large multi-country research projects. The objectives are: To increase knowledge on four dimensions of scale-up evaluation: 1) contextualisation of methods; 2) implementation evaluation; 3) cost-evaluation and 4) use of health information systemsTo present methods and results of implementation research on NCDs as an example for other chronic diseasesTo illustrate how contextualisation, implementation and evaluation varies across different stages of scale-upTo stimulate learning by experience through small-group discussion with session participants This workshop provides added value through the four coherent presentations combined with small group interactions on the same topics. It allows the audience to link the case study lessons to their own research and wider application. Format Four different elements of scale-up evaluation are addressed: 1) Contextualisation of evaluation methods from a common framework; 2) Implementation evaluation at operational level; 3) Cost-evaluation of NCD interventions; and 4) Large-scale evaluation through routine health information systems (HIS). Case studies from four large-scale Horizon2020 funded research projects in 14 countries in Europe, Africa and Asia will be presented, each case focusing on one dimension. Cross-cutting themes of adaptation and transferability of methods will also be addressed. After the presentations, there will be an interactive session to promote experience-based learning in small-group discussions. Presentations Self-Management Approach and Reciprocal Learning for Type 2 Diabetes (SMART2D)Scaling-up Packages of Interventions for cardiovascular disease prevention in Europe and Sub-Saharan Africa (SPICES)Scaling-Up NCD Interventions in South-East Asia (SUNI-SEA)The Scale-Up of Diabetes and Hypertension Care (SCUBY) The presentations will provide the introduction to subsequent small-table discussions, around the following questions: How to measure and monitor implementation and outcome of intervention scale-up?How to generate transferrable lessons from cross-country studies?How to conduct cross-setting evaluation of the effect and cost of NCD interventions? Key messages The global scale-up of NCD interventions calls for robust evaluation methods of effect, implementation and cost. Evaluation methods need to be fit to the country context and health information systems.

Policies, practices and barriers to implementing tuberculosis preventive treatment—35 countries, 2017

2019 ◽  
Vol 23 (12) ◽  
pp. 1308-1313 ◽  
Author(s):  
D. Surie ◽  
J. D. Interrante ◽  
I. Pathmanathan ◽  
M. R. Patel ◽  
G. Anyalechi ◽  
...  
Keyword(s):  
Scale Up ◽  
Preventive Treatment ◽  
Current Status ◽  
National Guidelines ◽  
Emergency Plan ◽  
Immunodeficiency Virus ◽  
The Us ◽  
Control And Prevention ◽  
Barriers To Implementation ◽  
Hiv Programs

BACKGROUND: Tuberculosis preventive treatment (TPT) reduces the development of tuberculosis (TB) disease and mortality in people living with human immunodeficiency virus (HIV) infection. Despite this known effectiveness, global uptake of TPT has been slow. We aimed to assess current status of TPT implementation in countries supported by the US President's Emergency Plan for AIDS Relief (PEPFAR).METHODS: We surveyed TB-HIV program staff at US Centers for Disease Control and Prevention (CDC) country offices in 42 PEPFAR-supported countries about current TPT policies, practices, and barriers to implementation. Surveys completed from July to December 2017 were analyzed.RESULTS: Of 42 eligible PEPFAR-supported countries, staff from 35 (83%) CDC country offices completed the survey. TPT was included in national guidelines in 33 (94%) countries, but only 21 (60%) reported nationwide programmatic TPT implementation. HIV programs led TPT implementation in 20/32 (63%) countries, but TB programs led drug procurement in 18/32 (56%) countries. Stock outs were frequent, as 21/28 (75%) countries reported at least one isoniazid stock out in the previous year.CONCLUSION: Despite widespread inclusion of TPT in guidelines, programmatic TPT implementation lags. Successful scale-up of TPT requires uninterrupted drug supply chains facilitated by improved leadership and coordination between HIV and TB programs.

Intensive Family Services in Australia: A ‘snapshot’

2004 ◽  
Vol 29 (4) ◽  
pp. 4-11
Author(s):  
Lynda Campbell
Keyword(s):  
Family Preservation ◽  
Family Preservation Services ◽  
Family Services ◽  
Intensive Family Preservation Services ◽  
Operational Issues ◽  
National Practice

This paper reports a survey of 21 Intensive Family Services programs, members of the Intensive Family Services National Practice Symposium. The survey was designed to elicit a ‘snapshot’ of program models, operational issues and policy matters within these services, in order to consolidate some understanding of the evolution of Intensive Family Preservation Services since the developments of the early 1990s.

scholarly journals “The right time is just after birth”: Acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers

2020 ◽  
Author(s):  
Emma Sacks ◽  
Philisiwe Khumalo ◽  
Bhekisisa Tsabedze ◽  
William Montgomery ◽  
Nobuhle Mthethwa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Point Of Care ◽  
Scale Up ◽  
Testing Machine ◽  
Strong Support ◽  
Return Of Results ◽  
Care Workers ◽  
Birth Testing ◽  
The Right

Abstract Background: Testing for HIV at birth has the potential to identify infants infected in utero, and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over two years. Methods: In order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N=28), health care workers (N=14), and policymakers (N=10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type. Results: Responses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups. Conclusions: There is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.

scholarly journals Outcomes that Matter © for Children and Young People in Out-of-Home Care

2013 ◽  
Author(s):  
Thom Garfat ◽  
Leon C. Fulcher
Keyword(s):  
Young People ◽  
Home Care ◽  
Daily Life ◽  
Developmental Outcomes ◽  
Life Space ◽  
Family Services ◽  
Children And Young People ◽  
Out Of Home Care ◽  
Corporate Parenting

Child, youth and family services require that outcomes are measured, although confusion persists around which outcomes really matter. Inputs, outputs and outcomes are frequently used interchangeably, while carers are rarely given voice and recognition for what they are doing in daily life-space encounters with young people in out-of-home care. An Outcomes that Matter recording format is introduced, which attends to developmental outcomes achieved by young people from week to week, positioning carers alongside these young people at the centre of corporate parenting endeavours.

Motivational Interviewing in Child Welfare Services: A Systematic Review

2019 ◽  
Vol 25 (3) ◽  
pp. 263-276 ◽  
Author(s):  
Martin T. Hall ◽  
Jeanelle Sears ◽  
Matthew T. Walton
Keyword(s):  
Child Welfare ◽  
Motivational Interviewing ◽  
Social Work Students ◽  
Evidence Based ◽  
Family Outcomes ◽  
Positive Effects ◽  
Out Of Home Care ◽  
Evidence Based Treatments ◽  
Meta Analyses ◽  
The Impact

Families in the child welfare (CW) system who cannot be engaged in services are at high risk of negative outcomes. As motivational interviewing (MI) has been shown to improve engagement in similar contexts. This study aimed to systematically review MI with CW families as well as MI training with CW workers and social work students training to become CW workers. The review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched multiple databases in June 2018. In September 2019, the initial search was repeated with additional searches to identify gray literature. Eight studies described the acquisition of MI among CW workers or student trainees, and 11 studies evaluated the impact of MI on families in CW. MI’s impact on some family outcomes, such as engagement in services, was mixed, though MI paired with other evidence-based treatments showed positive effects. With regard to training CW workers and students in MI, differences in training duration, intensity, and modality make conclusions difficult, though trainees generally described MI favorably and some studies showed training increased worker empathy and self-efficacy. Importantly, few published studies have evaluated whether MI-trained CW workers impact out-of-home-care placement, and no studies have evaluated their impact on maltreatment.

The Families First Pilot Program in Victoria: Cuckoo or contribution?

1994 ◽  
Vol 19 (2) ◽  
pp. 4-10 ◽  
Author(s):  
Lynda Campbell
Keyword(s):  
Program Development ◽  
Metropolitan Region ◽  
Family Preservation ◽  
Pilot Program ◽  
Children At Risk ◽  
Family Services ◽  
Developmental Issues ◽  
Home Based ◽  
Client Population ◽  
Families First

The Families First Pilot Program in the then Outer East metropolitan region of Melbourne began in mid-1991 as an intensive family preservation and reunification service for children on the verge of state care. The service offered was brief (4-6 week), intensive (up to 20 hours per week), home-based and flexible (24 hour a day, 7 day a week availability) and all members of the household or family were the focus of service even though the goals were clearly grounded in the protection of the child. This paper begins with some of the apprehension expressed both in the field and in Children Australia in 1993, and reports upon the now completed evaluation of the pilot, which covered the first 18 months of operation. The evaluation examined implementation and program development issues and considered the client population of the service against comparative data about those children at risk who were not included. The paper concludes that there is room for Families First in the Victorian system of protective and family services and points to several developmental issues.

Introducing Family Preservation in Australia: Issues in Transplanting Programs from the United States

1993 ◽  
Vol 18 (2) ◽  
pp. 3-9 ◽  
Author(s):  
Dorothy Scott
Keyword(s):  
United States ◽  
The United States ◽  
Family Preservation ◽  
Short Term ◽  
Out Of Home Care ◽  
Effective Interventions ◽  
Home Based ◽  
Australian Family ◽  
Intensive Family Preservation Services ◽  
Imminent Risk

This paper is based on a keynote address given at the first Australian Family Preservation Conference in Ballarat in November 1992 and addresses questions which need to be considered when transplanting programs from one service system context to another. A number of Australian States are in the process of introducing Intensive Family Preservation Services following the widespread adoption of such programs in the United States. These short term, intensive, home based therapeutic programs serve families whose children are at imminent risk of removal or who are being reunited with their family after being in out of home care. This paper argues that while such programs have the potential to provide more effective interventions with such families, placement avoidance on its own is an inappropriate outcome measure. Moreover, if the introduction of such programs is done by redirecting resources from other services, counterproductive effects may occur.

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