A Technology-Enhanced Approach for Implementing Evidence-Based Practices in Child Welfare

NCT02430337 | Completed Results

• 1 other identifier: 5R21MH098244-02
• Study Type: interventional
• Target: 31
• Locations: 1 country
• Sites: 1

Brief Summary

In this study, a computer-assisted adaptation of SafeCare, an evidence-based home visiting program, will be developed and tested in child welfare. This approach will assist home visitors with the delivery of SafeCare to families, with the goal of improving provider fidelity and implementation success. In the computer-assisted SafeCare sessions, a portion of the session will be delivered on a tablet computer that the home visitor brings to the family's home. The computer software will deliver the educational piece, or explain a piece of each session, along with modeling videos of the skills. The home visitor will follow up with the practice and feedback portions of the session. A randomized feasibility trial will be conducted to test the technology-based approach against the standard SafeCare implementation approach in terms of feasibility of implementation, provider job demands, and resources, as well as client outcomes such as skill acquisition and mental health.

Conditions

Child Maltreatment; Implementation; Technology

Outcome Measures

Primary Outcomes (4)

• Number of Providers Reporting Satisfaction With Technology

  The investigators examined provider qualitative feedback to count the number of participants reporting that the Technology-Assisted SafeCare was acceptable and feasible. Interview data was transcribed and summarized to examine themes reported by the Tech-Assisted SafeCare providers' at the time of their exit interview (approximately six months after the baseline assessment).

  Approximately six months after completing the baseline assessment

• SafeCare Fidelity

  The SafeCare fidelity checklist measures 30+ clinical behaviors that SafeCare providers are expected to deliver during an hour long SafeCare session. Fidelity on each behavior is scored as a + if occurs and a - if does not occur. Percentages are computed for the number of +'s divided by the number of total behaviors. Scores range from 0 to 100%, with higher numbers indicating higher fidelity. A score of 85% or greater is indicative of high competence with SafeCare delivery. SafeCare providers receive fidelity monitoring for nine sessions (three in each of three modules) until they reach certification and once per month thereafter. All fidelity scores for the participants will be collected from baseline assessment to six-month follow-up in order to assess the effect of implementation condition on fidelity scores. The frequency of fidelity assessment will vary depending on the caseload of each home visitor participant.

  The average of up to 9 scores across 6 months

• SafeCare Provider Implementation Status

  The investigators used 4 categories to indicate the status of the SafeCare providers at the end of their study participation, these groups: completed were workshop only, started SafeCare but became inactive, started and continued SafeCare active (but not certified), SafeCare certified (completed 9 family sessions with 85% fidelity)

  Status of provider at end of study participation

• SafeCare Time Diary

  Provider participants documented their time spent on SafeCare session preparation, completion, and follow-up using a time diary. This form was used to document the time home visitors spend on job-related activities such as preparing for home visits, conducting home visits, and completing notes, among other activities. All participants completed the form following each SafeCare session they complete during the six months of the study. The total number of time diaries completed will vary depending on the home visitor's caseload. Means were computed based on an average of the time diaries submitted per study arm and wer compared for differences.

  average of provider time preparing for and completing SafeCare sessions during the study period (6 months)

Study Arms (2)

Technology-Assisted SafeCare

EXPERIMENTAL

A modified version of SafeCare, using a tablet and online program to complete a portion of the session

Behavioral: Technology-Assisted SafeCare

SafeCare-as-usual

ACTIVE COMPARATOR

SafeCare as it is usually delivered

Behavioral: SafeCare

Interventions

Technology-Assisted SafeCare BEHAVIORAL

A technology-enhanced version of SafeCare

Also known as: SafeCareTech

Technology-Assisted SafeCare

SafeCare BEHAVIORAL

SafeCare, an evidence-based home visiting program

SafeCare-as-usual

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Home Visitors: Home Visitors who are being trained in SafeCare
• Parents: English-speaking SafeCare parents with a child between the ages of 1.5-5 years who are receiving services from a Home Visitor who is in this study

You may not qualify if:

• Home Visitors: Home Visitors not being trained in SafeCare; Home Visitors who exclusively serve Spanish-speaking families
• Parents: Parents not receiving SafeCare; parents whose Home Visitor is not a participant in this study; parents under age 18 or who have a child outside of the ages of 1.5-5 years

Sponsors & Collaborators

• Georgia State University: lead

Study Sites (1)

Georgia State University, School of Public Health, National SafeCare Training & Research Center

Atlanta, Georgia, 30303, United States

Location

Related Publications (1)

• Cowart-Osborne M, Jackson M, Chege E, Baker E, Whitaker D, Self-Brown S. Technology-Based Innovations in Child Maltreatment Prevention Programs: Examples from SafeCare(R). Soc Sci (Basel). 2014 Aug 15;3(3):427-440. doi: 10.3390/socsci3030427.

  PMID: 25606347 RESULT

Limitations and Caveats

Small sample; limited power: fidelity \& certification; tablets provided: generalizability; assessment battery was limited-restricted data collected on potential implementation barriers; abbreviated study period; no family-level data.

Results Point of Contact

• Title: Shannon Self Brown, PhD
• Organization: Georgia State University

sselfbrown@gsu.edu

404-413-1283

Study Officials

• Shannon Self-Brown, PhD

  Georgia State University

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: April 2, 2015
• First Posted: April 30, 2015
• Study Start: April 1, 2013
• Primary Completion: June 1, 2014
• Study Completion: December 1, 2016
• Last Updated: January 22, 2020
• Results First Posted: January 22, 2020

Record last verified: 2020-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)