Refining and Pilot Testing a Decision Support Intervention to Facilitate Adoption of Evidence-Based Programs to Improve Parent and Child Mental Health - PROJECT SUMMARY
Over 268,000 children entered foster care in the United States during fiscal year 2019 despite the existence of
evidence-based programs (EBPs) that can successfully prevent child maltreatment. Evidence-informed
decision-making (EIDM) can lead to the adoption of EBPs that are likely to be successfully implemented and
result in the intended impacts. Despite the existence of EBPs to prevent child maltreatment, EBPs are
underutilized in child welfare. Proposed study activities in this career development award respond to NIMH
Objective 4.2.c by developing, refining, and piloting an implementation strategy to increase EIDM when
decision makers are adopting EBPs to improve mental health and child welfare services. Activities leverage an
unprecedented federal policy opportunity to prevent child maltreatment and test implementation decision
support strategies in the real world: The Family First Prevention Services Act (FFPSA). FFPSA aims to prevent
child maltreatment and foster care entries by providing federal funding to states for implementing EBPs that
support child and parent mental health, reduce parental substance misuse, and improve parenting skills. This
project engages decision makers from four states implementing FFPSA to extend the candidate’s prior work
developing an innovative EIDM tool to support EBP adoption: Optimizing Responses through Collaborative
Assessments (ORCA). ORCA is based in multi-criteria decision analysis, which provides a structured approach
to reach quality, evidence-informed group decisions. Given that group decisions with tools such as ORCA
benefit from facilitation, this study will develop and test two facilitation modalities to accompany ORCA:
automated (ORCA-A) and live (ORCA-L). In addition, a web-based platform to host the ORCA tool and the
ORCA-A facilitation strategy will be developed with decision makers’ input (Aim 1). The impact of ORCA-A and
ORCA-L on quality of decision experiences, processes, and outcomes then will be tested (Aim 2).
Implementation process quality for each EBP adopted with ORCA-A and ORCA-L will be monitored (Aim 3). To
enhance her strong foundation in the implementation, decision, and systems sciences, the candidate, Dr.
Gracelyn Cruden, will leverage these research activities and training activities to expand her skillset to include:
leading implementation studies in service systems, employing a continuum of methods for engaging
community members, leveraging interdisciplinary approaches for eliciting members’ preferences, conducting
advanced simulation model testing, and using advanced statistics for multilevel, longitudinal studies. Cruden
will be mentored by an outstanding team led by Primary Mentor Dr. Lisa Saldana, who is accompanied by
Mentors Dr. Jason Chapman, Dr. Lindsey Zimmerman, Dr. R. Christopher Sheldrick, Dr. Jonathan Purtle, and
Consultants Dr. David Vanness, and Ms. Clare Anderson. Upon completion of these activities, Cruden will be
equipped to lead an interdisciplinary research team that will support quality mental health and child welfare
services by increasing decision makers’ use of EIDM.
