Trial Outcomes & Findings for A Technology-Enhanced Approach for Implementing Evidence-Based Practices in Child Welfare (NCT NCT02430337)

NCT ID: NCT02430337

Last Updated: 2020-01-22

Results Overview

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).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

31 participants

Primary outcome timeframe

Approximately six months after completing the baseline assessment

Results posted on

2020-01-22

Participant Flow

Participant milestones

Participant milestones
Measure
SafeCare- Intervention as Usual (SC-IU)
The SC-IU condition followed the protocol used in standard SafeCare implementation, which includes the following phases: (1) Agency readiness-NSTRC reviews the requisite organizational communication, service system and SafeCare funding plan, implementation requirements, and budgetary information with interested agencies to ensure fit of SafeCare within the organizational context of the agency, (2) SafeCare workshop training-This includes a 4-day classroom-based training that involves didactic presentations, modeling of the instruction, and role-playing for SafeCare trainees as well as structured assessments of the skills taught, (3) SafeCare provider certification process-Providers receive support from NSTRC as they begin SafeCare delivery with families. The support includes the SafeCare trainers listening to audio recordings of the providers' SafeCare sessions, assessing these sessions for fidelity, and then providing a follow-up coaching session to provide feedback to
SafeCare Technology-Assisted (SC-TA)
SafeCare providers assigned to the SC-TA condition participated in the standard SafeCare workshop and also received training in the technology-mediated approach to SafeCare delivery. The technology training took approximately 2 hr and focused on how the provider utilizes the technology in each session. Specifically, after greeting the parent, the provider was instructed to connect the parent to the web-based program, during which the parent participates in the multimodal learning (e.g., explanation and modeling of skills) of SafeCare target skills. When the parent completes the web-directed portion of the session, the provider is prompted by the web-based program to take over the session delivery, revisit any explanation and modeling the parent has questions about, and then engage the parent in live practice of the skills presented in the web program. Lastly, the provider offers positive and constructive feedback about the practice and closes the SafeCare session.
Overall Study
STARTED
11
20
Overall Study
COMPLETED
11
20
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

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

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
SafeCare-as-usual
n=11 Participants
SafeCare as it is usually delivered SafeCare: SafeCare, an evidence-based home visiting program
Technology-Assisted SafeCare
n=20 Participants
A modified version of SafeCare, using a tablet and online program to complete a portion of the session Technology-Assisted SafeCare: A technology-enhanced version of SafeCare
Total
n=31 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
11 Participants
n=5 Participants
20 Participants
n=7 Participants
31 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
19 Participants
n=7 Participants
27 Participants
n=5 Participants
Sex: Female, Male
Male
3 Participants
n=5 Participants
1 Participants
n=7 Participants
4 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants
n=5 Participants
4 Participants
n=7 Participants
9 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
6 Participants
n=5 Participants
16 Participants
n=7 Participants
22 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=5 Participants
5 Participants
n=7 Participants
7 Participants
n=5 Participants
Race (NIH/OMB)
White
4 Participants
n=5 Participants
10 Participants
n=7 Participants
14 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Region of Enrollment
United States
11 participants
n=5 Participants
20 participants
n=7 Participants
31 participants
n=5 Participants

PRIMARY outcome

Timeframe: Approximately six months after completing the baseline assessment

Population: Qualitative data were summarized for 14 of the 20 SafeCare Technology-Assisted Providers, who completed an exit interview regarding the technology usability

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).

Outcome measures

Outcome measures
Measure
Technology-Assisted SafeCare
n=14 Participants
A modified version of SafeCare, using a tablet and online program to complete a portion of the session Technology-Assisted SafeCare: A technology-enhanced version of SafeCare
SafeCare-as-usual
SafeCare as it is usually delivered SafeCare: SafeCare, an evidence-based home visiting program
Number of Providers Reporting Satisfaction With Technology
14 Participants

PRIMARY outcome

Timeframe: The average of up to 9 scores across 6 months

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.

Outcome measures

Outcome measures
Measure
Technology-Assisted SafeCare
n=20 Participants
A modified version of SafeCare, using a tablet and online program to complete a portion of the session Technology-Assisted SafeCare: A technology-enhanced version of SafeCare
SafeCare-as-usual
n=11 Participants
SafeCare as it is usually delivered SafeCare: SafeCare, an evidence-based home visiting program
SafeCare Fidelity
91.94 percentage of behaviors implemented
Standard Deviation 5.98
91.14 percentage of behaviors implemented
Standard Deviation 8.81

PRIMARY outcome

Timeframe: Status of provider at end of study participation

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)

Outcome measures

Outcome measures
Measure
Technology-Assisted SafeCare
n=11 Participants
A modified version of SafeCare, using a tablet and online program to complete a portion of the session Technology-Assisted SafeCare: A technology-enhanced version of SafeCare
SafeCare-as-usual
n=20 Participants
SafeCare as it is usually delivered SafeCare: SafeCare, an evidence-based home visiting program
SafeCare Provider Implementation Status
36.8 percentage of providers certified
36.4 percentage of providers certified

PRIMARY outcome

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

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.

Outcome measures

Outcome measures
Measure
Technology-Assisted SafeCare
n=11 Participants
A modified version of SafeCare, using a tablet and online program to complete a portion of the session Technology-Assisted SafeCare: A technology-enhanced version of SafeCare
SafeCare-as-usual
n=20 Participants
SafeCare as it is usually delivered SafeCare: SafeCare, an evidence-based home visiting program
SafeCare Time Diary
14.66 Minutes
Standard Deviation 4.56
13.23 Minutes
Standard Deviation 4.29

Adverse Events

SafeCare-as-usual

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Technology-Assisted SafeCare

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Shannon Self Brown, PhD

Georgia State University

Phone: 404-413-1283

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place