Title: The import of the IY to Norway, the clinical RCT and the Norwegian implementation policy
1The import of the IY to Norway, the clinical RCT
and the Norwegian implementation policy
- Prof. Dr. Willy-Tore Mørch
- University of Tromsø
- Center for Child and Adolescent Mental Health
North Norway (CCAMH-NN) - The Conference of Evidence 2008
- Helsingør May 20th 2008
2The IY import and implemenation progression
- 1998 The Expert Commitee recommends IY,
PMTO and MST - 1988-1999 Translations and preparation for RCT
in Trondheim and Tromsø - 1999-2001 Training of group leaders for RTC
- 2001-2004 RTC
- 2002-2004 Governmental mandates
- 2005-2008 National Implementation
- 2009 Dissemination, ordinary service,
maintenance of fidelity
3Ministry of HealthFinancial framework
- Covered by the Norwegian Government (1999-2008)
- Manuals, vignettes, puppets (for all agencies)
- Program Work-shops incl. registration fees
- Seven obligatory consultation days during the
three first groups for all agencies - Video-reviews
- Certification fee
- Books for parents and teachers
- Project leader posision
- Implementation secretary
- One posision for administrative support
- 40 posisions for all mentors
- All expences connected to mentoring (mentor
meetings, conferences, consultations) - One doctoral student posision (research fellow)
- All expences connected to the clinical and
universal prevention RCT
4Ministry of HealthFinancial Framework
- Expenses covered by the agencies
- Group leader posisions
- Group equipment (toys, flip-over, name tags etc)
- Transportation for parents and children
- Food, drinks etc
- Room facilities
- Child care
5The Governments mandate for implementation of
the IY
- Report no.16 (2002-2003) to the Storting on
peoples health. Chapter 10.3.3. Mental Health - The Governments Strategic Plan for Child and
Adolescent Mental Health (2004), Initiativ no 73 - Proposition no 1 (2003) on the National Budget.
Chapter on education and research on conduct
problems in children pp.173
6Governmental escalation plan for child and
adolescent mental health
- Period 2004-2008
- Investments 72 bill. NOK (7,2 bill)
- IY Appox 40 mill NOK ( 4 mill)
7IY secretariate
8IY management chart
9Service structure
- Community Services
- Universal service Parent program relation
building elements, 6 weeks. RCT - (all parents with children between 2 to 8 yrs.of
age) - Service to selective groups Parent groups, 12
weeks - (families in risk)
- Service to indicated groups Parent groups, 12
weeks - (children with CD/ODD symptoms)
- Specialist Services
- Clinical groups Parent program, Dinoschool and
Teacher program/Dino in the classroom - (Diagnosed children)
- Educational/Psychological Councelling Services
- School prevention Teacher program and Dina in
classroom 6 work-shops/24 weeks
10Program delivery Pyramideof the IY
- Treatment
Basic - (Diagnosed
Advanced - Children)
Dino School - Indicated
Basic - and Targeted
- Prevention
- Teacher program
- Universal
Relation - Prevention
building -
programs - in Basic
-
(Play,
praise, Reward) -
-
- Referrals
Clinic gt90 ECBI
Community Services lt90 of ECBI
Community health/social Services Paedagogical/psy
chological counselling services (Normal range of
ECBI)
Restricted to research only
11Implementation Strategy
- A combination of vouluntary application and
strategic targeted implementation - Criteria for strategic implementation
- Geographical dissemination
- Specialist service vs community services
- Treatemt vs prevention
- The implementation is coordinated with PMT-O
12Establishing IY in the agenciesProcedure
- First contact with the implemetation office
(voulontary or active from IY staff - Receive information brochure
- Informal contact with implementation staff
- Referral to Norwegian web-site
- Receiving a one day taster and/or formal
meetings with a mentor or trainer - Application procedure
- Agency readyness questionnaire (ARQ)
- Certification as IY agency
- Contract between IY and agency
-
-
13Quality assuranceand long term maintenance of
program fidelity
- Continous consultations with mentor
- Certification as group leader
- Re-certification (Catching up work-shop and video
review) - Annual IY delivery check (Quest back)
- Parent activity check list (for each group
meeting) - Regular pre-post data collection from all
agencies - Regional consultation days with mentor/trainer
- Weekly peer supervision meetings
- Mentors are responsible for the program fidelity
in his/her district
14Dispersion in Norway
15The agenciesN 51
- North Norway Alta kommune, BUP Alta, Nordreisa
kommune, BUP Tromsø, BUP Midt-Troms (Finnsnes),
BUP Nord-Troms (Storslett), Tromsø kommune, Vågan
kommune, BUP Gravdal - Mid Norway Trondheim kommune (alle 4 bydeler),
BUPTrondheim, Verdal kommune, Levanger kommune,
Melhus kommune, BUP Kristiansund, Kristiansund
kommune, Averøy kommune, Frei kommune , Inderøy
kommune, - Surnadal kommune, Innherred kommune, Verdal
kommune - West Norway Bergen kommune, BUP Fana, BUP
Sentrum, BUP Nordhordland, Fjell kommune, Sogndal
kommune, Odda kommune, Stavanger kommune, BUP
Stavanger, Strand kommune, Randaberg kommune,
Time kommune, Årstad familiesenter, Bufetat
region vest, BUP Sogndal, Odda kommune, Klepp
kommune, BUP haugesund, Sandnes kommune, BUP
Sandnes - South-East Norway Holmestrand kommune, BUP
Bærum, BUP Søndre Nordstrand, BUP Nydalen/AMT,
Forus/Kirkens bymisjon/Nanna Maries hjem, Arendal
SSHF, Gjerdrum kommune, Nøtterøy kommune,
Nittedal kommune, Ski kommune, Sørum kommune, BUP
Elverum, BUP Kongsvinger, Hamar kommune,
Lillehammer kommune, Sørum kommune, Ringsaker
kommune, Hole kommune, Røyken kommune, Sarpsborg
kommune, Skien kommune, Bleiker behandlingssenter
162009 -
- From implementation to dissemination
- Negotiation with the Govenrment has started
17The end
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