Launching and Sustaining a Statewide Incredible Years Program

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Launching and Sustaining a Statewide Incredible
Years Program

• Sarah Currier, Carla Fryling,
• Stephanie Pavlis

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Agenda

• History and program selection
• Pre-launch
• Initiative components
• Readiness
• Training
• Coaching
• Evaluation/QA
• IY Network
• Lessons learned
• Questions

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NC Institute of Medicine Task Force on Child
Abuse Prevention

• 2005 Task Force Recommendations
• 37 recommendations
• 7 regarding the dissemination of evidence-based
  prevention programs

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Child Maltreatment Prevention Leadership Team

• Expert Work Group on Evidence-Based Practices
• Alliance for Evidence-Based Family Strengthening
  Programs

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Constellation of Partners NC Childrens Trust
Fund NC Division of Social Services NC Division
of Public Health Division of Mental Health,
Substance Abuse and Developmental Disabilities NC
Partnership for Children The Duke Endowment Kate
B. Reynolds Charitable Trust Governors Crime
Commission NC Department of Juvenile Justice and
Delinquency Prevention NC Head Start State
Collaboration Office Staffed by PCA North
Carolina Center for Child and Family Policy
Working as an Alliance Community planning,
Secure funding, Training and technical
assistance, Evaluation, Quality
assurance, Coordination (agreements to be
established)
Pool of Programs Current Efforts Nurse Family
Partnership, The Incredible Years, Strengthening
Families Program
Intermediate Outcomes Children have a medical
home. Mothers have healthy pregnancies. Parents
demonstrate child development knowledge and
effective parenting skills. Parents provide care
that promote attachment. Parents receive
increased education and employment
support. Parents utilize family planning
services. Parents receive effective treatment for
maternal depression and other mental
illness. Parents receive appropriate treatment
and services for domestic violence. Parents
receive appropriate treatment and support for
substance abuse. Parents receive and provide
appropriate social support. (issues for further
discussion, such as measures)
Population Level Impact Improved School
Readiness Reduction of Child Maltreatment
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Implementation Research

• Core Drivers of Implementation
• Readiness
• Pre-service and in-service training
• Coaching
• Evaluation
• Quality assurance
• National Implementation Research Network

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Alliance Program Selection

• Does this support a demonstrated need in
  communities?
• Does the program have evidence of impacting the
  Alliances set of shared outcomes?
• Does the program have a solid theoretical
  foundation?
• Does the program have evidence of effectiveness
  from experimental evaluations using randomized
  control groups?
• Does the program have cost-benefit data?
• Does the program have resources to support
  replication in North Carolina (e.g., standardized
  training, accessible program developer, fidelity
  tools)?
• What is cost of implementing in local
  communities?
• Cost/benefit analysis of scaffolding
• Does the program already exist in North Carolina
  and have some degree of infrastructure or
  support?
• Does the program seem like a good fit with
  North Carolina communities and NC politics?
• Multiple-funder interest to co-invest?

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The Incredible Years

• 14 week parent training program
• Parents of children with challenging behaviors
  (ages 3-12)
• Long-term goals are to reduce
• Substance abuse
• Violence
• Delinquency

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Incredible Years Committee

• Pre-launch charges
• IY implementation guidelines
• Alliance agreements for fidelity
• Alliance agreements for technical assistance
• Sustainability plan
• Contracted business plan to inform multi-year
  budget
• Ongoing Alliance planning for sustainability
• Staffing
• IY Coordinator
• IY Coach

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Initial Start-Up Phase Staff Immersion
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Relationship-building

• Began with existing sites
• Personal phone calls to directors or group
  leaders
• Recognition of practitioners dedication
• Wise investment sets stage for future
  interactions

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Completion of group leader training

• 3 day experiential training
• Important for practice
• Introduction to curriculum
• Credibility for coordinator and coach

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Becoming familiar with IY curriculum

• Spending time reading manual
• Viewing DVD vignettes
• Reading Troubleshooting Guide for Parents
• Reviewing current research literature from IY
  website

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Live group observation

• Value of seeing group in action
• Continued relationship-building with current
  practitioners
• Time in the field helps drive the work

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Overview of Services

• Pre-implementation readiness support
• Training
• Coaching
• Managing IY Network

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Infrastructure Pre-Implementation Readiness
Support
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Role of IY Coordinator

• Organizational and community readiness
• Assessment of agencys capacity
• Facilitation of networking
• Program evaluation

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Importance of Readiness Support

• Assistance with community/ agency planning and
  readiness has an impact on the success of
  implementing an evidence-based program (NIRN)
• Long-term sustainability of program is linked to
  readiness
• Better outcomes for families

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Phases of readiness

• Tracking system helpful for monitoring
  pre-implementation process
• Modeled loosely after Stages of Change (James
  Prochaska and Carlo DiClemente)
• Precontemplation, Contemplation, Preparation,
  Action, Maintenance
• Change does not happen in one step
• People move at their own pace

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Phases of readiness

• Contemplation
• Preparation
• Action
• Halt

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Readiness considerations assessment process

• Organizational goals and philosophy
• Assessing the need and target population
• Organizations commitment

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Readiness considerations assessment process

• Human resources
• Assessing organizations financial capacity
• Preparing for program implementation

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Training and Networking
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Pre-Service Training

• Training offered twice/year in North Carolina
• Currently contract with National IY Office to
  bring trainer from Seattle
• Long-term plan to cultivate NC Mentor
  (trainer) within state

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In-Service Training Networking

• Annual face-to-face consultation session
• Conference calls
• Google group/list serve

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Infrastructure Coaching Support
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Importance of Coaching Support
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Role of IY Coach

• Clinical coaching - helping practitioners enhance
  skills and improve practice
• Program implementation support
• Model fidelity and quality service delivery
• Technical assistance

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Program Fidelity Positive Outcomes
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Ongoing Supervision

• Telephone consultation
• On-site consultation
• Regular peer and mentor support
• Videotape feedback
• Client weekly evaluation

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Fidelity Monitoring

• Session adherence protocols
• Session process checklists
• Final client evaluations

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Observation Narrative
NC Incredible Years Initiative Site
Consultation Date Coach Site Session
Number Site Contact(s) Number of Parents
What is going well (Site successes and
accomplishments) Current site challenges
(Recruitment/retention, program content, group
discussion, video vignettes, role play, parent
group process issues, individual family
issues) Follow-up from previous visit by Coach
(Were agreed upon ideas/objectives tried or
achieved?)
Page 1 of the NC Incredible Years Initiative
Observation Narrative
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Observation Narrative
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Agency Organizational Support

• Budget support for supervision and ongoing
  consultation
• Organizational support to decrease barriers
• Recruitment support
• Logistical support

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Coaching Support Plan

• Preliminary site visit
• Group observation with fidelity checklist
• Narrative report
• Clinical consultation and goal setting
• Group observation with fidelity checklist
• Narrative report
• Follow up contact

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Working Together
Local Sites
Scaffolding Supports
Funders
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Managing IY Network
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Data Collection Considerations

• Identify what information is helpful for your
  state to track
• In NC, tracking is used in readiness, training,
  current site management, and coaching processes
• Personal record keeping
• Logs of emails
• Mini case note of phone calls

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Development of marketing materials

• Relied on home grown products initially
• Fact Sheet/Program Overview
• Piloted initial products and made modifications
• Finalized resources as initiative grew

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Evaluation Systems

• Outcome and process data
• Impact on families
• Technical Assistance Satisfaction Survey
• Impact of services
• Change in fidelity
• Measure of site/practitioner outcomes

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Lessons Learned

• Collaborative decision making is key and hard
  work!
• Developing the infrastructure while supporting
  existing sites can be challenging.
• Operating within multiple funding timelines can
  be challenging.
• Ideas for sustainability have shifted with the
  economic climate.

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Thank you!

• Sarah Currier
• scurrier_at_preventchildabusenc.org
• 919-256-6608
• Carla Fryling
• cfryling_at_preventchildabusenc.org
• 919-256-6614
• Stephanie Pavlis
• spavlis_at_preventchildabusenc.org
• 919-256-6603