Worker Perspectives from the Front Line: Implementation of Evidence-Based Interventions in Child Welfare Settings

Abstract

Despite the expansion of evidence-based interventions (EBIs) into child welfare settings, there are gaps in existing knowledge about how to effectively put them into practice. Implementation scientists suggest that multiple factors influence quality EBI delivery and ultimately positive outcomes. To understand the applicability of existing implementation evidence for child welfare settings and to document real-world experiences of EBI implementation in this setting, this study interviewed program staff from two child welfare agencies in two separate states. We sought their perspectives on what helps and what hinders EBI implementation. Transcripts were coded and analyzed with a modified analytic induction approach. This analytic technique permitted researchers to confirm or disconfirm prior research on key implementation factors. Findings describe the role of six broad factors consistent with extant literature: process, provider, innovation, client, organizational, and structural. Front line workers conceptualized these factors as distinct but interrelated and viewed them as influencing the success of EBI implementation. Child welfare staff made several important suggestions including: interactive, engaging training; coaching supports that facilitate high-fidelity implementation alongside well-tailored interventions; organizational supports and leadership that create a welcoming environment for the EBI, including adequate resources for the day-to-day use of the EBI and proactive problem-solving to manage the inevitable unforeseen implementation barriers; and, efforts to actively educate and gain the buy-in of external stakeholders. As EBIs continue to expand into child welfare settings, local implementers should carefully consider how various factors at multiple levels may impede or facilitate effective implementation.