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A PATHWAY TO THE PREVENTION OF CHILD ABUSE AND NEGLECT CB-CAP/PSSF Grantee Meeting March 12, 2008 Vicky Marchand, Senior Associate vickym@starpower.net www.PathwaysToOutcomes.org. Policy, Funding, Community Contexts. Thriving, Successful Family. Child Abuse Or Neglect.
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A PATHWAY TO THE PREVENTION OF CHILD ABUSE AND NEGLECT CB-CAP/PSSF Grantee Meeting March 12, 2008 Vicky Marchand, Senior Associate vickym@starpower.net www.PathwaysToOutcomes.org
Policy, Funding, Community Contexts Thriving, Successful Family Child Abuse Or Neglect ** Mandatory Services ** Voluntary Services & Supports > differential response > universal or targeted
PATHWAYS PREMISES • Wise decisions are made with a framework that relates activities to intended outcomes, and are informed by a research, theory and practice. • Communities, funders, and policy-makers should not have to scrounge, unaided, to uncover the rich lessons learned by others. • Communities will be able to act most effectively when they can combine local wisdom with accumulated knowledge about what has worked and what appears promising. • Effective action requires cutting across systems and combining a range of interventions, with intentional focus and investment on the world beyond programs. • To learn from the experience of others, decision makers need information about the core elements or Key Ingredients of Effectiveness of services and supports.
NEW PARADIGM INCLUSIVE APPROACHES THAT INCLUDE THEORY AND PRACTICE-BASED EVIDENCE RANDOMIZED EXPERIMENTS PLUS To shed light on To shed light on CIRCUMSCRIBED, STYLIZED INTERVENTIONS THAT HAVE PROVEN EFFECTIVE INGREDIENTS OF EFFECTIVE PROGRAMS, AND OF COMPLEX, CONTEXTUAL INTERVENTIONS PROMISING PROGRAMS AND STRATEGIES CHANGES NEEDED IN POLICY AND FUNDING CONTEXT MISSING CONNECTIONS AND INFRASTRUCTURE
“Evidence on what is effective, and under what circumstances, is often lacking, poorly communicated to decision makers or inadequately applied, and despite significant expenditures on health care for Americans, these investments have not translated into better health.” Practice-based evidence provides the foundation for “a healthcare system that “learns” – one in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” IOM Roundtable on Evidence-Based Medicine, 2007
MENTAL MAPPING PROCESS • Convene knowledgeable individuals, including researchers, policy-makers, advocates, and practitioners, who are steeped in their respective fields and diverse in their perspectives and beliefs. • Ask participants to respond initially to the question, drawing on your knowledge and experience, what actions are most likely to achieve the specific outcome under consideration. • Dig deep and put on the table issues that might otherwise remain hidden -- highlight connections between programs and addressing barriers. • Supplement the information generated at meetings with a broad literature review, consulting other experts to fill any remaining gaps, and field-testing to make sure the information is readily understood, useful, and relevant. • Apply reasonable judgments based on a preponderance of “evidence” from research, theory, and experience.
Indicators of Effectiveness OUTCOME – PREVENTION OF CHILD ABUSE AND NEGLECT • Children free from intentional injury or harm • Families provide safe, stable homes. • Reduced incidence of abuse or neglect** CHILD CONDITIONS * Children in good physical and mental health * Children’s cognitive and socio-emotional development on track FAMILY CONDITIONS * Parental resilience (Parent functioning) * Strong social connections * Knowledge of child development and demonstrated skill in parenting * Basic supports and services used by families as needed * Family environment COMMUNITY CONDITIONS * Community environments support healthy child development and family functioning
“Combining Advocacy and Service Increases Impact” Policy Advocacy • Greater impact on the • ground • Grassroots support • Channels for • implementing ideas • Greater impact through • legislation • Government funding • Increased credibility and • influence Direct Service Programs Forces for Good, Crutchfield & Grant, 2008
RESULTS BASED ACCOUNTABILITY TOOL QUANTITY QUALITY EFFORT EFFECT Mark Friedman, www.raguide.org, 2008