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DC Home visiting Implementation and impact evaluation

DC Home visiting Implementation and impact evaluation. Deborah F. Perry, PhD Georgetown University Sarah Kaye, PhD Kaye Implementation & Evaluation, LLC. November 27, 2012. Importance of rigorous design. Federal funding is contingent on rigorous implementation and outcomes evaluation

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DC Home visiting Implementation and impact evaluation

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  1. DC Home visitingImplementation and impact evaluation Deborah F. Perry, PhD Georgetown University Sarah Kaye, PhD Kaye Implementation & Evaluation, LLC November 27, 2012

  2. Importance of rigorous design • Federal funding is contingent on rigorous implementation and outcomes evaluation • Evidence-based home visiting (HV) models • Implemented with fidelity • Determine impact of HV on children and families served • All local agencies receiving funding for expanded HV must participate in the evaluation study

  3. Evaluation design Impact Study Implementation Study Monitoring & Feedback

  4. Implementation Study Impact Study Implementation Study Monitoring & Feedback

  5. Importance of STUDYING implementation • Effective interventions cannot reach the majority of children and families with scaling up. • Effective interventions, when implemented poorly, do not provide the same benefit for children and families (Durlak & DuPre, 2008). • Implementing new programs and practices requires change (and change is hard). • Practice can “drift” back to business-as usual without support and reinforcement(Breitenstein et al., 2010; McGrew et al., 1994).

  6. IMPLEMENTATION Questions • Are Healthy Families America (HFA) services delivered with fidelity to the HFA model? • Are providers operating with adherence to the 12 HFA critical elements? • Are professional development activities improving staff capacity to delivery high quality HV services? • How are implementation strategies related to fidelity of HFA implementation? • How could implementation strategies be improved to enhance implementation outcomes?

  7. Implementation Study Impact Study Implementation Study • Readiness: qualitative interviews and focus groups • Fidelity: self report and independent raters checklists • Adherence to HFA’s critical elements: HFA Self-Assessment Checklist • Capacity: HV Capacity Assessment Implementation Strategies Review Instrument Monitoring & Feedback

  8. Impact Study Impact Study Implementation Study Monitoring & Feedback

  9. Impact study components • Random assignment of agencies awarded funding for HFA expansion • Cohort 1: training and implementation right away • Cohort 2: baseline data collection for 6 months, then training and implementation • Outcomes aligned with federal MIECHV benchmarks and DC Early Success Framework

  10. Outcomes • What are the differences in outcomes when community agencies implement HFA versus a non-evidence-based home visitation model? • Maternal depressive symptoms • Maternal social support • Maternal efficacy • Breastfeeding initiation and duration • Sleep routines (i.e., sleep location and positioning)

  11. Monitoring & Feedback Impact Study Implementation Study Monitoring & Feedback

  12. RE-AIM Evaluation Framework

  13. Empowerment evaluation • The Community Advisory Board to the evaluation will assist in: • Identification of relevant indicators, • Identification of stakeholders who could benefit from timely data about the status of implementation, • Dissemination of data to pertinent stakeholders. • Implementation and intervention indicators will be shared with DOH, HV Council, provider agency leadership, and other relevant stakeholders through defined feedback loops.

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