Phase II Evidence-Based Practice in Community-Based Social Work: A Multi-Media Strategy
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- 入组人数
- 179
- 试验地点
- 2
- 主要终点
- Change in confidence in CTI principles [attitudinal]
研究概览
简要总结
Clinical social workers and other staff providing direct care to individuals experiencing homelessness face multiple challenges in obtaining training and implementing evidence-based practices in diverse community settings. Critical Time Intervention (CTI) is an increasingly popular evidence based practice with these agencies.
With funding from a Phase II Small Business Innovation Research grant from the National Institute of Mental Health, the Center for Social Innovation developed an online multi-media training on CTI which incorporates a Community of Practice approach to encourage peer-based learning.
The primary aim of this longitudinal, randomized-control study is to compare and contrast this online training modality with a face-to-face training on implementation of and fidelity to the CTI model over time. Nearly two-hundred direct service providers from 20 homeless-service agencies were randomly assigned to complete either an online or face-to-face training in CTI. Pre-post training and knowledge-retention surveys, interviews with trainers, agency administrators, and providers were conducted to track satisfaction with the training and experiences in implementing CTI. CTI-specific chart forms are used to assess fidelity to the CTI model, and administrative data from the agencies capture client-level outcomes.
详细描述
In September 2008, the Center for Social Innovation (C4) was awarded a Small Business Innovation Research (SBIR) contract from the National Institute of Mental Health to test innovative ways to disseminate evidence-based practices (EBPs) in community settings. C4 selected the practice of Critical Time Intervention (CTI), a focused, time-limited case management model designed to prevent and end homelessness among people who have experienced mental illness, addiction, and trauma. CTI is widely recognized as an evidence-based practice. During Phase 1 of the project, C4 partnered with CTI experts at the Columbia University Mailman School of Public Health to develop and test a prototype version of an instructor-led online course that brought together live (synchronous) and multimedia self-paced (asynchronous) elements to train community-based social workers on the CTI model. The pilot study showed promising results in the areas of knowledge gain, knowledge retention, and confidence to implement the model. Based on these preliminary findings, C4 applied for Phase 2 funding, which was granted in September 2010.
Phase 2 of the study was completed in February 2013. This phase of the study included full product development of the online course and a randomized controlled trial comparing the online course with face-to-face CTI training (provided by our partners at the Center for Urban Community Services or CUCS). Specifically, the study included 179 service providers from 19 agencies across the United States and Canada. We randomly assigned each agency to one of two study conditions: 1) online training + community of practice, or 2) face-to-face training + telephone coaching. After they completed the training, we examined satisfaction with the training modalities, knowledge gains and knowledge retention. We then followed agencies' CTI implementation process and assessed CTI implementation readiness, experiences in implementing CTI, fidelity to the CTI model over time, and the impact of CTI implementation on the clients served by these agencies.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Agency Inclusion Criteria:
- •Possessing administrative-level support for implementing CTI within the agency
- •Capability of engaging at least one CTI team in training
- •Willingness to engage in evaluation
- •A willingness to collect and share administrative client data
排除标准
- •Not possessing administrative support
- •Not capable of of engaging at least one CTI team in training
- •Not willing to engage in evaluation
- •Not willing to collect and share administrative client data
- •Provider Inclusion Criteria:
- •Capacity to fill one of the three roles necessary for CTI team membership or eligibility to shift into those roles: Supervisor, Field Coordinator, or CTI Worker; and,
- •Willingness to engage in the CTI training and the study activities.
- •Provider Exclusion Criteria:
- •Individuals not working as a supervisor, field coordinator or CTI Worker within an eligible service organization.
- •Individuals not willing to engage in CTI training and study activities.
结局指标
主要结局
Change in confidence in CTI principles [attitudinal]
时间窗: Pre and post surveys (June and July, 2011; weeks 1 and 2)
Providers were asked to rate their confidence using a 5-point scale (1=not at all confident; 2=not really confident; 3=somewhat confident; 4=confident; 5=extremely confident) in eight key areas: 1) describing CTI as an intervention and its core principles; 2) describing who is on a CTI team and their roles; 3) describing the clinical treatment areas involved with CTI principles; 4) describing the five core skills of CTI and their purposes; 5) describing how to start a CTI program including identifying client and community needs; 6) identifying some of the challenges that might arise in trying to establish CTI in different settings; 7) how chart work differs from CTI work; and 8) describing the key indicators that CTi is implementing. Providers in both treatments were asked to complete these questions in both pre and post surveys.
次要结局
- Fidelity to CTI model(Post implementation (March 2012, June 2012, September 2012; weeks 40, 52, and 64))
- Training format preference [attitudinal](Prior to intervention (June, 2011; week 1))
- Participant satisfaction [attitudinal](Post intervention (March 2012; week 2))
- Confidence in readiness to implement CTI principles [attitudinal](Post intervention (June 2011; week 2))
- Knowledge retention [knowledge](Pre, post and follow up surveys weeks post training and six months post training (June 2011 and December 2011; weeks 1, 2 and 24))