Research Minutes

April, 2008 - Assessing System-wide Conditions for Wraparound Implementation:
The Community Supports for Wraparound Inventory

Janet Walker, P.I.    

The Community Supports for Wraparound Inventory (CSWI) is a survey tool that assesses the adequacy of the implementation context for wraparound, a team-based planning process intended to provide individualized, coordinated, family-driven care to meet the complex needs of children with severe emotional and behavioral difficulties. Achieving broad scale, high quality implementation of wraparound has proven to be difficult. Practical experience has shown that the successful implementation of creative, individualized wraparound plans at the team level requires extensive support from the larger system context (or policy and funding context) within which the teams operate. The CSWI was designed to be used by researchers--to determine the impact of contextual features on fidelity and outcomes of the wraparound process—and community evaluators—to provide information about system support that can be used as an input to strategic planning for sustainable wraparound implementation.

In this study, the CSWI was administered as an online survey, The measure includes 40 items in six themes: community partnership, collaborative activity, fiscal policies and sustainability, access to supports and services, human resource development and support, and accountability.  A total of 289 respondents in 7 communities around the nation completed the survey. Within communities, there was excellent interrater reliability, as measured by the average intraclass correlation, which ranged between .71 and .89. Factor analysis showed a factor structure that corresponded very strongly to the measure’s themes. The high intercorrelations among the factors was consistent the interpretation of the CSWI as a meaningful scale with correlated but also distinct subscales. Cronbach’s alpha for the six themes ranged from .87 to .95, and the entire measure had a reliability coefficient of .95, again showing  excellent reliability.

 Different communities show variation both in the overall level of implementation support and in particular items indicating areas of strength and challenge. Previous studies of system and organizational support for wraparound implementation have shown that greater levels of such supports are associated with higher wraparound fidelity scores.

References

Walker, J. S., & Koroloff, N. (2007). Grounded theory and backward mapping: Exploring the implementation context for wraparound. Journal of Behavioral Health Services & Research.
Walker, J. S., & Bruns, E. J. (2006a). Building on practice-based evidence: Using expert perspectives to define the wraparound process. Psychiatric Services, 57, 1597-1585.
Walker, J. S., & Bruns, E. J. (2006b). The wraparound process: Individualized, community-based care for chidren and adolescents with intensive needs. In J. Rosenberg & S. Rosenberg (Eds.), Community mental health: Challenges for the 21st century. New York: Routledge.

 

February, 2008 - Telephone Focus Groups:  A Qualitative Research Strategy for Learning from Rural Mental Health Consultants

Mary Dallas Allen, MSW

Telephone focus groups were used for a qualitative study of rural and urban early childhood mental health consultants who work with Head Start programs in rural Alaska and rural and urban Oregon.  Conducting focus groups by telephone allowed the study to gather information and ideas from mental health consultants working with Head Start programs in geographically distant communities in rural Alaska and Oregon who would have been excluded in face-to-face focus groups due to the time and expense of bringing them together.  Although focus groups are typically held in a neutral location as face-to-face groups, telephone focus groups are becoming increasingly common for connecting participants who are extremely busy or who are geographically separated (Krueger, 1996; Cooper, Jorgensen, & Merritt, 2003).  Telephone focus groups share the three key characteristics present in an inclusive definition of focus groups according to Morgan (1996): (a) they are a qualitative method of data collection; (b) the group process is the central source of data; and (c) the researcher actively guides the focus group discussion based on predetermined topics (Morgan; Seal, Bogart, & Erhardt, 1998).   However, telephone focus groups differ in that the researcher moderator and the participants communicate their ideas about the determined topic utilizing teleconference technology rather than through face-to-face meetings (Cooper et al., 2003).

 
Strategies for conducting telephone focus groups:

• Send a scheduling form to all participants, so that they can provide the days and times of the week that are most convenient for them to participate.  Also provide space for participants to write the dates that they are not available.
• Schedule the focus groups at a time most convenient for participants.
• Send participants a letter that includes the date and time of their focus group, directions for calling into the teleconference, and a copy of the focus group questions.  Having a copy of the questions will help participants follow the questions during the telephone focus group.
• A week before the teleconference call, mail participants a reminder postcard that includes the date and time of the call and directions for calling into the teleconference.
• On the day of the telephone focus group, call all participants at least one hour prior to the call to remind them of the call.
• When the focus group begins, ask all participants to state their name before speaking, so that the moderator, the participants, and the transcriber can identify the speaker.

References

Cooper, D.P., Jorgensen, C.M., & Merritt, T.L. (2003).  Report from the CDC.  Telephone focus groups:  An emerging method in public health research.  Journal of Women’s Health, 12(10), 945-951.

Hurworth, R. (2004). Telephone focus groups, Social Research Update (Vol. 44). Guilford, U.K.: University of Surrey

Krueger, R. A. (1994). Focus groups:  A practical guide for applied research. Thousand Oaks, CA: Sage.

Krueger, R. A. (2002). Telephone focus groups.   Retrieved June 18, 2006, from http://www.tc.umn.edu/~rkrueger/focus_tfg.html

Morgan, D. L. (1996). Focus groups. Annual Review of Sociology, 22, 129-152.

Ross, L.E. (2006).  Using telephone focus group methodology to examine the prostrate cancer screening practices of African-American primary care physicians.  Journal of the National Medical Association, 98(8), 1296-1299.

Schneider, S.J., Kerwin, J., Frechtling, J., & Vivari, B.A. (2002).  Characteristics of the discussion in online and face-to-face focus groups.  Social Science Computer Review, 20, 31-42.

Schopler, J.H., Abell, M.D., & Galinsky, M.J. (1998).  Technology-based groups:  A review and conceptual framework for practice.  Social Work, 43(3), 254-266.

Seal, D.W., Bogart, L.M., & Ehrhardt, A.A.  (1998).  Small group dynamics: The utility of focus group discussions as a research method.  Group Dynamics: Theory, Research, and Design, 2(4), 253-266.

 

November, 2007 - The Safer & Stronger Program – A Safety-Awareness Tool for Women with Disabilities and Deaf Women

Mary Oschwald, P.I.

Interpersonal violence (IPV), including domestic violence, sexual assault and personal assistant abuse, poses a significant threat to women with disabilities and Deaf women.  Women with disabilities who experience IPV frequently experience difficulty when accessing domestic violence services because of physical and attitudinal barriers towards people with disabilities.  Little attention has been given to providing women with disabilities and Deaf women safety planning strategies to reduce abuse.  The Safer and Stronger computer-assisted screening instrument was developed in partnership with women with disabilities and was recently field tested in Oregon, Southwest Washington, and Texas.  The purpose of the Safer and Stronger Program, an Audio-Computer-Assisted Self-Interview (A-CASI), is to provide a tool that enables the identification of existing or potential abuse; encourages safety-planning behaviors and strategies, and provides information about abuse resources. The A-CASI Program is accessible to women with visual, hearing, cognitive and physical disabilities. It is self-paced, interactive, and includes video clips of survivors with disabilities who provide messages of empowerment and validation. The A-CASI format provides a non-judgmental and safe way for women to identify abuse without having to disclose it to someone, who might also be a mandatory reporter. The 305 women who completed the Program evaluated it as extremely helpful, especially in increasing their understanding and awareness of being victimized. They also rated the Program as very accessible for their own disability and highly recommended it to other women with disabilities.