title: Is implementation fidelity associated with improved access to care in a school-based Child and Family Team model?
abstract: Effective child and family centered service planning is crucial to addressing vulnerable children's needs. However, there is limited evidence about what facets of these processes improve service use and outcomes. The current study used a Poisson random effects hazard model to test correlations between fidelity to NC's Child and Family Support Team model and time to service receipt, using case management data for 3396 children served by that program during the 2008-2009 school year. Students were more likely to receive recommended services more quickly when caregivers and the students attended planning meetings, when their plans included services for caregivers, and when child and family team leaders followed up after meetings to verify service receipt. Contrary to the Child and Family Support Team theory of change, match between student needs and the lead agency of the meeting was not associated with the odds of quicker service receipt, nor was attendance by natural supports. Findings from this study demonstrate the potential effectiveness of using case management systems to measure service planning process fidelity, as well as how results thereof can both inform process improvement and potential refinements to models' theories of change.
authors.affiliation: Center for Child and Family Policy, Duke University, Box 90545, Durham, NC 27708, USA. Electronic address: beth.gifford@duke.edu.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Gifford
authors.affiliation: Health Policy & Management, Texas A & M, 1266 TAMU, College Station, TX 77843, USA. Electronic address: wells@srph.tamhsc.edu.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Wells
authors.affiliation: Center for Child and Family Policy, Duke University, Box 90545, Durham, NC 27708, USA. Electronic address: yu.bai@duke.edu.
authors.forename: Yu
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Psychology, Barnwell College, 533 Barnwell, University of South Carolina, Columbia, SC 29208, USA. Electronic address: malone@sc.edu.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Malone
mesh_terms: D000293:Adolescent; D019090:Case Management; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D017146:Models, Organizational; D009657:North Carolina; D016730:Program Development; D058996:Quality Improvement / Q000458:organization & administration; D012572:School Health Services / Q000458:organization & administration* / Q000600:supply & distribution
keywords: Academics; Child and Family Teams; Fidelity; Mental health, access; Services