operationalizing success• interview results • findings • implications for service delivery....
TRANSCRIPT
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JanaLeyrerSarahSheffield
OperationalizingSuccess:
AnAnalysisofRiskandProtectiveFactorsofTransition-AgeYouthinResidentialFosterCareat
HillsboroughCountyChildren’sServices
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ACKNOWLEDGEMENTS
Projectandpresentationmadepossiblethroughacollaborationbetween:• UniversityofSouthFloridaInstituteforTranslationalResearchin
AdolescentBehavioralHealth• UniversityofSouthFlorida,CollegeofPublicHealth• UniversityofSouthFlorida,CollegeofBehavioral&CommunitySciences• HillsboroughCountyDepartmentofChildren’sServices
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AGENDA
• BackgroundandSignificance• PurposeofEvaluation• Methods• SurveyResults• InterviewResults• Findings• ImplicationsforServiceDelivery
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CHILDREN’S SERVICES
Programs
-Outpatient
-CINS/FINS
-RGC
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BACKGROUND AND SIGNIFICANCE
ResidentialGroupCareyouth– Transition-age(16-17)
Literatureontransition-agefosteryouth– Pooroutcomes– Interdependencevsindependence– Heterogenous– Developmentalconsiderations– Ecologicalconsiderations
Cultivatingprotectivefactorsinresidentialfostercareprogramscanhelpimproveyouthoutcomes
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PURPOSE OF EVALUATION
ExpectedResults
Toidentifyimportantyetunmeasuredprotectivetreatmentpractices
Developprogramming
Attractprogramfunding
Toexploreresidentialfostercareyouthandstaffperceptionsofsuccess
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AGENDA
• BackgroundandSignificance• PurposeofEvaluation• Methods
• SurveyResults• InterviewResults• Findings• ImplicationsforServiceDelivery
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METHODS
Recruitment– Staffemployed>6months– Youthincare>6months
DataCollection– Nov2016– Feb2017– Surveyandsemi-structuredinterview
Analysis– Recodedinterviewstranscribed– Aprioricodingbasedonyouth.govlist
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METHODS – SAMPLE
Children’sServices
20
Staff11
Administration2
DirectCare9
Clinical4
Operations3
Maintenance1
Dining1
Youth9
Pre-TAY3
TAY3
Emancipated3
Remote2
Local1
RGCYouth=15Staff≈90Ratio=1:6
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METHODS – INTERVIEW
Staffandyouthinterviewquestions– Definitionsofsuccess– Supportintransitiontoadulthood– “TherapeuticCommunity”– Protectivefactorsfostered– Meaningfulanecdote
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AGENDA
• BackgroundandSignificance• PurposeofEvaluation• Methods• SurveyResults
• InterviewResults• Findings• ImplicationsforServiceDelivery
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SURVEY RESULTS
MostYouthEndorsedItems
• Clearbehavioralexpectations
• Highoutcomeexpectations
• Highacademicexpectations
• Connectionstomentors
• Supportiverelationships
MostStaffEndorsedItems
• Physicalhealthcare
• Positiveorganizationalclimate
• Highacademicexpectations
• Organizationalstability
• Connectionstoactivities
• Self-esteemdevelopment
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SURVEY RESULTS
LargestRelativeDifferences
– Clearbehavioralexpectations(72.5%)
– Supportbeforeleaving(58.5%)
– Highoutcomeexpectations(45.5%)
– Preparedforindependentliving(44%)
Youthreportmoreprotectivefactordevelopmentthanstaff;
Staffisconcernedaboutpreparingyouthforagingout
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AGENDA
• BackgroundandSignificance• PurposeofEvaluation• Methods• SurveyResults• InterviewResults
• Findings• ImplicationsforServiceDelivery
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RISK FACTORS IDENTIFIED
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INTERVIEW RESULTS
Describesuccessfulemancipatedyouth.Staff
• …understandtheroleofbeingagoodcitizen.• …contribution tothecommunity.• …fundamentals ofadulthood…• …beingplugged intothecommunity…
Youth
• Achievingyourgoals.• Somethingthatsomebodycanlookupto.• …havingtheabilitytonotquitbuttokeepgoingforward.• Alotofmoney.
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INTERVIEW RESULTS
What hasbeenmosthelpful?Staff
• Thestructure.Thestability…• …thatconsistency.• …stablerelationship withanotheradult…• …supports…follow-up withthem…• …continued support…
Youth
• …theone-on-one therapy[and]interactionIgotfromeverybody…• Thestaff…they’realwaystherewhenyouneedthem.• …givingmelike,knowledge andexperiences…theytellyouhowitis…• …giventhatopportunitytospeak.
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PROTECTIVE FACTORS
IndividualDomain FamilyDomain CommunityDomain
PhysicalDevelopment
IntellectualDevelopment
Self-Esteem
Self-RegulationofEmotions
Coping&Problem-solvingskills
Engagementin2+activities
Supportive
relationshipswith:
Family
Friends
Staff
Interest/SkillDevelopmentbymentor
EngagementwithSchool&Community
PositiveNorms
ClearbehavioralExpectations
Physical&Psychologicalsafety
AdaptedfromO’Connell,M.E.,Boat,T.,&Warner,K.E..(2009).Preventingmental,emotional,andbehavioraldisordersamongyoungpeople:Progressandpossibilities.Washington,DC:TheNationalAcademiesPress;andU.S.DepartmentofHealthandHumanServices,SubstanceAbuseandMentalHealthServicesAdministration(2009).Riskandprotectivefactorsformental,emotional,andbehavioraldisordersacrossthelifecycle.Retrievedfromhttp://dhss.alaska.gov/dbh/Documents/Prevention/programs/spfsig/pdfs/IOM_Matrix_8%205x11_FINAL.pdf
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RESULTS – INDIVIDUAL DOMAIN
Self-Esteem
Development
• Self-Investment• Independence• Decision-Making
“Theyhavetoknowthattheycandoit…Theyhavetosee thesuccess.”
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RESULTS – INDIVIDUAL DOMAIN
Copingand
Problem-SolvingSkills• TherapyGroups• ModelingProsocialSkills• Communication• ConflictResolution• AskingforHelp
“Wemodelgoodcommunication…Wemodelitwitheachother.Wemodelitwiththem,andwhatweseeisdeficitsinthekids.Weuse
thatasamomenttoteach.”
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RESULTS – FAMILY DOMAIN
SupportiveRelationships
withFamily
• Treatment• Events• Reunification• Sign-outs
“Alotofthetimes,we’reaprogramthatbelievesthatwewantourkidstohaveaconnectionwiththeirfamilies;ifit’ssafe,wedoreachout.”
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RESULTS – FAMILY DOMAIN
SupportiveRelationships
withStaff
• Trust• Rolemodel• Family• Resource
“Yeah,ittooksixweekstogetthroughmyheadbecauseIwouldrunawaylikeeveryweekend…shewouldyellatmeandshewouldn’tgiveuponme…you
couldfeelthemotherinstinctcomeout...”
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RESULTS – COMMUNITY DOMAIN
PersonalInterestor
SkillDevelopment
byMentor
• LifeSkillsTraining• CommunityExperiences• EmploymentCertifications
“Ithinkwe’regreatathelpingtheyouthfindtheirgifts,andthenmeetingthemwherethey’reatandthen– Idon’twanttosay
glorifyingthosegifts,buthonoringthosegifts.”
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RESULTS – COMMUNITY DOMAIN
Physicaland
PsychologicalSafety
• SafetyPlan• Round-The-ClockStaff• Referrals• SafetyInfrastructure
“Inorderforustobeabletoevenstarttohelpouryouth,wehavetoensurethattheyfeelsafe.”
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AGENDA
• BackgroundandSignificance• PurposeofEvaluation• Methods• SurveyResults• InterviewResults• Findings
• ImplicationsforServiceDelivery
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FINDINGS
Importantyetunmeasuredprotectivetreatmentpracticesare:
1.Establishmentofsafety– Nightshiftprotocols
2.Encouragementofself-exploration– SummerSkillsCamp
3.Facilitationofmentorshipopportunities– Unstructuredtime,volunteering
4.Immersioninthecommunity– YMCA,bustransit
5.Careerandeducationpreparation– Collegevisits,applications
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LIMITATIONS
– Smallsamplesize
– Surveyandinterviewinstrumentsmaynothaveadequatelycapturedallprotectivefactordomains
– Variableinterestfromstaffandchildrentoshareexperiences
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AGENDA
• BackgroundandSignificance• PurposeofEvaluation• Methods• SurveyResults• InterviewResults• Findings• ImplicationsforServiceDelivery
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IMPLICATIONS FOR SERVICE DELIVERY
• CBPRandYouth-AdultPartnership
• InformstandardizedRGCcurriculumforservicedelivery
• Futureresearchonoutcomeevaluationaftertransition
• Informchildwelfarepolicy
• Improveoutcomesforvulnerableyouth
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