Program records as a source for program implementation assessment and youth outcomes predictors during residential care |
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| Institution: | 1. University of Nebraska — Lincoln, The Academy for Child and Family Well-Being, 247 Barkley Memorial Center, Lincoln, NE 68583, United States;2. National Research Institute at Father Flanagan''s Boys'' Home, 14100 Crawford Street, Boys Town, NE 68010, United States;3. Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR 97401, United States;4. Tennessee State University, Department of Psychology, 3500 John A Merritt Blvd, Nashville, TN 37209, United States;1. Center for Surgical Outcomes Research, Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children''s Hospital, 700 Children''s Drive, Columbus, OH 43205, USA;2. Department of Pediatrics, Nationwide Children''s Hospital, 700 Children''s Drive, Columbus, OH 43205, USA;1. Ghent University, Department of OrthopedagogicsBelgium;2. OC Sint-Idesbald, De Zilten 52, 8800 Roeselare Belgium;3. OOBC Nieuwe Vaart GhentBelgium;1. Institute of Psychiatry, Psychology, & Neurosciences, King''s College London, UK;2. Graduate School of Comprehensive Human Sciences, Tsukuba University, Japan;3. Faculty of Letters & Konan Institute of Human Sciences, Konan University, Japan;4. T. Denny Sanford School of Social and Family Dynamics, Department of Psychology, Arizona State University, USA;1. University of Kansas Life Span Institute at Parsons, 2601 Gabriel, Parsons, KS 67357, United States;2. Child and Family Center, Prevention Science Institute, University of Oregon, Eugene, OR 97403, United States |
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| Abstract: | This study used point card information from a residential program to generate treatment fidelity metrics and determine if the metrics predicted youth outcomes after six months in care. Youth outcomes included staff (n = 52) and youth (n = 143) ratings, youth conduct records kept by the residential program's teaching-family homes and school records. Treatment fidelity metrics included the program components: (a) percentage of positive interactions, (b) number of privileges earned, and (c) a skills taught to interactions ratio. The percentage of positive interactions averaged 90% per youth; 76% of the point cards indicated that privileges were earned; and a variety of life skills were typically taught to the youth (skills ratio = .61). The data from the treatment fidelity metrics supported that the program was implemented consistent with program expectations. The range of implementation quality for each measured component was then used to predict youth outcomes. Increased percent of positive interactions predicted significantly decreased externalizing behaviors as reported by staff (β = ? 0.31, p < .001) and youth (β = ? 0.30, p < .001), and significantly fewer incidents of non-compliance (Exp(b) = 0.93, p < .001) and school problems (Exp(b) = 0.91, p < .001) as indicated on the program records. The skills ratio indicated similar trends across outcomes, although non-significant at the p < .01 level. Permanent products may be helpful to develop program treatment fidelity metrics, which may be useful for monitoring implementation and may be associated with improved youth outcomes. |
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