Considering the high prevalence of mental health challenges among the residential youth care (RYC) population, it is imperative that research-informed interventions are implemented in this setting. However, little research is available regarding RYC implementation practices. Leadership is a vital influencer of implementation success. Therefore, the aim of this study was to further the knowledge base concerning effective implementation in RYC by investigating implementation leadership behavior. Utilizing qualitative methods, RYC providers were asked about effective implementation leadership behaviors, with an emphasis on similarities and variations in behavior enacted by different leadership levels within the organization. The results indicate that relations-oriented and task-oriented leadership behavior are more important than change-oriented implementation leadership behavior among the providers interviewed. The reported behaviors differed in terms of leadership level. The top executive leadership was more involved in taskoriented leadership behavior (i.e., monitoring activities, resource procurement), while the facility management was more involved with relations-oriented behaviors (i.e., providing support, facilitating cooperation). Finally, the results are discussed in light of RYC characteristics and implementation stages.
Background: Youth who reenter communities after forensic or residential care are overrepresented in prevalence rates for mental disorders, delinquency, incarceration, low academic achievement, and unemployment. Supportive interventions that aid youth in the reentry to their communities can be crucial for successful reintegration. In systematic reviews (SR) on this topic, only specific interventions or programs are described. Therefore, a summary of evidence about transitional interventions for various groups of reentry youth is needed. Method: This overview of SRs was preregistered in PROSPERO. We searched PsycINFO, Ovid MEDLINE, Cochrane Library, Campbell Library, Web of Science, Sociological Abstracts, Criminal Justice Abstracts, Social Care Online, and Epistemonikos. SRs that fit the search criteria were evaluated using the AMSTAR checklist for methodological quality and the GRADE tool for assessing confidence in effect estimates. Results: We screened 2,349 publications for eligibility. Eight SRs were included for analysis. The methodological quality of five SRs was critically low, two were of low quality, and one was of moderate quality. Recidivism was reported as the only outcome in five SRs. Detrimental outcomes were reported in five SRs. Confidence in effect estimates was low or very low for all outcomes. Ninety-five percent of primary study populations were from the United States. Conclusion: We offer a rigorous appraisal of SRs on transitional interventions. The gaps of knowledge are vast regarding what works, how it works, and for whom. Development of a knowledge base should include defining the term 'recidivism', systematic reporting of demographics, and identifying effective common elements.
Key Practitioner Message• The SR literature on transitional interventions for reentry youth provides inconclusive and contradictory evidence about their efficacy.• 95% of primary studies report on US populations. There is a need for SRs on study samples from diverse cultural and geographical contexts.• 95% of primary studies were published before 2010. The field is ripe for updated, rigorous studies on transitional interventions.• Disparate operationalizations of the primary outcome 'recidivism' impede comparison between SRs and primary studies.
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