Use of evidence-based interventions in child welfare: Do attitudes matter?

Abstract

Implementation of evidence-based programs in progressed slowly, with the majority of services in child welfare settings lacking empirical evidence for effectiveness. In other settings, research has identified providers’ attitudes about evidence-based practices (EBPs) as a potential barrier to adoption of EBPs. As little research has focused on the role of attitudes in influencing use after training in an EBP in child welfare, the potential for attitudes to impede implementation efforts in child welfare is unclear. This study addressed this question in a sample of 55 caseworkers and therapists randomly assigned to enhanced support to use an EBP following training or a training-only condition. Information on providers’ use of the intervention after training and their attitudes about EBPs were measured for up to five time points. Results indicate that attitudes did not predict providers’ use of the EBP, and attitudes did not change overall or in the enhanced condition that provided greater exposure to the intervention. Providers perceived of requirements to use a practice as more influential in their use than their openness to EBPs. However, those who were more open to EBPs were more likely to participate in implementation support after the training, suggesting that openness facilitates participation in activities that support use of a new intervention.

Changes in Practitioners’ Attitudes, Perceived Training Needs and Self-Efficacy over the Implementation Process of an Evidence-Based Parenting Program

“…In support of this idea, this study appears to be among the only ones to nd positive changes over time in practitioners' attitudes and training needs towards EBPs. Contrary to the present study, no structured implementation strategy was put in place to support practitioners following their EBP training in the other studies (22,23). The authors had suggested that this may be a reason why there was no change in practitioners' perceptions over time.…”

“…Regarding attitudes, Lim et al (14) observed an increase in the appeal of EBPs as perceived by community mental health practitioners immediately following their participation in three workshops on evidence-based techniques intended to decrease internalizing and externalizing problems among youths. Another study involving ve measures over a 14-month period yielded different results, with no changes in attitudes towards EBPs being observed among practitioners in the child welfare sector who received training in an evidence-based parenting program (22). However, as pointed out by the authors of this study, the study context did not involve a "full implementation strategy."…”

“…Indeed, in the present study, an initially critical or neutral stance regarding the organization's capacity to implement an EBP was associated with greater positive changes in both the appeal of EBPs and the practitioners' openness to new practices over time. As demonstrated by Leathers et al (22), such an improvement in attitudes could lead to higher engagement in support activities following training (e.g., seeking consultation with a mentor), which could in turn improve implementation and program outcomes.…”

Changes in Practitioners’ Attitudes, Perceived Training Needs and Self-Efficacy over the Implementation Process of an Evidence-Based Parenting Program

“…In support of this idea, this study appears to be among the only ones to nd positive changes over time in practitioners' attitudes and training needs towards EBPs. Contrary to the present study, no structured implementation strategy was put in place to support practitioners following their EBP training in the other studies (22,23). The authors had suggested that this may be a reason why there was no change in practitioners' perceptions over time.…”

“…Regarding attitudes, Lim et al (14) observed an increase in the appeal of EBPs as perceived by community mental health practitioners immediately following their participation in three workshops on evidence-based techniques intended to decrease internalizing and externalizing problems among youths. Another study involving ve measures over a 14-month period yielded different results, with no changes in attitudes towards EBPs being observed among practitioners in the child welfare sector who received training in an evidence-based parenting program (23). However, as pointed out by the authors of this study, the study context did not involve a "full implementation strategy."…”