Program Model Purveyors Play an Essential Role in Family First Act Implementation

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Context

Purveyors face a unique set of challenges as states implement the Family First Act. Many program models were not originally designed with scaling in mind. For example, models developed by researchers based on theory and tested in smaller, controlled settings (e.g., university labs) may be less culturally relevant and harder to implement in real world settings.[3] Other program models have been developed and refined by local providers over time to best serve their communities, and these providers may lack the capacity to support the implementation of their program model in other communities.

The literature highlights other challenges facing purveyors. Purveyors who are the original model developers may be more interested in research and development than dissemination and implementation support.[4] Moreover, developers and purveyors often lack needed skillsets for dissemination (e.g., marketing and management), and they may also lack adequate staffing, sufficient funding, and incentives to expand their model’s reach.[5] Finally, few models were designed specifically for the child welfare context and may require adaptations to better meet the needs of families and systems.[6]

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Factors that may impact purveyors’ capacity to scale services

As more states begin implementing the Family First Act, we anticipate that the purveyors of models that meet the evidence criteria will experience increased demand, while the purveyors of models not yet rated or with lower evidence ratings will seek to build evidence of effectiveness. Purveyors’ capacity to meet the rising demand and successfully partner with state and local child welfare agencies, providers, and evaluators could impact the timeliness and quality with which services are made available under the Family First Act. Through our examination of two evidence-based models implemented in New York City, we identified four factors impacting purveyors’ capacity to effectively scale their models[7]:

Purveyors need adequate staffing at the national and local levels to support implementation. Purveyors must be adequately staffed at their national offices to fulfill key functions and build out the capacity and localized expertise of staff or consultants who provide responsive and tailored support to the providers delivering the services.

Purveyors need a business model that generates sufficient revenue to provide high-quality support. Pricing structures should cover the true costs of supporting jurisdictions to implement their program models with fidelity and will help child welfare agencies better budget for implementing evidence-based models at scale.

Purveyors located within university settings face unique circumstances. Some evidence-based models were developed and tested in university settings, and those developers now serve as the purveyors of the models. While university-based purveyors may benefit from cross-departmental partnerships, they may also face restrictions that limit their ability to scale services (e.g., university overhead rates).

Purveyors must navigate the needs and expectations of their new, child welfare agency implementation partners. Jurisdictions can promote alignment and shared understanding by identifying and resolving discrepancies between child welfare agency and model requirements prior to implementation, and by maintaining open channels of communication between the purveyor, child welfare agency, and service providers.

As more states begin implementing the Family First Act and more program models become eligible for funding, model purveyors’ role in implementation will expand. Purveyors will partner with new jurisdictions to implement their models and/or scale services in existing locations. For more information on the needs of purveyors and other related factors that can facilitate the scaling of evidence-based programs (i.e., skilled workforce, data monitoring and evaluation capacity, and leadership and support), see Considerations for Scaling Evidence-Based Prevention Programs under the Family First Prevention Services Act.

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This research was funded by the Annie E. Casey Foundation. We thank them for their support but acknowledge that the findings and conclusions presented in this report are those of the author(s) alone, and do not necessarily reflect the opinions of the Foundation.

References

[1] The Family First Act includes several other provisions. For an overview of the Act and additional resources, see www.FamilyFirstAct.org.

[2] Three additional programs have been approved for transitional payments through independent systematic reviews.

[3] Fagan, A.A., Bumbarger, B.K., Barth, R.P., Bradshaw, C.P., Rhoades Cooper, B., Supplee, L.H., & Klein Walker, D. (2019). Scaling up evidence-based interventions in US public systems to prevent behavioral health problems: challenges and opportunities. Prevention Science 20, 1147-1168. https://doi.org/10.1007/s11121-019-01048-8

[4] Fagan, A.A., Bumbarger, B.K., Barth, R.P., Bradshaw, C.P., Rhoades Cooper, B., Supplee, L.H., & Klein Walker, D. (2019). Scaling up evidence-based interventions in US public systems to prevent behavioral health problems: challenges and opportunities. Prevention Science 20, 1147-1168. https://doi.org/10.1007/s11121-019-01048-8

[5] Neuhoff, A., Loomis, E., & Ahmed, F. (2017). What’s standing in the way of the spread of evidence-based programs? The Bridgespan Group. https://www.bridgespan.org/insights/library/performance-measurement/the-spread-of-evidence-based-programs 

[6] Aarons, G. & Chaffin, M. (2013). Scaling-up evidence-based practices in child welfare services systems. CYF News. https://www.apa.org/pi/families/resources/newsletter/2013/04/child-welfare

[7] While these two case studies highlight important considerations, additional findings would likely emerge from interviews with more purveyors and implementing providers.