Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct;27(6):664-675.
doi: 10.1177/1049731515601897. Epub 2015 Sep 8.

Research-Supported Intervention and Discretion Among Frontline Workers Implementing Home Visitation Services

Cathleen E Willging  1 , Elise M Trott  1 , Danielle Fettes  2 , Lara Gunderson  1 , Amy E Green  2 , Roseann Myers  3 , Michael S Hurlburt  4 , Gregory A Aarons  2
Affiliations

Research-Supported Intervention and Discretion Among Frontline Workers Implementing Home Visitation Services

Cathleen E Willging et al. Res Soc Work Pract. 2017 Oct.

Abstract

Objective: We examine how frontline workers and supervisors delivering a research supported intervention (RSI) to reduce child neglect negotiated system-related challenges, the pragmatics of RSI implementation, and their professional identities and relationships with clients.

Methods: We conducted semi-structured interviews, small group discussions, and focus groups with frontline workers and supervisors in one large county over two time periods. We used iterative coding to analyze qualitative data.

Results: Frontline workers navigated several aspects of RSI implementation and sustainment: (1) contract requirements and information dissemination, (2) fidelity, (3) competing demands and crises, (4) structure versus creativity, and (5) relationships with clients.

Conclusions: Workers dynamically negotiated multiple system- and provider-level (or outer- and inner-contextual) demands influencing RSI provision for clients with complex service needs. Results affirm the need to attend to the unintended consequences of implementing new contract, reimbursement, and other system organizational processes and to address the "committed work" supporting RSI delivery.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Aarons GA, Fettes DL, Flores LE, Jr, Sommerfeld DH. Evidence-based practce implementation and staff emotional exhaustion in children's services. Behaviour Research and Therapy. 2009;47:954–960. doi: 10.1016/j.brat.2009.07.006. - DOI - PMC - PubMed
    1. Aarons GA, Fettes DL, Hurlburt MS, Palinkas LA, Gunderson L, Willging CE, Chaffin MJ. Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice. Journal of Clinical Child and Adolescent Psychology. 2014;43(6):915–928. - PMC - PubMed
    1. Aarons GA, Green AE, Palinkas LA, Self-Brown S, Whitaker DJ, Lutzker JR, Silovsky JF, Hecht DB, Chaffin MJ. Dynamic adaptation process to implement an evidence-based child maltreatment intervention. Implementation Science. 2012;7:32. Available from http://www.implementationscience.com/content/7/1/32. - PMC - PubMed
    1. Aarons GA, Horowitz JD, Dlugosz LR, Ehrhart MG. The role of organizational processes in dissemination and implementation research. In: Brownson RC, Colditz GA, Proctor EK, editors. Dissemination and implementation research in health: Translating science to practice. New York, NY: Oxford University Press; 2012. pp. 128–153.
    1. Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research. 2011;38(1):4–23. doi: 10.1007/s10488-010-0327-7. - DOI - PMC - PubMed