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Is more better? Examining whether enhanced consultation/coaching improves implementation.

Maureen E Murray1, Dalia Y Khoury1, Elizabeth M Z Farmer2

  • 1Services Effectiveness Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.

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Summary

Implementing evidence-based interventions like Treatment Foster Care (TFC) is challenging for community agencies. Enhanced coaching support shows promise for improving TFC implementation and outcomes.

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Area of Science:

  • Implementation Science
  • Child Welfare Research
  • Evidence-Based Practice Dissemination

Background:

  • Community-based agencies face significant constraints (time, resources, personnel) in implementing evidence-based interventions with fidelity.
  • Together Facing the Challenge (TFTC) was developed to improve Treatment Foster Care (TFC), with initial trials showing positive results from study-led support.
  • Dissemination efforts indicated a need for more intensive support for supervisors to ensure consistent and sustained TFTC implementation.

Purpose of the Study:

  • To compare standard consultation with enhanced consultation incorporating a coaching approach for TFTC implementation.
  • To assess the impact of enhanced support on the quality, fidelity, and intensity of TFTC implementation in community agencies.

Main Methods:

  • A randomized trial comparing standard consultation versus enhanced coaching/consultation for TFTC supervisors.
  • Data collection focused on practice changes and outcomes within community-based agencies implementing TFTC.

Main Results:

  • Enhanced coaching/consultation was associated with small- to medium-effect size improvements compared to standard consultation.
  • Initial results suggest that enhanced support strategies can positively influence the implementation of evidence-based models like TFTC.

Conclusions:

  • Enhanced coaching/consultation shows promising results for improving the implementation of evidence-based interventions in community settings.
  • Further research is needed to fully understand the mechanisms and optimal strategies for enhancing implementation support for new evidence-based approaches.