Supporting Sustainable Positive Interactions in the Child Welfare System: The R3 Supervisor Strategy (R3)

December 16, 2021 updated by: Oregon Social Learning Center
Opportunities to implement and evaluate system-wide change are rare. This observational, Hybrid II study leverages a real-world, system-initiated roll-out of R3, a supervisor-targeted implementation strategy aimed at infusing the use of evidence-based principles across multiple levels of the workforce within a public child welfare system. This project aims to study the effectiveness of R3 in impacting organizational inner-context variables and subsequent positive outcomes for one of the nation's most costly and vulnerable populations-families involved in the child welfare system.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Large knowledge gaps remain regarding strategies to promote change in public child welfare systems (CWS), yet opportunities to evaluate strategies to create system-wide change and the resulting public health impact are rare. The CWS in the United States is populated with vulnerable children and families at high risk for negative outcomes, including substance use, risky sexual behavior, delinquency, incarceration, homelessness, and early mortality. This proposal addresses the National Institute of Health (NIH) priority to understand methods for "scale-up and sustainability of evidence-based interventions." Leveraging a real-world, federally funded, system-initiated effort to infuse the use of evidence-based principles throughout the multi-levels of the Tennessee CWS workforce, this study will evaluate the effectiveness of a supervisor-targeted implementation strategy in creating organizational change and subsequent positive family outcomes. The R3 Supervisor Strategy was developed to modify the way that the CWS workforce supports families toward completing their treatment plans, by utilizing evidence-based behavioral principles found in previous intervention trials to improve system-level outcomes, including child permanency, stability, and well-being. The R3 strategy provides training, consultation, and fidelity-monitoring to supervisors, who are centrally positioned in the system between caseworkers (who have daily interactions with CWS-involved families) and leadership (who make decisions that affect the organization in which families receive services). The three Rs include reinforcement of (1) effort, (2) relationships and roles, and (3) small steps toward goal achievement. R3 is founded on social learning theory; these reinforcement targets are encouraged in interactions between supervisors and their supervisee- caseworkers and between caseworkers and the families they serve. Utilizing a variation of a dynamic wait-listed design, four Tennessee CWS regions (serving over 12,000 children annually) that have been awarded a federal Title-IV-E Waiver and have opted to adopt R3 as part of their waiver plan will be observed. The CWS workforce (n = 85 regional administrators, 50 supervisors, and 220 caseworkers) will be recruited to participate in a Hybrid Type II trial of the effectiveness of R3 in achieving organizational and subsequent positive system-level, client-level outcomes. This project will examine the potential of R3 to influence supervisor interactions with caseworkers and subsequent family outcomes (Aim 1); the impact of R3 on organizational characteristics known to impact staff retention and the successful adoption of innovations such as climate, leadership, readiness, and citizenship (Aim 2); and the potential for maintaining fidelity standards to the R3 strategy as consultation and coaching are fully transferred to the system (Aim3). This project will inform the potential for R3 to effectively infuse evidence-based principles into the daily interactions of those involved in the CWS, and to narrow the gap for achieving outcomes for one of the nations most costly and vulnerable populations-families involved in the child welfare system.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
531

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

17 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The population being studied is the child welfare workforce including supervisors and their staff

Description

Inclusion Criteria:

  • Child Welfare Workforce in the state of Tennessee

Exclusion Criteria:

  • Contract Workers

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
R3 Supervisor Strategy Region 1
First cohort to be trained and monitored with remote coaching in the R3 model
Behavioral: R3 Supervisor Implementation Strategy
Supervisors will be trained to provide supervision to their caseworkers using R3 principles and strategies. Monthly monitoring and remote coaching will be provided.
Other Names:
  • R3
R3 Supervisor Strategy Region 2
Second cohort to be trained and monitored with remote coaching in the R3 model
Behavioral: R3 Supervisor Implementation Strategy
Supervisors will be trained to provide supervision to their caseworkers using R3 principles and strategies. Monthly monitoring and remote coaching will be provided.
Other Names:
  • R3
R3 Supervisor Strategy Region 3
Third cohort to be trained and monitored with remote coaching in the R3 model
Behavioral: R3 Supervisor Implementation Strategy
Supervisors will be trained to provide supervision to their caseworkers using R3 principles and strategies. Monthly monitoring and remote coaching will be provided.
Other Names:
  • R3
R3 Supervisor Strategy Region 4
Fourth cohort to be trained and monitored with remote coaching in the R3 model
Behavioral: R3 Supervisor Implementation Strategy
Supervisors will be trained to provide supervision to their caseworkers using R3 principles and strategies. Monthly monitoring and remote coaching will be provided.
Other Names:
  • R3

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Examination of child welfare supervisor ratings using the Fidelity of R3 Implementation for Supervisors (FRI_S) standardized measurement.
Time Frame: Monthly for 3 years from baseline to 36 months
The Fidelity of R3 Implementation for Supervisors (FRI_S) measure will be used to rate supervisors' monthly delivery of the R3 model with fidelity over time, from baseline to 36 months.
Monthly for 3 years from baseline to 36 months

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Organizational Climate, Leadership, Readiness, Attitudes toward Evidence-Based Practice:
Time Frame: Once a year for 3 years
Organizational health and factors known to be related to successful adoption of new practices will be collected from child welfare staff members annually for 3 years.
Once a year for 3 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Oregon Social Learning Center

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
National Institute on Drug Abuse (NIDA)

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 15, 2015

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 31, 2021

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
July 31, 2021

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 14, 2016

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 5, 2017

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 11, 2017

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
December 17, 2021

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 16, 2021

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2021

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • R01DA040416 (NIH)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Behavioral

Clinical Trials on R3 Supervisor Implementation Strategy

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Cookie Settings

We use cookies to ensure that we give you the best experience on our website. For more details carefully read our Privacy and Cookies Policy. ...>>>You can change your preferences or withdraw your consent at any time by deleting the cookies from your website or computer as described in the policy. Please accept it and choose your preferences by ticking the corresponding boxes in the "Manage Settings" section below. Please carefully read our Terms of Service before you proceed with using any part of this website.
«Manage Settings