Testing the CrOss Systems Technical Assistance for Retaining Staff (COSTARS) Model for Improving Staff Retention Among Child Welfare Workers and Peer Supporters, and Implementation of Evidence Based Interventions. (COSTARS)

February 23, 2026 updated by: Alicia Bunger

Staffing and Supports for Implementing Cross-System Interventions With Peer Mentors

The goal of this study is to test whether the CrOss System Technical Assistance for Retaining Staff (COSTARS) supervision leadership institute can promote workforce stability and improved implementation outcomes within the Ohio START child welfare program. The main questions it aims to answer are:

  • Among supervisors, caseworkers, and family peer mentors, what is the effect of COSTARS on staff retention and perceptions of the work environment?
  • What is the effect of COSTARS on service timeliness, implementation fidelity, and parent outcomes within Ohio START?

Researchers will compare public children services agencies implementing COSTARS to those implementing supervision practices as usual to see if there are differences between groups in the outcomes described above.

Participating supervisors will:

  • Complete a 6-hour training workshop in the FOCUS model of supervision.
  • Participate in monthly group coaching sessions with other supervisors, for approximately one year.
  • Receive individualized feedback from coaches about their supervision performance.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • Not Applicable

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Adults employed as supervisors in child welfare agencies who are leading teams of case workers and family peer mentors as part of Ohio START implementation.

Exclusion Criteria:

  • Not involved in Ohio START

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

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: COSTARS
To receive the COSTARS intervention
Other: COSTARS
CrOss System Technical Assistance for Retaining Staff (COSTARS) is designed to help child welfare supervisors support the case workers and family peer mentors on their teams so that they can deliver programs like Ohio START to families affected by substance use disorder. COSTARS will deliver personalized coaching support to child welfare supervisors by a pair of coaches: one with child welfare expertise and one with lived recovery/child welfare experience. Supervisors will participate in a group training that emphasizes supportive supervision practices, and then receive up to two years of ongoing coaching support that involves monthly calls, and written feedback based on recorded supervision sessions.
Other: Implementation As Usual
Implementation as Usual includes training on the model, monthly technical assistance calls focused on model fidelity, regular audits of programmatic data, and monthly group calls with implementers from across the state.
Active Comparator: Implementation As Usual
Other: Implementation As Usual
Implementation as Usual includes training on the model, monthly technical assistance calls focused on model fidelity, regular audits of programmatic data, and monthly group calls with implementers from across the state.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change Over Time in Employee Intention to Leave Position, as Assessed by the Turnover Intention Scale (TIS-6)
Time Frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
The Turnover Intention Scale (TIS-6) measures the degree to which an employee intends to leave their job.
Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Staff Retention
Time Frame: Collected at Baseline, Year 2, Year 3, Year 4, Year 5
Number of months family peer mentors and caseworkers serve in their position.
Collected at Baseline, Year 2, Year 3, Year 4, Year 5

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change Over Time in Service Timeliness
Time Frame: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.

Count of days to receive:

  • Family peer mentor visit
  • Substance use disorder assessment
  • First substance use disorder treatment
Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Implementation Fidelity
Time Frame: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.

Delivery of START model components.

  • Family peer mentor visit, any substance use disorder treatment, medically assisted treatment (binary)
  • Total number of substance use disorder treatment sessions received (count)
Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Program Completion Rate
Time Frame: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Administrative records indicate parent discharge reason as "completed the family case plan" (binary)
Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Family Reunification Rates
Time Frame: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
At the time of child welfare case close, proportion of child(ren) who are living with family.
Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Perceived Stigma as assessed by the Child Welfare Worker Attitudes about Addiction Scale
Time Frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
This scale contains 13 items rated along a 6-point scale from 0 = strongly disagree to 6 = strongly agree
Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Role Clarity as Assessed by the Role Conflict-Role Ambiguity Scale
Time Frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
This scale contains 14 items that measure the degree to which respondents perceive that there is conflict or incongruence (8 items; role conflict) and uncertainty in what is expected of them in their role (6-items, role ambiguity). Participants rate each statement on a 7-point scale (1=Very false, 7=Very true)
Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Implementation Leadership as Assessed by the Implementation Leadership Scale (ILS)
Time Frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
The Implementation Leadership Scale (ILS) measures the degree to which those in leadership positions support or hinder the process of implementation. This scale contains four subscales (proactive, knowledgeable, supportive, and perseverant leadership) measured using 12 items that are rated on a 5-point scale from 0=not at all to 4=very great extent.
Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Implementation Climate as assessed using a 9-item scale
Time Frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
The degree to which START is perceived to be expected, supported, and rewarded within the systems will be assessed using a 9-item scale that assesses innovation supports, expectations, and rewards. Items are rated on a 5-point scale from 1=disagree to 5=agree.
Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Job Satisfaction as Assessed by the Job Satisfaction Survey (JSS)
Time Frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
This survey was developed for use in human service and public organizations and contains 36 items that reflect satisfaction with 9 job dimensions: pay, benefits, contingent rewards, promotion opportunities, supervision, nature of the work, communication, coworkers, and work conditions. Items are rated on a 6-point scale from 1=disagree very much to 6=agree very much. The JSS is one of the few job satisfaction scales with evidence of validity and reliability.
Collected at Baseline, Year 2, Year 3, Year 4, and Year 5

Collaborators and Investigators

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

Sponsor

Alicia Bunger

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 (Estimated)

March 30, 2026

Primary Completion (Estimated)

August 31, 2030

Study Completion (Estimated)

August 31, 2030

Study Registration Dates

First Submitted

September 17, 2025

First Submitted That Met QC Criteria

February 23, 2026

First Posted (Actual)

February 27, 2026

Study Record Updates

Last Update Posted (Actual)

February 27, 2026

Last Update Submitted That Met QC Criteria

February 23, 2026

Last Verified

September 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • R33DA059893 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Sharing Time Frame

August 31, 2030

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • ANALYTIC_CODE
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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.

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