Evaluating implementation strategies in a community model to facilitate early identification and treatment of developmental and social-emotional problems in young children in out-of-home placement

Young children who have been removed from their homes and placed in the child welfare system due to abuse and neglect are at high risk for a variety of developmental and social-emotional problems. Research and policies highlight the importance of coordinated efforts to identify early developmental and social-emotional needs and actively link children with needs to recommended services for this high risk population. These efforts often require service systems and programs to employ multiple implementation strategies. Characterizing implementation from these community-driven implementation efforts has the potential to generate generalizable knowledge about the utility, relevance and effectiveness of specific strategies used to promote implementation. In a large metropolitan region, the area's pediatric health care center and county child welfare system collaborated to implement complementary strategies and services to support young children, caregivers and birth parents, in addition to providing social workers with timely evaluations to support their decision making and case planning. The purpose of this study is to (1) retrospectively characterize the specific implementation strategies employed to deliver a coordinated set of evidence-based screening and linkage practices to facilitate identification and treatment of early developmental and social-emotion problems; and (2) examine preliminary indicators of the impact of these strategies. Implications for addressing this at-risk clinical population and advancing implementation science are discussed.