Organization Intervention Assignment Part 2
By: Rickard Jean-Noel
“Child First” is one of the few programs on evidencebasedprograms.org that has a “Near Top Tier”. According to the website the “Child First” program is “a home visitation program for low-income families with young children at high risk of emotional, behavioral, or developmental problems, or child maltreatment”. Their website goes on to state that their evaluation methods is “A well-conducted randomized controlled trial (RCT) with a sample of 157 low-income families”. The article went on to state that the “Child FIRST” is a “home visitation program for low-income families with children ages 6-36 months at high risk of emotional, behavioral, or developmental problems, or child maltreatment, based on child screening and/or family characteristics such as maternal depression. Families are visited in their homes by a trained clinical team consisting of (i) a master’s level developmental/mental health clinician, and (ii) a bachelor’s level care coordinator” (https://evidencebasedprograms.org/programs/child-first/)
There are four components that we can try to identify in the article regarding the study by “Child FIRST”. The first component of intervention monitoring and evaluation we would look for would be “evaluability or formative assessment”, which “answers the question whether or not a change initiative is in a position to be evaluated and whether or not to exert the resources and effort needed to properly complete an outcome evaluation”. We can see that this concern was addressed in the highlights on the “Child FIRST” evidence rating page. It goes on to state that “At the three-year follow-up, a 33% reduction in families’ involvement with child protective services (CPS) for possible child maltreatment. At the one-year follow-up, 40-70% reductions in serious levels of (i) child conduct and language development problems, and (ii) mothers’ psychological distress”. These statements not only would show that the results were being measured, but also that the program experienced success. These statements can also be used to justify that they also used “Process Evaluation” which according to the modules slides state that it is “used to determine how well the intervention is being implemented and whether or not it is following the plan of the logic model. It allows programs to self-correct prior to moving to outcome evaluation”. We can see in the article that this is addressed under “OTHER” which states “A study limitation is that its sample was geographically concentrated in Bridgeport, Connecticut. Replication of these findings in a second trial, in another setting, would be desirable to confirm the initial results and establish that they generalize to other settings where the program might be implemented (https://evidencebasedprograms.org/document/child-first-evidence-summary/).
One of the most important factors is “Outcome Evaluation”. This is because it is used to “answers the question whether or not the change has been effective and achieved the expected outcomes stated in the logic model. In the article “Evidence Summary for Child FIRST” it describes the success of the program by displaying the benefits to society as: “At the three-year follow-up, a 33% reduction in families’ CPS involvement for possible child maltreatment. One year after random assignment, 40-70% reductions in serious levels of (i) child conduct and language development problems, and (ii) mothers’ psychological distress. In regard to “Cost-benefit analysis”, the price of the program per family was said to be approximately $7,285 in 2017 for the services to be delivered. Based on their success rate, they feel as if the price is justified (https://evidencebasedprograms.org/document/child-first-evidence-summary/).
There were several date sources used during the evaluation activities. The most obvious would be key informants, which would be the social worker and case worker that are going into the client’s homes, and ACS. This is also a focus group because a certain group of people in a certain location are being tested. This data is also based on direct observation, which is what the workers will do in the client’s home. There were also several measures used to collect data during the evaluation. This includes behavioral measures, which track the change in the client’s behavior. There was also a standardized scale which would be used to compare this study to others. There was also a self-anchored rating scale based on the success of the first program. A quantitative measure would be that in 2017 it costed $7,285 per family for this program. Another quantitative measure would be that during the 3 year follow up it was 33% reduction in family’s involvement with CPS. An example of qualitative date from the article would be “Child FIRST and control group families in the original randomized sample, as well as the follow-up sample, were highly similar in their observable pre-program characteristics (e.g., demographics, child language and behavior, and maternal mental health)” (https://evidencebasedprograms.org/document/child-first-evidence-summary/).
In Conclusion is it safe that say that the “Child FIRST’ program is a great idea and how it is highly successful. The only downsize to the program would be the price per family. That can be justified if it is cost efficient in the long run. This would have to be justified by those running the program and those that are in the program receiving those services.