Co-Creating the Infrastructure to Scale and Sustain Evidence-Based Programs: A Case Study of New York City Preventive Child Welfare Services

Allison Metz

Aim: This presentation shares “what it takes” to align policy and practice in one of largest service systems globally to support effective implementation of evidence-­‐based programs at scale. Changes in policy and regulatory environments to support mainstreaming evidence will be linked to the implementation infrastructure, fidelity scores for 11 evidence-­‐based programs, and outcomes for children and families. Stakeholder roles will be discussed.

Methods: A mixed methods approach will include qualitative data collected through key informant interviews and focus groups which describes how all parties involved negotiated roles and responsibilities in this initiative and developed policy-­‐practice feedback loops to create systems changes. Quantitative data will describe the impact of evidence-­‐based models on service utilization, length of treatment stays, program fidelity, and child outcomes.

Results: Qualitative findings demonstrate three key areas for creating a hospitable environment for scaling evidence: 1) policy-­‐practice alignment ; 2) organizational capacity and leadership; and 3) evaluation and monitoring. Quantitative data demonstrate that the use of evidence-­‐based models has significantly increased the capacity of the service system to meet family needs. Fidelity and outcome data also look promising at early stages of implementation.

Preliminary Conclusions/Discussion: Findings demonstrate that scaling evidence to achieve outcomes is possible under the following conditions: 1) the governmental or public agency is committed and able to make policy, regulatory and funding changes to accommodate for the programs, for example modifying service standards to align with model expectations; and 2) feedback loops involve the public agency, program developer, and service provider to facilitate role clarity.