What It Really Takes – Planning and Implementing an Online Training Pilot in Child Welfare

Background and Purpose Applying the National Implementation Research Network stages of implementation, this study identifies early-stage implementation strategies of an online pilot training model. The National Adoption Mental Health Competency Training Initiative (NTI) is a web-based curriculum currently being piloted in seven states. NTI is a 20-hour training designed to infuse best practices in adoption mental health within child welfare systems. Targeted technical assistance (TA) is provided to support implementation of the training program within state systems. This study uses qualitative interview data from TA providers to identify their perceptions of the most relevant considerations, barriers, and facilitators to early stage implementation. 

Methods Semi-structured qualitative interviews were conducted during early planning with three TA providers working in pilot states (n = 7). Interviews elicited TA providers’ perceptions of each state’s resources, needs, progress, and plans. Interviews lasted between 30 and 75 minutes and were conducted via telephone by three researchers. Audio recordings were transcribed, then double-coded thematically by two primary coders. Following open coding of the first two interviews, coders established a unified coding scheme, which was then applied to all interviews. Constant comparison methods, guided by a phenomenological approach, informed analyses.  Differences between coders were reconciled through discussion with a third researcher.

Findings Facilitators and barriers to early implementation emerged within three major themes: characteristics of the online training model, organizations, and TA activities.  Because of its evidence-informed designed and emphases on improving permanency outcomes and workforce competencies, NTI was seen as highly relevant to state child welfare agency priorities. The online training platform was perceived to be cost-effective and as presenting minimal staff and administrative burden to systems.  However, delays in curriculum development hampered enthusiasm in some sites and there were concerns about the training length given limited staff time. 

Organizational facilitators to planning included states’ ability to leverage resources such as prior experience with similar initiatives and actively involved, experienced, and directive leaders.  Barriers included delays processing contractual agreements to participate in the project; working with overburdened, novice, or shifting leaders; and integrating NTI with existing trainings.  In addition, TA providers perceived specific system characteristics (e.g., regionalization, privatization) as slowing implementation. 

According to TA providers, planning activities that advanced implementation included investing time in engagement with site leads, careful follow through, and the development of detailed implementation plans with supports for user completion (e.g., set timelines).  TA problem solving activities such as supplementing system gaps as needed (e.g., providing guidance to less experienced leaders or filling administrative support roles as needed) also facilitated progress.

Conclusion and Implications Study results suggest that alignment between innovative practices and agency goals and priorities, alongside efforts to make a training curriculum pragmatic and manageable, promote early stage implementation. Effective TA in early implementation stages is a labor intensive process that must maximizes congruence between initiatives and the perspectives of workers and leverage human and system resources at multiple levels within organizations. Child welfare organizations should partner with consultants who have relevant technical expertise as well as implementation science knowledge.