Developing Infrastructure to Support a State System of Prevention
Background and Purpose: Coordinating a statewide, multi-agency, system of home visiting services that supports over 200 evidence based home visiting programs in a large, diverse state is a daunting task. In 2009, Illinois received federal funding to develop the infrastructure for evidence-based home visiting programs in the state and evaluate the progress of that infrastructure development. Central to the evaluation was the question of whether a diverse state system could be coordinated to deliver supports across a variety of programs to meet the needs of both programs and at-risk families. For the past 4 years, the evaluation has examined key developments within the state system and how the system supports communities in implementing home visiting programs with quality and model fidelity. This presentation will focus on the professional development and training component of the state infrastructure.
Methods: The evaluation is a mixed methods study with three main components: a process evaluation of the state infrastructure, a study of an array of trainings to support home visitors, and an administrative data study of performance, capacity, and fidelity indicators. Primary data collection methods about training include structured surveys from about 400 home visitors and semi-structured interviews and focus groups with state agency administrators and a sample of local providers. Training data were analyzed using effect size calculations to monitor growth in knowledge from pre to post training and whether that effect is maintained at a third point once the worker has returned to the field. Qualitative data were analyzed for key trends and themes among home visitors with regard to training or needs for training. Additionally, GIS mapping was used to analyze the spread of training by topic throughout the state over a 2-year period.
Results: Over time we have observed growth in several domains of the state system of support, especially in leadership, state-level collaboration, and professional development and training. Trainings were developed to meet needs identified by home visiting providers and delivered throughout the state. Analysis indicates significant growth in knowledge and confidence among workers at the time of training, as well as retention of knowledge and confidence, and application of training at follow-up, effect sizes (Cohen’s d) >1. Analysis also showed the spread and saturation of key topic trainings throughout the state, informing system stakeholders of regions where training remained minimal and needs may still exist.
Conclusions and Implications: The initiative has resulted in a number of accomplishments that strengthened the training infrastructure, leadership, inter-agency collaboration, and administration of the system. Training has been effective in bringing new knowledge to home visiting staff and increasing confidence in work with high risk families. Further, it is evident that a diverse system of home visiting providers across a large geography can be reached by a centralized training provider, and meet the needs of these diverse providers. At the same time, unstable state funding and other, challenges remain in the state’s efforts to strengthen the system and improve program quality and fidelity.