Fiscal-Institutional Determinants of Organizational Infrastructure to Support Research Evidence Use in Private Child Welfare Agencies

Background/Purpose. The current study examined variation in four types of organizational infrastructural supports for research evidence use (REU) in private child welfare agencies (PCWAs). These supports range from intraorganizational to interorganizational in nature, and concern: (1) strategic alignment (SA), involving internal efforts to establish an organizational culture and climate that prioritizes evidence use; (2) technical infrastructure, involving internal data systems and/or other tools that facilitate access/use of evidence; (3) knowledge management staff positions designed to build capacity to use/promote evidence; and (4) linkage/exchange ties to external knowledge brokers. Although research has identified the importance of these and other infrastructural supports for REU in public health systems (e.g., Hu et al., 2019; Makkar et al., 2018) and in implementation science (e.g., Moullin et al., 2019), social work research has not systematically charted the incidence of intraorganizational and interorganizational infrastructural supports in PCWAs. Nor has research examined whether these supports are informed by fiscal-institutional factors promoting REU.

Methods. This study drew upon a 2016 online survey of executive directors of 219 of 414 PCWAs (53% response rate) in six US states. Quantitative measurement of the four types of organizational infrastructural supports (which served as dependent variables) involved counts of: (1) (for strategic alignment) specific attention to REU in formal agency documents (e.g., mission statements, strategic plans, position descriptions); (2) (for technical infrastructure) organizational access to computers, internet, internal management information systems, and statewide child welfare databases; (3) (for knowledge management) administrative positions responsible for supporting/disseminating research (e.g., continuous quality improvement, information technology, research/evaluation); and (4) (for linkage/exchange ties) connections to external researchers, professional associations, and research use networks. Fiscal-institutional predictors of the four types of infrastructural supports concerned whether PCWAs were required to: implement interventions from an EBP list; conduct research/evaluation as part of a grant/contract; and incorporate findings of statewide child welfare system improvement plans and regulations. Two additional dichotomous predictors concerned whether PCWAs received: (1) revenue based upon capitation or another managed care system of financial controls; and (2) revenue based upon one or more performance-based contracts (PBC). Separate multivariate negative binomial regression analyses were run, while controlling for organizational demographic factors and clustering standard errors by state.

Results. Multivariate findings suggested that: requirements to conduct research/evaluation as part of a grant/contract were associated with knowledge management (IRR=1.22); and, self-perceived pressures to incorporate findings of statewide child welfare system improvement plans and regulations were associated with knowledge management (IRR=1.14) and with linkage/exchange ties (IRR=1.29). Related fiscal-institutional factors associated with the four types of infrastructural supports included: PBC was associated with technical infrastructure (IRR=1.09); and, capitation was associated with technical infrastructure (IRR=1.08) and with linkage/exchange ties (IRR=1.52).

Conclusions/Implications. Although fiscal-institutional variation existed across the intraorganizational and interorganizational infrastructural supports, executive directors of PCWAs in the six states appeared to use knowledge management staff, and develop relationships with external research bodies, in response to public child welfare agency requirements. The non-significance of EBP implementation requirements implies that executive directors may see EBPs as important but difficult to incorporate in the agency context.