(Converted as ePoster, See Poster Gallery) Interprofessional Collaboration, Job Stress, and Intention to Leave Among the Child Welfare Workforce: A Structural Equation Model

Background and Purpose: Stress, dissatisfaction, and turnover are common problems among the child welfare workforce and can contribute to adverse worker health outcomes, financial strain on agencies, and a lack of service continuity for children and families. In healthcare settings, interprofessional collaboration (IPC) has been shown to improve job satisfaction and retention through improving efficiency and professionals’ sense of efficacy. Despite the integral role of such collaboration between case management staff, court professionals, and service providers in the child welfare system, little research has been conducted on the potential role that IPC may play in improving working conditions and workforce outcomes in this setting. Accordingly, this secondary data analysis used structural equation modeling to examine the extent to which increased levels of IPC were directly and indirectly associated with child welfare staff’s appraisals of time pressure, job stress, job satisfaction, and intention to remain in the profession.

Methods: This study utilized data from the National Child Welfare Workforce Institute’s Comprehensive Organizational Health Assessment survey that was administered in two Midwestern state agencies and one large West Coast county agency. The subsample analyzed (n = 1505) consisted of staff who worked directly with families and collaborated at least monthly with court professionals and service providers. Using a randomly selected half of participants to fit measurement and structural models, a series of confirmatory factor analyses were conducted to assess fit between individual scale items and their intended constructs. A general structural equation model was then hypothesized based upon the transactional model of stress and coping, and was then cross-validated using both subsamples to ensure model stability.

Results: Overall, the proposed measurement and structural models fit the data well. Individual scales showed adequate internal consistency (α=.82-.95) and model fit (CFI/TLI=.99-1; RMSEA=.00-.07; factor loadings = .50-.99). Further, the structural model fit the data well in both random subsamples: x²=1181.52, p<.001; CFI=.998; TLI=.998; RMSEA=.04. The model confirmed associations found in the literature between time pressure and stress (β=.73, SE=.03, p<.001), stress and satisfaction (β=-.50, SE=.04, p<.001), satisfaction and intention to remain at one’s agency (β=.72, SE=.04, p<.001), and satisfaction and intention to remain in the child welfare field (β=.68, SE=.04, p<.001). IPC with court professionals was found to predict lower time pressure (β=-.24, SE=.05, p<.001) and higher job satisfaction β=.11, SE=.05, p<.05), while IPC with service providers was only associated with higher job satisfaction (β=.14, SE=.05, p<.01).

Conclusions and Implications: The results of this study suggest that frequent and high-quality IPC in the child welfare system may be linked to key indicators of workforce health within child welfare, and therefore may be a key strategy for improving not only client service quality but also staff effectiveness and resilience. Further, given these initial results, this study indicates a need for further investigation and intervention development regarding the potential individual and systemic impacts of IPC. Administrators, policymakers, and researchers should think critically about strategies to expand and evaluate IPC within the child welfare system as a means of mobilizing scarce resources for system improvement.