Using Implementation Drivers Framework to Understand Implementation Barriers & Levers to an Intervention at the Intersection of Domestic Violence & Child Welfare

Background and Purpose: Implementation science, which aims to illuminate the complex workings of implementing innovations, has utility for social work intervention research that seeks to challenge injustice through practice and system change. To ground the federally-funded U.S. Quality Improvement Center on Domestic Violence in Child Welfare (QIC-DVCW), the QIC-DVCW utilized distinct implementation science frameworks to assess implementation (e.g., stages, fidelity, teams, implementation drivers) of the three demonstration projects. This implementation science approach served toward achieving QIC-DVCW’s aim to test an approach to improve how child welfare agencies and their partners work collaboratively to help families experience domestic violence. As part of this process, key informant interviews were conducted at the end of the five-year project. The purpose of the key informant interviews was to understand QIC-DVCW project key decision makers’ perceptions of what supported and got in the way of the intervention at the end of the implementation.

Methods: The study interview guide was collaboratively developed by members of the QIC-DVCW management team. Questions focused on two main research questions: what supported and what got in the way of the implementation of the intervention? Two researchers (the first and second authors) conducted 26 remote interviews, with individuals from the three demonstration sites, who were on site-level implementation and/or management teams, had been trained in the intervention and/or had significant project engagement. After audio recordings were professionally transcribed, they were uploaded into Dedoose, a qualitative software, where, based on a research team developed codebook, they were coded by two research team members and then analyzed using thematic analysis principles, including case by case comparison. An Implementation Drivers framework was applied after thematic analysis was conducted.

Results: From participants’ responses, what supported and got in the way of the implementation were most often two sides of the same coin. This both/and perception of implementation experiences clustered into two themes with the corresponding implementation drivers: (1) technical assistance provision (Drivers = Systems Intervention, Training, Coaching) and (2) collaboration efforts across systems (Drivers = Systems Intervention and Fidelity). The uniquely identified barrier to implementation of the Approach surfaced across all participants was environmental/structural barriers (Drivers = Facilitative Administration, Systems Intervention, Leadership). While the uniquely identified levers that led to support of implementation were the project change agents (Drivers = Facilitative Administration and Leadership).

Conclusion and Implications: Interventions implemented in real time across multiple systems, to solve intractable problems such as adult and child domestic violence survivors being caught up in the child welfare system, are complex and require concentrated time and effort to get in place and then evaluate. This study adds to the literature of both DV-child welfare interventions and implementation science, examining what supported and got in the way of a distinct multi-site intervention implementation, the QIC-DVCW. The Implementation Drivers framework’s application in this study, identifying and categorizing the complex workings of implementation, demonstrates its ongoing utility in social work implementation research.