Is implementation fidelity associated with improved access to care in a school-based Child and Family Team model?

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Effective child and family centered service planning is crucial to addressing vulnerable children's needs. However, there is limited evidence about what facets of these processes improve service use and outcomes. The current study used a Poisson random effects hazard model to test correlations between fidelity to NC's Child and Family Support Team model and time to service receipt, using case management data for 3396 children served by that program during the 2008-2009 school year. Students were more likely to receive recommended services more quickly when caregivers and the students attended planning meetings, when their plans included services for caregivers, and when child and family team leaders followed up after meetings to verify service receipt. Contrary to the Child and Family Support Team theory of change, match between student needs and the lead agency of the meeting was not associated with the odds of quicker service receipt, nor was attendance by natural supports. Findings from this study demonstrate the potential effectiveness of using case management systems to measure service planning process fidelity, as well as how results thereof can both inform process improvement and potential refinements to models' theories of change.





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Gifford, Elizabeth J, Rebecca S Wells, Yu Bai and Patrick S Malone (2015). Is implementation fidelity associated with improved access to care in a school-based Child and Family Team model?. Eval Program Plann, 49. pp. 41–49. 10.1016/j.evalprogplan.2014.11.005 Retrieved from

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Elizabeth Joanne Gifford

Associate Research Professor in the Sanford School of Public Policy

Beth Gifford is an associate research professor in the Sanford School of Public Policy, a core faculty member of the Center for Child and Family Policy and the Margolis Center for Health Policy, and leads the Social and Economic pillar of the Children’s Health and Discovery Institute. She leads a multidisciplinary research team that examines the health and social services engagement of children and families. Motivating her research is the need to understand how social policies and practices can better support children and families. Her work spans many public institutions including education, social services, criminal justice, and health care systems.


Yu Bai

Statistician III

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