Trial Outcomes & Findings for TEAMS R34 #1 After-Action Reviews in Child Welfare Services (NCT NCT05629013)

Following completion of the CFT meeting, adult CFT meeting attendees were invited to participate in the trial. CFT meeting attendees included child welfare protective social worker or supervisor, bioparents, resource parents/caregivers, formal supports (e.g., providers, attorneys), and informal supports (e.g., family members, friends). Youth were not enrolled in the study. Under a waiver of consent/assent, administrative data was extracted to assess youth service linkage.

Upon providing their informed consent, participants in the CFT+AAR condition would proceed with the AAR, followed by an anonymous, web-based survey. Participants in the CFT-as-usual condition would proceed with the anonymous, web-based survey only. The web-based survey allowed participants to skip questions. As a result, some participant baseline characteristics remain unknown.

TEAMS R34 #1 After-Action Reviews in Child Welfare Services

Items from the Satisfaction subscale of the Collaboration \& Satisfaction About Care Decisions (CSACD) measure was used in this study to assess satisfaction with the decision-making process, and satisfaction with the decision itself. Each participant completes the CSACD Satisfaction items immediately following their completion of the intervention (\<1 hour). Participants respond to each item using a 7-point likert-type scale ranging from 1=strongly disagree to 7=strongly agree. Higher values indicate greater satisfaction.

For child welfare involved youth with behavioral health treatment plans, SD County Behavioral Health Administrative Data will be assessed to determine successful service linkage. Data indicate whether or not a child welfare involved youth utilized behavioral health services at any time through study completion.

Three subscales of the Mathieu Team Processes Scale were administered to participants immediately following study participation (\<1 hour) to assess the team process of the CFT. The subscales included goal specification, strategy formulation, and coordination. Participants respond on a scale ranging from 1=Not at all to 5=to a very great extent. Scale scores are computed by calculating the average item response. Higher scores indicate better team processes.

This 12-item measure will be administered to CFT+AAR participants immediately following completion of the CFT+AAR intervention (\<1 hour). The measure includes three subscales assessing the After-Action Review's 1) Acceptability (appealing, liked, and welcomed in their setting), 2) Appropriateness (fitting, suitable, and applicable in their setting), and Feasibility (possible and doable in their setting). Each item is rated using the following response options: 1=completely disagree, 2=disagree, 3=neither agree nor disagree, 4=agree, and 5=completely agree. Subscale scores are calculated by averaging responses for items representing acceptability, appropriateness, and feasibility, respectively. Higher scores reflect greater acceptability, appropriateness, and feasibility.

Card sorting elicits individual mental models to understand how participants structure their knowledge. In closed card sorts, participants are similarly given a set of key concepts, but participants are given pre-defined categories that each concept must be sorted into. Within team environments, card sorting can be used to examine the degree to which team members are thinking about key concepts in a similar manner (e.g., team mental models) by comparing the categories and sorted content across members. For this proposal, each participant will complete the card sorting task immediately following completion of the intervention (\<1 hour). The card sort task includes 11 tasks that participants bust organize into CFT member roles. Card sorts can be scored by analyzing team-level same bucket counts. Team-level same bucket count scores range from 0 to 11. Higher scores indicate greater shared mental model.

The 5-item scale assesses perceptions of affect-based trust amongst CFT members. Items center on individual's perceptions that team members can share ideas freely, that team members listen to one another, that team members care for one another, and that team members are invested in working well with one another. Each participant will complete the measure immediately following their completion of the intervention (\<1 hour). Participants respond on a scale ranging from 1=strongly disagree to 7=strongly agree. Scale scores are computed by calculating the average item response. Higher scores indicate greater trust.

Edmondson's 7-item Psychological Safety Climate Measure evaluates perceptions of the work environment (in this case, the CFT meeting) as being one wherein policies and procedures foster a safe and comfortable space for interpersonal risk. Each participant will complete the Psychological Safety Climate Measure immediately following their completion of the intervention (\<1 hour). Participants respond on a scale ranging from 0=doesn't apply at all to 4=entirely applies. Overall scale scores are computed by calculating the average item response. Higher scores indicate greater psychological safety.

The CFT Meeting Observation Tool is intended to support agencies in evaluating quality of and adherence to intended practice of child and family team (CFT) meetings. Research team observers of the CFT will complete the observation tool throughout the duration of CFT observation indicating the extent to which certain CFT quality practices were present during the CFT meeting. Response options range from 1=strongly disagree to 4=strongly agree. A CFT fidelity score is calculated by taking the average score across items. Higher scores reflect greater fidelity.

Knoll and Van Dick's Silence Measure includes two subscales representing acquiescent silence and quiescent silence. Participants respond on a scale ranging from 1=strongly disagree to 7=strongly agree. Scale scores are computed by calculating the average item response. Higher scores indicate greater acquiescent and quiescent silence.