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The Washington State Institute for Public Policy (WSIPP) reports
that high-fidelity Intensive Family Preservation Services (IFPS) reduce
out-of-home placements, reduce official reports of child abuse and
neglect, and produce a benefit of $2.54 for every dollar spent. In
contrast, low-fidelity IFPS programs have mixed results.
Fidelity
in the WSIPP meta analysis was based on the level of documented
adherence to the HOMEBUILDERS ® model. Sixteen components essential to
the model were identified:
- Imminence of placement
- 24/7 intake availability
- Immediate response to referral
- Service in the natural environment
- Intensity of services
- Brevity of services
- 24/7 availability to clients
- Two-family caseload
- Single therapist with team back-up
- Organizational support (flextime and training)
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- 24/7 consultation availability
- Accountability (tracking outcomes)
- Flexibility and responsiveness of services
- Interactive assessment and goal setting
- Teaching/skills-based approach
- Concrete/advocacy services
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Of the 14 IFPS evaluations reviewed, 4 documented adherence to 13 or
more of the essential components and were considered high-fidelity. The
remaining 10 evaluations documented adherence to 5 or fewer of the
essential components. Combined results from all 14 studies showed no
significant effect of IFPS on out-of-home placement.
However, separating out the IFPS programs demonstrating fidelity
to the HOMEBUILDERS® model showed that these programs reduced
out-of-home placement by 31%. The high-fidelity programs also
significantly reduced subsequent official reports of child abuse and
neglect.
WSIPP then estimated the cost of child abuse and
neglect in the areas of crime, test scores, K-12 grade repetition, high
school graduation, and drug/alcohol use. The benefit–cost ratio was
$2.54 in benefits for each dollar of IFPS services.
What are the implications of this study?
- High-fidelity
IFPS programs are highly effective. From the beginning, IFPS has held
itself to an outcome standard of reducing out-of-home placements. That
outcome is clearly met with high-fidelity IFPS programs. Not only is
that standard met, but high-fidelity IFPS also reduces future
maltreatment and is cost-effective.
- The demonstrated outcomes of high-fidelity IFPS place it
firmly in the continuum of services of Evidence-Based Practice (EBP) in
the child welfare system. The high-fidelity studies included two
randomized control trials and two well-controlled quasi-experimental
(comparison group) evaluations.
- The EBP status of high-fidelity IFPS will bring renewed
interest in the HOMEBUILDERS® model. The parent agency, Institute for
Family Development (IFD), is available to provide training and
resources to agencies that wish to implement the HOMEBUILDERS® model.
- A key component to ensuring high model fidelity is ongoing
quality assurance. Every agency offering IFPS needs to establish a
Quality Assurance component.
- More funding will be needed to establish high-fidelity
IFPS programs, including program design, training, 24/7 availability,
limited caseloads, tracking outcomes, adequate supervision, and quality
assurance. Agencies need to begin to identify funding sources.
Government agencies and foundations should be encouraged to prioritize
funding for high-fidelity IFPS based on their good outcomes and
cost-effectiveness.
- Agencies that do not offer high-fidelity IFPS may need to
consider retooling or else seek funding to demonstrate that their
programs are also effective.
- It is important to note that some of the programs studied
may well have had higher adherence to the IFPS model than was
documented in the research. Future researchers will want to include
fidelity measures in their research design, so that the programs
studied can be accurately categorized.
Download the full research report online:
http://www.wsipp.wa.gov/rptfiles/06-02-3901.pdf
For more information on the HOMEBUILDERS® model, visit the Institute for Family Development website (www.institutefamily.org).
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