Over 268,000 children entered foster care in the United States during fiscal year 2019
despite the existence of Maltevidence-based programs (EBPs) that can successfully prevent
child maltreatment. Evidence-informed decision-making (EIDM) can lead to the adoption of
EBPs that are likely to be successfully implemented and result in the intended impacts.
Despite the existence of EBPs to prevent child maltreatment, EBPs are underutilized in
child welfare. Proposed study activities in this career development award respond to NIMH
Objective 4.2.c by developing, refining, and piloting an implementation strategy to
increase EIDM when decision makers are adopting EBPs to improve mental health and child
welfare services. Activities leverage an unprecedented federal policy opportunity to
prevent child maltreatment and test implementation decision support strategies in the
real world: The Family First Prevention Services Act (FFPSA). FFPSA aims to prevent child
maltreatment and foster care entries by providing federal funding to states for
implementing EBPs that support child and parent mental health, reduce parental substance
misuse, and improve parenting skills. This project engages decision makers from four
states implementing FFPSA to extend the candidate's prior work developing an innovative
EIDM tool to support EBP adoption: Optimizing Responses through Collaborative Assessments
(ORCA). ORCA is based in multi-criteria decision analysis, which provides a structured
approach to reach quality, evidence-informed group decisions. Given that group decisions
with tools such as ORCA benefit from facilitation, this study will develop and test two
facilitation modalities to accompany ORCA: automated (ORCA-A) and live (ORCA-L). In
addition, a web-based platform to host the ORCA tool and the ORCA-A facilitation strategy
will be developed with decision makers' input (Aim 1). The impact of ORCA-A and ORCA-L on
quality of decision experiences, processes, and outcomes then will be tested (Aim 2).
Implementation process quality for each EBP adopted with ORCA-A and ORCA-L will be
monitored (Aim 3). To enhance her strong foundation in the implementation, decision, and
systems sciences, the candidate, Dr. Gracelyn Cruden, will leverage these research
activities and training activities to expand her skillset to include: leading
implementation studies in service systems, employing a continuum of methods for engaging
community members, leveraging interdisciplinary approaches for eliciting members'
preferences, conducting advanced simulation model testing, and using advanced statistics
for multilevel, longitudinal studies. Cruden will be mentored by an outstanding team led
by Primary Mentor Dr. Lisa Saldana, who is accompanied by Mentors Dr. Jason Chapman, Dr.
Lindsey Zimmerman, Dr. R. Christopher Sheldrick, Dr. Jonathan Purtle, and Consultants Dr.
David Vanness, and Ms. Clare Anderson. Upon completion of these activities, Cruden will
be equipped to lead an interdisciplinary research team that will support quality mental
health and child welfare services by increasing decision makers' use of EIDM.