背景:改善青少年司法(JJ)系统行为健康服务中的家庭参与是JJ系统的高度优先事项,改革组织,和美国各地的家庭倡导团体。家庭驱动型护理(FDC)是青年服务系统使用的家庭参与框架,用于提高组织各级的家庭发言权和决策权。家庭驱动的护理系统的关键领域包括:1)确定家庭并使其参与所有过程,2)准确告知家庭,可以理解,和透明的信息,3)与家庭合作做出决定和计划治疗,4)回应家庭多样性和包容性,5)与家庭合作,做出组织决策和政策改变,6)提供家庭同伴支持的机会,7)提供后勤支持,帮助家庭克服参与障碍,8)解决家庭健康和功能问题。FDC加强家庭参与,赋权,和青年服务的决策权;最终,改善青年和家庭行为健康结果,增强家庭与儿童的联系,并减少JJ环境中的青少年累犯。
方法:我们评估了工作人员认为在佐治亚州拘留和社区服务机构中采用FDC的八个领域。我们收集了混合方法数据,涉及调查和对JJ系统管理员的深入定性访谈,工作人员,和从业者在2021年11月至2022年7月之间。总的来说,来自61个独特的JJ机构的140人参加了调查;16名JJ主要线人参加了定性访谈。
结果:各机构接受率最高的FDC领域包括识别和涉及家庭,通知家人,协同决策和治疗计划,家庭多样性和包容性。其他领养混合或较低的领域包括让家庭参与组织反馈和政策制定,家庭同伴支持,后勤支援,家庭健康和功能。FDC领域的采用因员工和组织特征而异。
结论:这种混合方法评估的结果将为该州JJ机构扩大FDC战略的战略规划提供信息,并作为评估在国家系统中应用家庭参与做法的优势和劣势的模板。
BACKGROUND: Improving family engagement in juvenile justice (JJ) system behavioral health services is a high priority for JJ systems, reform organizations, and family advocacy groups across the United States. Family-driven care (FDC) is a family engagement framework used by youth-serving systems to elevate family voice and decision-making power at all levels of the organization. Key domains of a family-driven system of care include: 1) identifying and involving families in all processes, 2) informing families with accurate, understandable, and transparent information, 3) collaborating with families to make decisions and plan treatments, 4) responding to family diversity and inclusion, 5) partnering with families to make organizational decisions and policy changes, 6) providing opportunities for family peer support, 7) providing logistical support to help families overcome barriers to participation, and 8) addressing family health and functioning. FDC enhances family participation, empowerment, and decision-making power in youth services; ultimately, improving youth and family behavioral health outcomes, enhancing family-child connectedness, and reducing youth recidivism in the JJ setting.
METHODS: We evaluated staff-perceived adoption of the eight domains of FDC across detention and community services agencies in the state of Georgia. We collected mixed methods data involving surveys and in-depth qualitative interviews with JJ system administrators, staff, and practitioners between November 2021- July 2022. In total, 140 individuals from 61 unique JJ agencies participated in surveys; and 16 JJ key informants participated in qualitative interviews.
RESULTS: FDC domains with the highest perceived adoption across agencies included identifying and involving families, informing families, collaborative decision-making and treatment planning, and family diversity and inclusion. Other domains that had mixed or lower perceived adoption included involving families in organizational feedback and policy making, family peer support, logistical support, and family health and functioning. Adoption of FDC domains differed across staff and organizational characteristics.
CONCLUSIONS: Findings from this mixed methods assessment will inform strategic planning for the scale-up of FDC strategies across JJ agencies in the state, and serve as a template for assessing strengths and weaknesses in the application of family engagement practices in systems nationally.