Association for Public Policy Analysis & Management

Ohio has one of the highest rates of drug overdose deaths in the country, more than twice the national rate (U.S. CDC, 2018; California Evidence-Based Clearinghouse for Child Welfare, 2017). In response to the opioid epidemic and increase in service needs, there is increasing demand on public organizations to coordinate efforts to mitigate the effects of the crisis, through education, prevention, treatment, and rehabilitation efforts. Among human service organizations, there is a shift towards collaborative and integrative approaches. Child welfare services are being integrated with substance abuse treatment to address parental addiction and improve parental capacity, while ensuring child well-being.

Children are among the most vulnerable victims of this crisis. From 2013 to 2017, the number of children in the Ohio foster care system increased by almost 3,000 to more than 15,550 primarily due to the effects of the state-wide drug epidemic. In response, the Ohio Attorney General and the Public Children Services Agencies of Ohio, a nonprofit, piloted the Ohio START (Sobriety, Treatment, and Reducing Trauma) program. START is an evidence-based program (EBP) that uses an integrative approach to foster service delivery among child welfare agencies and substance abuse treatment providers to improve outcomes for children and their families.

The implementation of EBPs in child welfare agencies is a relatively new phenomenon with a small, but growing body of research (Horwitz et al., 2010; Horwitz et al., 2014; Mildon & Shlonsky, 2011). Implementation efforts in these agencies is a challenging and complex process, often leading to unsuccessful outcomes due to a variety of factors not properly addressed prior to or during implementation. Extant literature has identified the organizational barriers and facilitators that may impact implementation in these organizations but their effects are not well understood or studied. One of these factors - organizational readiness for implementation - is the subject of this study.

The purpose of this research is to identify the organizational factors that contribute to child welfare caseworkers’ readiness to implement the START program in Ohio. Using organizational readiness for change theory (Weiner, 2009), the study will examine how organizational factors in county-level child welfare agencies impact readiness to affect program implementation. This study will use data from surveys of public managers and caseworkers in seven county child welfare agencies in Ohio collected pre- and post-START implementation. Survey data is coupled with administrative and demographic data, such as the design of contracts between agencies and behavioral health providers, agency capacity, provider density, and other county-level characteristics. The results of this study will advance our understanding of implementation of EBPs in public agencies and support public managers and their organizations as they implement policy initiatives.

This study also complements the conference theme, “Evidence for Action: Encouraging Innovation and Improvement,” which emphasizes the iterative and collaborative nature of the policy process. This research provides a front-line perspective on evidence-based policy, and programmatic decision making, addressing two key questions posed in this year’s call for proposals.