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Theory of Change Logic Models

TOOLS FOR SUSTAINING COMMUNITY CREATED SYSTEMS OF CARE

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Family Participation in Systems of Care

Quick Guide for Self-Assessment of Family-Run Organizations in Systems of Care (2007)

Lazear, K., Anderson, R., & Boterf, E. (2007) Quick guide for self-assessment of family-run organizations in systems of care. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

The Quick Guide is for use by family-run organizations. The guide is divided into nine sections addressing important elements of family-run organization development and sustainability. Each section represents several components or characteristics of effective family-run organizations in a system of care. The guide was derived from the work of Research and Training Center investigators Kathy Lazear, René Anderson & Eloise Boterf.

Monograph: Family Experience of The Mental Health System (FEMHS) - Findings Compendium

Lazear, K. & Worthington, J. (2004). Monograph: Family experience of the mental health system (FEMHS) - Findings compendium. Tampa, Florida: University of South Florida, Louis de la Parte Florida Mental Health Institute, Department of Child and Family Studies, The Research & Training Center for Children's Mental Health.

The Findings Compendium provides a brief summary of the Research and Training Center for Children's Mental Health Study of the Family Experience of the Mental Health System (FEMHS). The study was designed to meet a need for information from family perspectives about service access and delivery, as well as about specific aspects of services that are most and least helpful.

Creating Culturally Competent Systems of Care

Creating a Front Porch: Strategies for Improving Access to Mental Health Services

Callejas, L. M., Nesman, T., Mowery, D., & Hernandez, M. (2008). Creating a front porch: Strategies for improving access to mental health services (Making children's mental health services successful series, FMHI pub. no. 240-3). Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research & Training Center for Children's Mental Health.

This monograph shares results of interviews conducted with personnel from selected organizations and focuses on key practices that were reported to increase accessibility of mental health services for underserved populations. It includes a description of each of the target populations served by the participating study sites, as well as information about the history and context of, and general service delivery information for each organization.

Examining the Research Base Supporting Cultural Competence in Children's Mental Health Services

Hernandez, M., Nesman, T., Isaacs, M., Callejas, L. M., & Mowery, D. (Eds.) (2006). Examining the research base supporting culturally competent children's mental health services. (Making children's mental health services successful series, FMHI pub. No 240-1). Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research & Training Center for Children's Mental Health.

This document results of an in-depth literature review which will become the basis of an attempt to operationalize cultural competence, with the eventual result being an organizational cultural competence assessment tool. This review identifies and describes organizational factors associated with increased access for ethnically/racial diverse children and their families to quality mental health services and supports.

Organizational Cultural Competence: A Review of Assessment Protocols

Harper, M., Hernandez, M., Nesman, T., Mowery, D., Worthington, J., & Isaacs, M. (2006). Organizational cultural competence: A review of assessment protocols (Making children's mental health services successful series, FMHI pub. no. 240-2). Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research & Training Center for Children's Mental Health.

This document contributes to understanding how cultural competence is currently operationalized and measured at the organizational level. This monograph compares organizational assessment instruments through the following questions:

For what type of organization was the instrument developed?
How were the instruments developed?
How do the authors define cultural competence?
What domains do the authors use as categories of analysis?

History and Impact of the Systems of Care Movement

Strategies for System of Care Development: Making Change in Complex Systems

Hodges, S., Ferreira, K., Israel, N., & Mazza, J. (2006). Strategies for system of care development: Making change in complex systems. Tampa, Florida: University of South Florida, Louis de la Parte Florida Mental Health Institute, Department of Child and Family Studies, The Research and Training Center for Children's Mental Health.

This paper introduces a framework for analysis of system implementation. The framework has been utilized by the research team to examine points of leverage in established systems of care in which stakeholders took strategic action to move their systems forward. These concepts related to leveraging system change were informed by Meadows (1999). [300kb pdf]

The System of Care Twenty Years Later

Kutash, K., Duchnowski, A. J., & Friedman, R. M. (2005). The system of care twenty years later. In M. H. Epstein, K. Kutash, & A. J. Duchnowski (Eds.), Outcomes for children with emotional and behavioral disorders and their families: Program and evaluation best practices, 2nd ed. (pp. 3-22). Austin, TX: Pro-Ed.

In this chapter the authors discuss the current impact and relevancy of the system of care model for the children's mental health services system. The chapter begins with a brief description of the context that led to the development of the systems of care nationally. This is followed by an examination of recent empirical advances that have been made in understanding the number of youth who have emotional disorders, components within systems of care, and outcomes related to the model. The chapter concludes with recommended next steps for systems of care research.

Transformation Work Group Report

Friedman, R. (2005). Transformation work group report. Tampa, Florida: University of South Florida, Louis de la Parte Florida Mental Health Institute, Department of Child and Family Studies. Unpublished manuscript.

This report describes the compatibility of the SOC vision, values and principles, and general practices with those expressed by the President's New Freedom Commission. Recommendations are based on findings of a national survey of key stakeholders in the children's mental health field, individual interviews of key informants, and focus groups and general forums were conducted by the Transformation Work Group of the Council on Collaboration and Coordination, CMHS Child and Family Branch.

A Historical Perspective on National Child Mental Health Policy

Lourie, I., & Hernandez, M. (2003). A historical perspective on national child mental health policy. Journal of Emotional and Behavioral Disorders 11(1), 5-10.

This article presents a historical perspective on the formalized child mental health policy in the United States. The perspective ranges from a century to the present day, and discusses challenges associated with the creation of meaningful policy in the area of children's mental health. The difficulty that children and their families have in receiving appropriate services is reviewed, and the need for a comprehensive policy is strongly encouraged.

Financing Strategies for Systems of Care

Critical Financing Strategies with System-level Outcomes, Indicators, Data Sources, and Data Analysis Plan

Hodges, S., Israel, N., Ferreira, K., & Mazza, J. (2007). System implementation issue brief #2 - Critical Factors in System of Care Implementation. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

Within the Center's theoretical framework of critical implementation factors, one set relates to the financing structures and strategies that communities build into their theories of change and implementation plans. This document provides a framework that identifies preliminary sets of financing indicators, system level outcomes, data collection methods, and a data analysis plan for each critical financing component. A resource document to support systems planning, these guidelines were developed by Study 3: Financing Structures and Strategies to Support Effective Systems of Care.

A Self-Assessment and Planning Guide: Developing a Comprehensive Financing Plan

Armstrong, M., Pires, S., McCarthy, J., Stroul, B., Wood, G., & Pizzigati, K. (2006). A self-assessment and planning guide: Developing a comprehensive financing plan. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

The purpose of the Guide is to aid states, communities, tribes, territories, and organizations to assess their current financing structures/strategies; identify outcomes to achieve; consider a variety of financing strategies; and to prepare to develop a strategic financing plan. The Guide is designed to put policymakers and planners one step closer to developing a comprehensive financing plan to support effective systems of care.

Implementation Factors for Effective Systems of Care

Organizational Structures and Processes within an Evidence-based Practice: Cross-site Findings from a Study of Teaching Family Organizations

Nesman, T. (2006). Organizational structures and processes within an evidence-based practice: Cross-site findings from a study of teaching family organizations. In C. Newman, C. Liberton, K. Kutash, & R. Friedman (Eds.). The 18th Annual Research Conference Proceedings, A System of Care for Children's Mental Health: Expanding the Research Base (pp. 311-315). Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

Describes phase II findings of the Community-based Theories of Change Study. The summary provides an example of how actual service deliery relates to operations at the local end, and asks how organizations turn their ideas about implementation into action, what structures support and organization's ability to carry out its goals, and how such an organization sustains its focus.

A Model for Implementing Effective Systems of Care

Friedman, R. M. (2006). A model for implementing effective systems of care. In C. Newman, C. Liberton, K. Kutash, & R.M. Friedman (Eds.), The 18th Annual Research Conference Proceedings, A System of Care for Children's Mental Health: Expanding the Research Base (pp. 3-9). Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

This paper provides a discussion of the model of implementation factors developed by the Research and Training Center for Children's Mental Health. The Center's model includes 14 implementation factors and builds upon systems of care values.

Case Studies of System Implementation

Hodges, S. (2006). Case studies of system implementation. In C. Newman, C. Liberton, K. Kutash, & R.M. Friedman (Ed.), The 18th Annual Research Conference Proceedings, A System of Care for Children's Mental Health: Expanding the Research Base (pp. 11-15). Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

This study identifies strategies undertaken by local communities in implementing community-based systems of care. The authors also seek to understand how factors affecting system implementation contribute to the development of local systems of care.

Implementation Issue Briefs

Issue Brief #1: System of Care Definition System Implementation

Hodges, S., Ferreira, K., Israel, N., & Mazza, J. (2007). System implementation issue brief #1 - Lessons from successful systems: System of care definition. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

This issue brief describes the use of the system of care (SOC) definition by the team to identify established SOC communities for the study, and the evolution of this process into the development of an expanded definition of the system of care concept. This issue brief offers the expanded definition and is intended to raise awareness regarding the need for a shared understanding of the system of care concept and facilitate discussion about the proposed definition, system implementation, and evaluation of impact.

Issue Brief #2: Critical Factors in System of Care

Hodges, S., Israel, N., Ferreira, K., & Mazza, J. (2007). System implementation issue brief #2 - Critical Factors in System of Care Implementation. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

This issue brief presents cross-site patterns of system implementation based on lessons learned from data collected in Phases I and II of Case Studies of System Implementation. The issue brief offers a suggested model in which established system of care (SOC) communities leverage change. A description of the model, lessons learned from established SOC communities and broad guidelines for the use of implementation factors are provided. [187kb pdf]

Issue Brief #2 Supplement: Strategies for System of Care Development: Locally Identified Factors for System Implementation

This document provides locally identified and defined system implementation factors from data collected in Phases I and II of the study. This document is not intended to stand alone, but rather to provide additional information for readers of Issue Brief #2. [300kb pdf]

Issue Brief #3: Leadership Qualities in Successful Systems of Care System Implementation

Ferreira, K., Hodges, S., Israel, N., & Mazza, J. (2007). System implementation issue brief #3 - Lessons from successful systems: Leadership qualities in successful systems of care. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

This issue brief describes system of care leadership as described by SOC stakeholders within Phase I and II sites for the study, Case Studies of System Implementation. It describes the challenge of leadership within a complex system, lessons learned from established systems of care, and strategies for successful leadership within system of care communities based on research findings to date. [185kb pdf]

Issue Brief #4: Evidence-based Practices and Systems of Care: Implementation Matters System Implementation

Israel, N., Hodges, S., Ferreira, K., & Mazza, J. (2007). System implementation issue brief #4 - Lessons from successful systems: Evidence-based practices and systems of care: Implementation matters. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

This issue brief provides key findings on the relationship between evidence-based practices (EBPs) and system of care based on data collected for Case Studies of System Implementation. A description of the integration of evidence-based practices into established system of care communities, lessons learned, and strategies for successful integration are offered. [167kb pdf]

About the National Evaluation and its Findings

The System of Care Handbook: Transforming Mental Health Services for Children, Youth, and Families

Stroul and Blau, 2008 In: B.A. Stroul and G.M. Blau, Editors, The system of care handbook: Transforming mental health services for children, youth, and families, Paul H. Brookes Publishing Co., Baltimore (2008).

This comprehensive volume helps administrators, program developers, and clinicians from mental health and partner child-serving systems skillfully navigate every key issue they may encounter on the road to effective service delivery. Weaving all the latest research and best practices into a single accessible handbook, more than 60 expert contributors give readers in-depth, practical knowledge for establishing, evaluating, and improving services and systems of care for children and adolescents with mental health challenges and their families.

The National Evaluation of the Comprehensive Community Mental Health Services Program for Children and their Families Program. A Commentary

Friedman, R. M. & Hernandez, M. (2002). The national evaluation of the comprehensive community mental health services program for children and their families program. A commentary. Children's Services: Social Policy, Research, and Practice, 5(1), 67-74.

This commentary appeared in a special issue describing the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program. Friedman and Hernandez' commentary identifies general issues and themes in development and evaluation of systems of care, and discusses these in the context of the articles appearing in this volume. Themes included (a) impact of complexity of community-based systems of care on evaluation design; (b) relevance of theories of change; (c) implications of diversity in populations served; and (4) strategies for conducting evaluation within the constraints imposed.

Overview of the National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program

Holden, E. W., R. M. Friedman, & R. L. Santiago (2001). Overview of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program [Special Issue]. Journal of Emotional and Behavioral Disorders, 9(1), 4-12.

This lead article to the special issue of the Journal of Emotional and Behavioral Disorders provides an overview of the methodology and status of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program, conducted by Macro International, Inc., in collaboration with the University of South Florida and other partners.

Use of the System of Care Practice Review in the National Evaluation

Hernandez, M., Gomez, A., Lipien, L., Greenbaum, P. E., Armstrong, K., & Gonzalez, P. (2001). Use of the System of Care Practice Review in the national evaluation: Evaluating the fidelity of practice to system of care principles. Journal of Emotional and Behavioral Disorders, 9, 43-52.

This article describes the empirical support of the System of Care Practice Review (SOCPR), a methodology developed to measure the alignment between the principles of a system of care and mental health practices in a community setting. To test this approach, two communities with well-developed systems of care were compared on the SOCPR with two communities with less developed systems of care. Results indicate that the SOCPR was successful in differentiating between those communities that were able to implement systems of care principles into mental health practices from those who did not.

Developing Community-based Theories of Change

Applying a Theory of Change Approach to Interagency Planning in Child Mental Health

Hernandez, M. & Hodges, S. (2006) Applying a theory of change approach to interagency planning in child mental health. American Journal of Community Psychology, 38(3) 165-173.

This paper describes the use of a theory of change approach to community-based cross-agency service planning in Contra Costa County, California for a population of youth who had been arrested and involved with juvenile probation.

Community-based Theories of Change: Overview of Findings (2006)

Hernandez, M. (2006). Community-based theories of change: Overview of findings. In C. Newman, C. Liberton, K. Kutash, & R. M. Friedman (Eds.), The 18th Annual Research Conference Proceedings, A System of Care for Children's Mental Health: Expanding the Research Base (pp. 305-306).

Discusses results to date of the Community-based Theories of Change study. Four characteristics from this cross-site cross-phase study are also discussed: identity, integration, initiative, and innovation. The study examines organizational structures and processes that human service organizations believe allow them to carry out their mission and goals and to sustain this effort over time.

Community-based Theories of Change: Study Background and Design Description

Hodges, S. (2006). Community-based theories of change: Study background and design. In C. Newman, C. Liberton, K. Kutash, & R. M. Friedman (Eds.), The 18th Annual Research Conference Proceedings, A System of Care for Children's Mental Health: Expanding the Research Base (pp. 303-304). Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

This article discusses the background and design of the Community-based Theories of Change Study. The study seeks to understand how child-serving organizations with a widely held theory of change carry out their mission and goals. Such a theory of change facilitates local policy implementation.

Organizational Structures and Processes within an Evidence-based Practice: Cross-site Findings from a Study of Teaching Family Organizations

Building upon Theory of Change for Systems of Care Description

Hernandez, M., & Hodges, S. (2003). Building upon theory of change for systems of care. Journal of Emotional and Behavioral Disorders 11(1), 19-26.

This article describes the concept of systems of care for children with serious emotional disturbance and their families. Systems of care are presented as mutable strategies for improving organizational relationships that are best judged by outcomes focused at the organizational level. Implications for rethinking and expanding the theory of change that underlies the system of care is discussed.

Creating Change and Keeping it Real: How Excellent Child-serving Organizations Carry out their Goals: Cross-Site Findings for Phase I of Community Based Theories of Change (2002)

Hodges, S., Hernandez, M., Nesman, T., & Lipien, L. (2002). Creating change and keeping it real: How excellent child-serving organizations carry out their goals. Tampa, Florida: University of South Florida, Louis de la Parte Florida Mental Health Institute, Department of Child and Family Studies, The Research and Training Center for Children's Mental Health.

Community-Based Theories of Change is a national study funded by the federal Center for Mental Health Services (CMHS-SAMHSA) and National Institute on Disability and Rehabilitation Research that is designed to address how human service organizations carry out their mission and goals, how they transfer their policy agendas across stakeholders, and how they sustain their service strategies over time. This report summarizes the cross-site findings of Community-Based Theories of Change and presents lessons learned across the three participating sites in 2002.

Development of the SOCPR

Monograph: Measuring the Fidelity of Service Planning and Delivery to System of Care Principles

Midiendo la Fidelidad de la Planeacion y Entrega de Servicios a los Principios del Sistema de Cuidado: La Revision de la Practica del Sistema de Cuidado (SOCPR)

Hernandez, M., Worthington, J., & Davis, C. (2005). Monograph: Measuring the fidelity of service planning and delivery to system of care principles. Tampa, Florida: University of South Florida, Louis de la Parte Florida Mental Health Institute, Department of Child and Family Studies, The Research & Training Center for Children's Mental Health.

This monograph describes the System of Care Practice Review (SOCPR), a procedure that explores direct service fidelity to system of care values. This monograph will discuss how the use of the SOCPR can enhance quality improvement efforts, and identify system-wide strengths and areas for improvement.

Use of the System of Care Practice Review in the National Evaluation

Hernandez, M., Gomez, A., Lipien, L., Greenbaum, P. E., Armstrong, K., & Gonzalez, P. (2001). Use of the System of Care Practice Review in the national evaluation: Evaluating the fidelity of practice to system of care principles. Journal of Emotional and Behavioral Disorders, 9, 43-52.

Crafting Logic Models

Monograph: Crafting Logic Models for Systems of Care: Ideas Into Action

En Espanol: Diseñando Modelos Lógicos para los Sistemas de Cuidado: Ideas en Acción

Hernandez, M. & Hodges, S. (2005). Crafting logic models for systems of care: Ideas into action. [Making children's mental health services successful series; no. 216-1-rev]]. Tampa, FL: University of South Florida, The Louis de la Parte Florida Mental Health Institute, Department of Child & Family Studies.

This monograph is designed to provide a guide for communities engaged in developing systems of care. It provides a straightforward method that system stakeholders can use to turn their ideas into tangible action-oriented strategies for achieving their goals for system development.

2009 Theory of Change Logic Model Project
Department of Child & Family Studies | Louis de la Parte Florida Mental Health Institute | College of Behavioral and Community Sciences | University of South Florida
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