1 - (SYM 125) Stakeholder Perceptions on the Implementation of a Caregiver Assessment Service at a Child Advocacy Center

Background: Every year nearly one in five children experience abuse or neglect after which significant developmental difficulties are common. Support from a caregiver is an important predictor of children’s recovery from maltreatment. However, agencies that provide services to maltreated children often narrowly focus their initial efforts on gathering forensic evidence and assessing child mental health symptoms. As a result, triage decisions and mental health referrals are made without an adequate understanding of caregiver support and family functioning, which limits agencies’ sensitivity to family needs and decreases caregiver engagement in services. This study involved a collaboration between an academic research partner and a local child advocacy center to understand the best way to implement a comprehensive assessment service of caregiver support and family functioning.

Methods: We conducted focus group discussions with providers (n = 11) at a Child Advocacy Center (CAC) and interviews with caregivers (n = 10) of children referred for CAC services to assess their opinions and needs of a comprehensive assessment of caregiver support and family functioning. Guided by the Consolidated Framework for Implementation Research, thematic analysis was conducted using a hybrid deductive-inductive coding process. Themes were further refined through discussion between academic and community partners at the CAC.

Results: Common themes emerged across both providers and caregivers in the desire to adopt a more comprehensive service to assess caregiver needs. Both groups identified several barriers related to the timing and format of the service and caregiver comfort with the assessment questions. Participants noted the service would need to be tailored to the diverse populations of families at the CAC. Overall stakeholders agreed the potential benefits of identifying families’ needs outweighed these challenges.

Conclusions: Given the dearth of services specifically designed for caregivers of maltreated children it is critical to understand multiple stakeholder perspectives to support successful implementation. Although the current study included a small sample, this research strengthened the academic-community partnership and will inform a comprehensive assessment service. This research has the potential to scale-up to enhance service satisfaction and treatment effectiveness across broad populations of children and their families referred for suspected child maltreatment.