Innovation and child neglect prevention

Innovation and child neglect prevention

By Gabriel McGaughey and Rachael Meixensperger

Families who experience stressors including housing instability, financial insecurity, or trauma, can become overloaded, leading to an increased level of need, child welfare involvement, and possible neglect. In 2020, 64% of family separations were due to neglect nationally (AFCARS Report #28, 2021), with many of its risk factor tied to issues of poverty, with a minimal number of evidence-based interventions available for communities to implement. To address this unmet need, innovative communities have been able to design high quality, evidence-informed, programs to reduce the sources of stress in families’ lives that contribute to neglect. These innovations not only provide potentially scalable solutions but can also inform how communities might approach addressing the unmet needs of families.

Neglect is a complex challenge, which often presents as a constellation of concurrent issues, that have come to a crisis point by the time a family has contact with the child welfare system. The Family First Prevention Services Act (FFPSA) provides flexibility in funding to be used for specific evidence-based interventions in the IV-E Prevention Services Clearinghouse that reach “candidates for foster care” to prevent separations once a family has contact with child protective services.  The Title IV-E Prevention Services Clearinghouse fails to specify which interventions target neglect, but at the time of this writing, only three of one hundred and seven programs in the Clearinghouse include “economic and housing stability” as target outcomes.

To fill this gap, many organizations and communities work to support families overloaded by economic stress utilizing often limited resources to create new solutions that work within their community. Social innovation is the creation and implementation of proposed solutions that promote change. Successful innovation is context specific and requires consideration of specific characteristics of communities and community members.  Different communities have specific needs and perspectives that must be accounted for to truly cultivate change. How do innovative communities support innovations to support families overloaded by stress?

Evidence Informed: Drawing on principles rooted in brain science and/or trauma informed care principles, communities strive to develop innovations that meet their specific context while still being rooted in the best available evidence. Integrating these principles into innovation, or improvement, efforts will provide a foundation for scaling successes, and advancing programs towards being evidence-based.

Co-creation: Participation of individuals and families with lived experience, or context experts, in the change process provide crucial insight into the factors that impact their communities and into what works and what does not work. Without the co-creating of solutions with context experts, content experts may enter the field with preconceived notions of community needs and solutions. While co-creation may be new, and at times feel slower than prior practices, the learning and insights present with co-creation contribute to more efficient solutions.

Resources: Prevention services get a fraction of the funding compared to child welfare, often limiting the number of resources available to support improvement and innovation efforts at scale. Operating in this scarcity environment can make taking the time for an innovation process feel like a luxury. However, scaling to pilots, or larger implementations of ideas, can be inefficient, even generating negative attitudes towards current and future change efforts from staff, stakeholders, and families. Funders can support infrastructure for innovation in prevention through targeted innovation grants, clarity and simplification of rules, training, and encouraging collaboration instead of competition. Organizational culture can provide the scaffolding for innovation by providing time, elevating shared learning as an outcome, and supporting scaling of innovation with ongoing quality improvement support.

Evaluation: The first ‘real world’ interaction most innovations have are as prototypes, small scale tests of ideas that inform if an idea may warrant eventual pilot testing. Approaches to evaluating prototypes can be different compared to quality improvement efforts with set assessment tools and metrics. The challenge for innovators is to select the prototype evaluation approach that best suits their situation and capacity. Taking evaluation approaches that fit the small scale and provide rapid feedback from participants, both those providing and receiving the service, is essential to thoughtful iteration and innovation.

Strategic learning: Learning is an outcome. Strategic learning is about deliberately gathering lessons learned in near real time to inform strategic decision making. Strategic learning serves multiple purposes, including creating institutional memory, supporting just-in-time iteration, and clarifying our hypotheses about our work. Innovators can use tools and processes from Strategic Learning to help clarify thinking, develop or refine a theory of change, and support rapid iteration.

Neglect is a prevalent wicked problem with few available options for communities to address it, requiring new evidence-informed innovations that can work in unique community contexts. At times, there is a hesitation to implement innovation due to existing struggles in current programs and the strong emphasis on the need to utilize evidence-based interventions. Evidence based interventions are important tools, however the current scope of interventions is insufficient. Innovation is all around our work, as people strive to work together to address the complex problems that overload families. By creating a clearer path to support innovation in preventing neglect, sharing lessons learned, while remaining rooted in evidence-informed principles, we create conditions to foster practices that may be the evidence-based interventions to support overloaded families of tomorrow.

Communities need more interventions to address neglect and its root causes.

Resources For Social Innovation

Center on the Developing Child at Harvard
Tamarack Institute
Greater Good Studio
Here 2 There Consulting
Social Workers Who Design

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