Maximizing Pilot Phase Measures to Inform Quality Improvement: Using a Sequential Mixed-Methods Design With Interrupted Time Series to Examine Feasibility, Uptake, and Drivers of an Evidence-Based Practice in Part C/Early Intervention Systems

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dc.contributor.advisorSquires, Jane
dc.contributor.authorStegenga, Sondra
dc.date.accessioned2019-09-18T19:18:32Z
dc.date.available2019-09-18T19:18:32Z
dc.date.issued2019-09-18
dc.description.abstractReviews of published research indicate only a 33% median success rate of complex systems change initiatives. This lack of uptake is becoming known as implementation failure. Social emotional interventions with infants and young children and their caregivers also have a history of high attrition rates, putting efforts focused on this area at high risk of implementation failure. This failure rate is especially pertinent because 28 of 55 states and jurisdictions providing Part C early intervention services are focusing improvement efforts on social emotional development as part of the State Systemic Improvement Planning processes. Although policy-mandated quality improvement is occurring in local, state, and federal systems, published research is lacking on quality improvement measures and implementation-focused outcomes within this population. The pilot phase of implementation holds immense potential for identifying quality improvement needs before scale-up, ultimately resulting in large potential savings of money and time by avoiding implementation failure. However, focused objective measures are often missing or underutilized within these cycles. The goal of this study was to examine factors with potential impact on implementation and uptake of an evidence-based practice (EBP) in a quality improvement project. The study focus was on the feasibility, acceptability, and appropriateness of a policy-related EBP implemented in a Part C early intervention system. Potential determinants (barriers and supports), uptake rates, and driver influence relative to the uptake were analyzed. The efficacy of these elements for improving measurement accuracy and for understanding quality improvement needs in the pilot phase of initial implementation was evaluated. Two specific research questions were addressed: “What are the feasibility, acceptability, and appropriateness of the use of an EBP (i.e., electronic social emotional assessment) used in Part C/early intervention pilot sites?” and “What is the relationship between the identified key drivers and uptake rates for the use of electronic social emotional assessments?” Key drivers identified were initial training, leadership coaching, and implementation completion rates.en_US
dc.identifier.urihttps://hdl.handle.net/1794/24855
dc.language.isoen_US
dc.publisherUniversity of Oregon
dc.rightsAll Rights Reserved.
dc.subjectEarly Childhood Educationen_US
dc.subjectEarly Interventionen_US
dc.subjectImplementation Scienceen_US
dc.subjectMixed Methodsen_US
dc.subjectProgram Evaluationen_US
dc.subjectShort Interrupted Time Seriesen_US
dc.titleMaximizing Pilot Phase Measures to Inform Quality Improvement: Using a Sequential Mixed-Methods Design With Interrupted Time Series to Examine Feasibility, Uptake, and Drivers of an Evidence-Based Practice in Part C/Early Intervention Systems
dc.typeElectronic Thesis or Dissertation
thesis.degree.disciplineDepartment of Special Education and Clinical Sciences
thesis.degree.grantorUniversity of Oregon
thesis.degree.leveldoctoral
thesis.degree.namePh.D.

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