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Social workers can promote resiliency among refugee families by referring them to evidence-based programs to reduce the stressors of resettlement. The purpose of this study was to complete a structured adaptation process with the SafeCare® program for implementation in a refugee resettlement community. Participants included 21 members of an adaptation team made up of administrators, supervisors, and family service providers from three community agencies and community health workers. Quantitative findings suggested that content, process, and literacy-related adaptations were necessary to ensure cultural relevance of program materials. Qualitative feedback suggested the adaptation approach was a meaningful process that engaged community members and resulted in an acceptable and feasible curriculum for delivery in the refugee resettlement community, which will be further tested in a forthcoming implementation trial. The multi-pronged, community-engaged approach to SafeCare adaptation is presented as a potential framework for other programs that could benefit refugee children and their families.

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It is important to understand the impact of implementation of evidence-based practices (EBPs) on the workforce. EBP implementation can increase job demands, stress, and burnout, and may thereby exacerbate turnover. This study examined the effects of implementation of an EBP on turnover among staff at nine child welfare agencies. A total of 102 providers were randomized to either adopt an EBP, SafeCare © , or continue providing services as usual. Participants completed a baseline survey assessing demographics, attitudes toward EBPs, and organizational functioning, and provider turnover was recorded for up to 18 months following implementation. The overall turnover rate was 35%, but did not differ by EBP assignment (odds ratio [OR] = 1.27; 95% confidence interval [0.66, 2.45]).Variables associated with turnover included age (OR = 0.92), years since degree completion (OR = 0.94), prior exposure to EBP (OR = 3.91), believing that adopting an EBP was burdensome (OR = 0.52), and motivation for change (OR = 0.89). EBP assignment moderated two aspects of negative attitudes toward EBP (divergence and monitoring) to predict turnover; those attitudes were only positively related to turnover for individuals assigned to the EBP (OR = 1.46, 1.16). Implications of the findings for implementation are discussed.turnover, implementation, evidence-based practice, child welfare 1 | INTRODUCTION In 2016, there were an estimated 4.1 million reports of child maltreatment made to state and county child welfare departments (U.S. Department of Health and Human Services, 2018). The frontline child welfare workforce that responds to those reports and provides services consists of caseworkers who work for counties or states, and providers who work for private agencies that receive service referrals from local caseworkers. To equip frontline workers with tools necessary to effectively address child abuse and neglect, child welfare systems are increasingly adopting evidence-based practices (EBPs). EBPs typically require a high degree of training and support (Fixsen, Blase, Naoom, & Wallace, 2009) and effort, at least initially, to implement. The labor-intensive nature of EBP implementation may increase job demands and stress, increase job burnout, and increase turnover risk, especially since frontline jobs in the child welfare system have documented high levels of job burnout (Travis, Lizano, & Mor Barak, 2016) and turnover (Kim & Kao, 2014). This paper examined job turnover among frontline child welfare providers who were randomly assigned to implement an EBP (SafeCare © ), or to continue services as usual (SAU) as part of randomized trial. Demographic, attitudinal, and organization functioning measures were collected at baseline, and were examined as predictors of subsequent job turnover, with a focus on whether the assignment to EBP implementation impacted turnover. | Job turnover in child welfareJob turnover is a well-documented problem in child welfare serving agencies. For the purpose of this paper, turnover is defined as when an individ...

Background Delivering evidence-based interventions to refugee and immigrant families is difficult for several reasons, including language and cultural issues, and access and trust issues that can lead to an unwillingness to engage with the typical intervention delivery systems. Adapting both the intervention and the delivery system for evidence-based interventions can make those interventions more appropriate and palatable for the targeted population, increasing uptake and effectiveness. This study focuses on the adaptation of the SafeCare© parenting model, and its delivery through either standard implementation methods via community-based organizations (CBO) and a task-shifted implementation in which members of the Afghans, Burmese, Congolese community will be trained to deliver SafeCare. Method An adaptation team consisting of community members, members of CBO, and SafeCare experts will engage a structured process to adapt the SafeCare curriculum for each targeted community. Adaptations will focus on both the model and the delivery of it. Data collection of the adaptation process will focus on documenting adaptations and team member’s engagement and satisfaction with the process. SafeCare will be implemented in each community in two ways: standard implementation and task-shifted implementation. Standard implementation will be delivered by CBOs (n = 120), and task-shifted implementation will be delivered by community members (n = 120). All interventionists will be trained in a standard format, and will receive post-training support. Both implementation metrics and family outcomes will be assessed. Implementation metrics will include ongoing adaptations, delivery of services, fidelity, skill uptake by families, engagement/completion, and satisfaction with services. Family outcomes will include assessments at three time points (pre, post, and 6 months) of positive parenting, parent-child relationship, parenting stress, and child behavioral health. Discussion The need for adapting of evidence-based programs and delivery methods for specific populations continues to be an important research question in implementation science. The goal of this study is to better understand an adaptation process and delivery method for three unique populations. We hope the study will inform other efforts to deliver health intervention to refugee communities and ultimately improve refugee health.