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

Evaluating the Fidelity of Practice to System-of-Care Principles

FMHI-USF, 13301 Bruce B. Downs Blvd., Tampa, FL 33612, Department of Child and Family Studies at the Louis de la Parte Florida Mental Health Institute, University of South Florida

Angela Gomez

Department of Child and Family Studies at the University of South Florida

Lodi Lipien

University of South Florida

Paul E. Greenbaum

Department of Pediatrics and Florida Mental Health Institute

Kathleen H. Armstrong

Department of Child and Family Studies at the University of South Florida

Patricia Gonzalez

Department of Child and Family Studies at the University of South Florida

Evaluating the fidelity of service practices to system-of-care principles (SOC) represents a challenge in the human service field. The inadequate infusion of SOC principles into direct services could limit the usefulness of this approach. In this study we compare practice-level variables between well-developed SOC and traditional service systems and test the hypothesis that the adoption of SOC principles at the organizational level was associated with greater implementation of SOC at the practice level. Sites implementing SOC for at least 5 years are compared to sites providing mental health services using a traditional service delivery model. The study administered the SOC Practice Review (SOCPR) protocol. The SOCPR represents a case study approach that employs interviews and document reviews to arrive at ratings of SOC principles.This methodology proved to be an effective tool in interpreting the meaning of child and family experiences that emerged from the SOC.The findings were generally significant and support the hypothesis. Overall, SOC sites scored significantly higher (p < .05) than non-SOC sites in the child-centered and family-focused, community-based, and cultural competence domains.The implication is that SOC principles can be tested at the level of practice.

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