Project Overview

TF-CBT is designated as a “promising” practice by the Clearinghouse. It was prioritized for the state’s short-term Family First strategy, to ensure wide availability of a mental health service that targets an expansive age range with multiple access options.

Aligned with Step 5 on the Steps to Building Evidence, the Center for Policy Research (CPR) implemented a school-based, cluster randomized controlled trial (RCT), with the goal of expanding the evidence base, increasing the Clearinghouse rating, and testing how best to leverage the school-based mental health delivery setting. The study aimed to assess the impact of TF-CBT on child well-being (behavioral, emotional, and social functioning).

This evaluation began in June 2022. Due to external constraints on the evaluation and implementation challenges, CPR and the Hub decided to pause the TF-CBT study in early 2024. CPR is documenting lessons learned to inform the Family First strategy and future evaluation designs.

Project Partner

The Hub selected CPR to serve as the research team to build evidence for TF-CBT. The CPR team conducts rigorous evaluations of initiatives on child welfare, homeless and runaway youth, intimate partner violence, workforce and public benefit programs.

Project Resources

• TF-CBT Evaluation Plan

Project Overview

FHF Preteen (FHF-P) is designated as a “supported” practice by the Clearinghouse. Stakeholders identified FHF-P as a complementary service within the mental health domain positioned to meet the needs of children aged 9-11.

Aligned with Step 5 on the Steps to Building Evidence, two 5-year randomized controlled trials (RCTs) of FHF-P demonstrated favorable impacts on child permanency, delinquency, and well-being. Dr. Heather Taussig is conducting follow-up RCT analysis with the goal of building evidence toward a “well-supported” designation. The analysis explores FHF-P’s impact on child well-being, specifically suicidality and substance use.

FHF Teen (FHF-T) extends this service to an older demographic and is designated as “does not meet criteria.” Dr. Taussig is developing an evidence-building strategy for FHF-T with the goal of achieving an evidence designation from the Clearinghouse.

The FHF-P evaluation began in July 2022 and is expected to be completed in June 2024. Final results will be reported by the end of 2025.

Project Partner

Dr. Heather Taussig at the University of Denver Graduate School of Social Work serves as Principal Investigator for the evaluation of FHF-P and FHF-T. Dr. Taussig directs the FHF program, an evidence-based mentoring program for children with child welfare involvement that was developed and tested with funding from the National Institutes for Health.

Project Resources

• 2024 FHF-P Preliminary Findings Report
• Long-term impact of the Fostering Healthy Futures for Preteens program on suicide-related thoughts and behaviors for youth in out-of-home care: A randomized controlled trial
• FHF-T Evidence-Building Strategy

Project Overview

MST is designated as a “well-supported” practice by the Clearinghouse and is considered an anchor evidence-based service within Colorado’s mental health service array. It is costly to deliver fully in person in rural or other environments with long commutes for therapists. TE-MST is considered an adaptation by the Clearinghouse because it is a change in delivery method and requires separate evidence-building to receive a Clearinghouse rating.

Aligned with Step 2 on the Steps to Building Evidence, the Kempe Center is assessing the feasibility and acceptability of a telehealth-enhanced service delivery model of MST. The study uses mixed methods to compare implementation and clinical outcomes to typical in-person delivery of MST in Colorado.

This evaluation began in March 2022 and was completed in May 2024. Findings suggest that the telehealth enhanced version is both feasible and acceptable to therapists and families. Clinical outcomes were comparable to what is typically achieved through a standard delivery approach. TE-MST could serve as a valuable alternative to standard delivery of MST, particularly for youth and families who reside in rural communities.

Project Partner

This evaluation is led by Dr. Suzanne Kerns through the Rocky Mountain MST Network located at the Kempe Center for the Prevention and Treatment of Child Abuse and Neglect at the University of Colorado Anschutz Medical Campus (Kempe Center) This evaluation is associated with a Transition Fund Act-resourced contract for implementation of this innovative model.

Project Resources

• 2024 TE-MST Final Findings Report

Project Overview

TBRI-Caregiver Training is designed for caregivers of children who have experienced abuse, neglect, or other trauma. It is designated as “promising” by the Clearinghouse and was prioritized in Colorado’s long-term strategy to bolster the mental health array and reach a wider age range of children and youth.

Aligned with Step 5 on the Steps to Building Evidence, Colorado State University’s Social Work Research Center (SWRC) proposed a randomized controlled trial (RCT) with the goal of achieving a “well-supported” evidence designation. The study will explore child safety and permanency outcomes, measured by Trails administrative data, and child well-being outcomes, measured by the Strengths & Difficulties Questionnaire and the Trauma Symptoms Checklist. A process evaluation will collect data from county child welfare caseworkers and the training provider to explore strengths and challenges of the referral process.

This study will begin in summer 2024 and is expected to be completed in late 2027.

Project Partner

In March 2024, the Hub selected SWRC to evaluate TBRI-Caregiver Training. SWRC partnered with the Human Services Research Institute on an RCT for Colorado Kinnected which yielded a “promising” rating from the Clearinghouse. SWRC will partner with Raise The Future, Colorado’s TBRI ambassador organization, who offers the Caregiver Training series in Colorado to over 600 caregivers each year.

Project Overview

SBIRT uses motivational interviewing, brief intervention, and referral to treatment to reduce and prevent health consequences related to risky use of alcohol and other substances. This service was prioritized because it fills a gap in the Family First array by providing early support for substance use without a diagnosis. SBIRT is designated as a “promising” practice by the Clearinghouse.

Aligned with Step 4 on the Steps to Building Evidence, the OMNI Institute proposed a quasi-experimental design (QED) with the goal of achieving a “supported” evidence designation. The QED would explore substance use and mental well-being for adolescents in school-based settings. The OMNI Institute will first lead a planning phase beginning in summer 2024, including a feasibility study to ensure follow-up data can be collected.

Project Partner

In March 2024, the Hub selected the OMNI Institute to evaluate SBIRT. From 2006 to 2016, OMNI conducted a mixed-methods process and outcome evaluation of SBIRT Colorado that resulted in numerous publications in peer-reviewed journals.

Project Overview

There is a federal Family First requirement to monitor adherence across all programs and services included in Colorado’s Plan. Continuous quality improvement (CQI) is also required for programs and services in Colorado’s Plan that have achieved a “well supported” evidence designation. State program intermediaries (SPIs), who provide technical assistance and support to providers, play the primary role in CQI. The Hub developed a dashboard to support monitoring of fidelity to evidence-based models and inform investments.

Colorado’s Family First Fidelity Monitoring Dashboard allows SPIs to upload quarterly data on each provider’s adherence to evidence-based programs and services. Adherence has been standardized into a three-point scale, based on extensive consultation with model developers and SPIs, to ensure complex fidelity and CQI processes can be comparable across programs. The dashboard allows users to disaggregate by Family First domain, program or service, county, and provider.

The Hub has also developed a decision-making tool to support case workers with identifying Family First programs and services for families based on their needs, eligibility, and availability.

Project Partner

The Hub is working with the following SPIs on CQI activities:

• Invest in Kids: Child First and Nurse-Family Partnership
• Kempe Center: Multisystemic Therapy, SafeCare, and Fostering Healthy Futures Preteen
• Parent Possible: Parents as Teachers
• FFT LLC: Functional Family Therapy
• Illuminate Colorado: Healthy Families America
• Parent-Child Interaction Therapy

The Hub engaged Oak City Labs and Sonic Bunny Software to develop the fidelity monitoring dashboard. The Hub manages the dashboard on behalf of CDHS. Dashboard access is currently restricted to CDHS and SPI users; the long-term goal is to make the information publicly available.

Project Resources

• Colorado’s Family First Fidelity Monitoring Dashboard (currently login access only)
• Decision-Making Tool for Matching Families to Family First Programs and Services