Patterns of Engagement over Time of an Evidence-Based Practice

Title: Patterns of Engagement Over Time of an Evidence-Based Practice

Presentation type: Individual Poster Presentation

Category/Theme: Dissemination and Implementation Science

Abstract/Body:

Introduction: Client engagement is a critical part of service delivery, especially among populations coerced into service, such as clients receiving parenting programming through child welfare services. Engagement is typically assessed as whether one completes services (dropout), but engagement may wax and wane over the course of services as parents see more or less benefit. Additionally, reduced engagement over time may be an indicator of impending dropout, and could trigger a treatment provider to address engagement issues. This research examined changes in engagement of parents during their participation in the SafeCare® intervention, an 18-session behavior parenting program.

Methods: Data were collected from 212 families who receives services from agencies participating in a trial of SafeCare. A mobile app was used to collect engagement data at the end of each session via a 10-item measure. Questions were focused around measuring program effectiveness, satisfaction, and burden, and nine of the items were averaged to form a single measure of engagement (alpha = .83). Analysis was conducted to understand the extent to which engagement changed throughout service delivery and whether engagement decreased prior to dropout.

Results: There were 212 parents that completed at least one session, and the mean number of sessions completed was 7.0 (sd = 5.8) with 15% completing most or all of SafeCare (15 or more sessions). Engagement was high, with an average engagement score across time and families of 4.4 (sd = .49) on a 5-point scale. Simple correlational analyses showed a small correlation between session number and engagement (r = .08, p< .01). When comparing engagement among clients who dropped out early (5 sessions or sooner) vs. midway (6-14 session) vs. completers (15+ sessions), no difference was found (p > .10). In addition, we failed to find a difference in engagement on the last session prior to dropout, to the session prior to the last session before dropout, p > .10, even when only focusing on early dropouts.

Discussion. Engaging clients in services is necessary to promote program effectiveness. Here we observed a small overall increase in engagement across sessions, but no difference in reported engagement by dropout status. It may be that other factors or circumstances influence dropout beyond simple reported engagement, defined here as perceived program benefit.