Heany Julia, Torres Jennifer, Zagar Cynthia, Kostelec Tiffany
Michigan Public Health Institute, Center for Healthy Communities, 2342 Woodlake Drive, Okemos, MI, 48864, USA.
Michigan Public Health Institute, Public Health Services, 2364 Woodlake Drive, Suite 180, Okemos, MI, 48864, USA.
Matern Child Health J. 2018 Oct;22(Suppl 1):13-21. doi: 10.1007/s10995-018-2538-6.
Introduction In order to achieve the positive outcomes with parents and children demonstrated by many home visiting models, home visiting services must be well implemented. The Michigan Home Visiting Initiative developed a tool and procedure for monitoring implementation quality across models referred to as Michigan's Home Visiting Quality Assurance System (MHVQAS). This study field tested the MHVQAS. This article focuses on one of the study's evaluation questions: Can the MHVQAS be applied across models? Methods Eight local implementing agencies (LIAs) from four home visiting models (Healthy Families America, Early Head Start-Home Based, Parents as Teachers, Maternal Infant Health Program) and five reviewers participated in the study by completing site visits, tracking their time and costs, and completing surveys about the process. LIAs also submitted their most recent review by their model developer. The researchers conducted participant observation of the review process. Results Ratings on the MHVQAS were not significantly different between models. There were some differences in interrater reliability and perceived reliability between models. There were no significant differences between models in perceived validity, satisfaction with the review process, or cost to participate. Observational data suggested that cross-model applicability could be improved by assisting sites in relating the requirements of the tool to the specifics of their model. Discussion The MHVQAS shows promise as a tool and process to monitor implementation quality of home visiting services across models. The results of the study will be used to make improvements before the MHVQAS is used in practice.
引言 为了实现众多家访模式所展现出的与家长和孩子相处的积极成果，家访服务必须得到妥善实施。密歇根家访倡议组织开发了一种工具和程序，用于监测各模式的实施质量，即密歇根家访质量保证系统（MHVQAS）。本研究对MHVQAS进行了实地测试。本文聚焦于该研究的一个评估问题：MHVQAS能否跨模式应用？方法 来自四种家访模式（美国健康家庭、基于家庭的早期开端计划、家长即教师、母婴健康项目）的八个当地实施机构（LIA）和五名评审员参与了该研究，他们通过完成实地考察、记录时间和成本以及填写关于该过程的调查问卷来参与。LIA还提交了其模式开发者最近的评审意见。研究人员对评审过程进行了参与观察。结果 各模式在MHVQAS上的评分没有显著差异。各模式在评分者间信度和感知信度方面存在一些差异。各模式在感知效度、对评审过程的满意度或参与成本方面没有显著差异。观察数据表明，通过帮助各站点将工具的要求与自身模式的具体情况联系起来，可以提高跨模式适用性。讨论 MHVQAS作为一种监测跨模式家访服务实施质量的工具和流程，显示出了前景。该研究结果将在MHVQAS实际应用前用于改进。
