Identifying and Prioritizing Factors to Improve Implementation of an Evidence-Based Program for Child Maltreatment Prevention in Rural Missouri Communities

Abstract

AbstractPrevention of child abuse and maltreatment is critical in the Ozark region of Missouri where rates are higher than in other areas of the state. Community-based organizations seeking to address these issues in rural areas face significant challenges both internal and external to the organization. Guided by the Consolidated Framework for Implementation Research (CFIR), Whole Kids Outreach (WKO) utilized a modified concept mapping approach to identify strategies needed to address these challenges and more effectively implement the Healthy Families America (HFA) program in seven counties in the rural Missouri Ozark region. Semi-structured interviews were used to identify barriers and supports to the implementation of HFA. Statements were generated via in-person and telephone interviews with key stakeholders (WKO internal staff and external partners). These stakeholders then sorted statements into like piles and rated them according to importance. Concept mapping systems software, using multidimensional scaling and hierarchical cluster analysis, was used to determine the most salient cluster solution. The resulting cluster map depicted six thematic clusters and provided a visual representation of relationships between clusters. Stakeholders were then guided through a nominal group process to prioritize key issues and begin to develop strategies to address them.