Understanding a Care Management System’s Role in Influencing a Transitional Aged Youth Program’s Practice – A Mixed Methods Study (Preprint)

Abstract

Extended foster care programs help prepare transitional-aged youth (TAY) to step into adulthood and live independent lives. Aspiranet, one of California’s largest social service organizations, employed a social care management solution (SCMS) to render effective, efficient, and tailored services to meet TAY’s needs.

This study’s purpose was to investigate the impact of a SCMS, IBM Watson Care Manager (WCM)® in transforming foster program service delivery and improve TAY outcomes.

A mixed-methods study was employed by collecting primary data from stakeholders through semi-structured interviews in 2021 and pulling secondary data from various resources including annual reports, system usage logs, and data repositories from 2014 to 2021. Thematic analysis based on grounded theory was employed to analyze qualitative data using NVivo® software. Descriptive analysis of aggregated outcome metrics in the quantitative data was performed and compared across two time periods: Pre-SCMS (before 10/31/2016) and Post-SCMS (11/01/2016-03/31/2021).

Six Aspiranet employees (4 leaders, 2 life coaches) were interviewed with median time of 56 (53,67) minutes. The majority were female (5,83%), over 30 years of age (median, (Q1,Q3)=37, (32,39)) with 6 (5,10) median years of experience at Aspiranet, and overall field experience of 10 (7,14) years. The majority of participants (4,67%) rated their technology skills as expert. Thematic analysis of participants’ interview transcripts resulted in 24 sub-themes that were grouped into 6 super-ordinate themes: study context, impact of the new tool, key strengths, commonly used features, expectations with WCM, and limitations and recommendations. The tool met users’ initial expectations of streamlining tasks and adopting essential functionalities such as cross-team communications, intuitive dashboard, and advanced search engine. Median satisfaction scores around Pre- and Post-WCM workflow processes remained constant between two life coaches (3.25 (2.5, 4)); however, among leaders, Post-WCM scores (4 (4, 5)) were higher than Pre-WCM (3 (3, 3)) scores. Across the two study phases, Aspiranet served 1,641 TAY having consistent population demographics: median age of 18 years (18,19); female (903,55%); race/ethnicity (Hispanic/Latino (621,38%), Black (470,29%), White (397,24%), and Other (153,9%)). Between Pre- and Post-WCM, there was an increase in full-time (359(68%) to 833(75%)) and a reduction in part-time (61(11%) to 91(8%)) school enrollment. The median number of days spent in the foster care program remained the same (247 (125, 468)), however, the number of incidents monthly reported per hundred youth showed a steady decline even with an exponentially increasing number of enrolled youth and incidents.

The SCMS for coordinating care and delivering tailored services to TAY streamlined Aspiranet’s workflows and processes and positively impacted youth outcomes. Further enhancements are needed to for even better alignment with user and youth needs.