Implementing Child First Meets HHS Criteria

Implementation last updated: 2020

The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the research reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Similarly, models described here may not all have impact studies, and those with impact studies may vary in their effectiveness. Please see the Effectiveness button on the left for more information about research on the effectiveness of the models discussed here.

Materials and forms to support implementation

Operations manuals

A Child First Training Manual and Toolkit provide information on Child First procedures, operations, and the formal assessments and forms needed for implementation. The Child First and CPP Learning Collaboratives each have an accompanying manual containing all presentations and handouts from their learning collaboratives. The CPP manual is provided to all clinicians. Additional manuals include the Child First Clinical Directors’ Manual, the Child First Accreditation Guide, the Child First Comprehensive Clinical Record User Guide, and the Absorb User Guide for distance learning modules.

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Service delivery forms

All service delivery forms are included in the Child First Toolkit and can be downloaded from the CFCR.

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Assessment tools

Child First begins with an assessment phase and incorporates assessment throughout the intervention. The assessment protocol specifies required and optional assessments to be given at baseline, six months, and discharge. Child First uses formal, standardized assessments; formal assessments developed by Child First; and informal assessments based on the clinical team’s discussions with or observations of the family. The assessments provide information on child and family history; trauma and adversity; child language development, emotional/behavioral health, and physical health; parents’ mental health and parenting; parent-child relationships; and service needs and utilization. All assessments are entered into a Child First database. The results are analyzed quarterly to show child and parent progress over time.

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The Child First curriculum includes topics, concepts, and implementation methods delivered based on the unique needs of the child and family. Child First is a flexible, relationship-based, psychotherapeutic intervention. The curriculum does not designate what content should be covered for specified visits. However, it does specify what constitutes fidelity to the Child First model.

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Available languages

Child First materials are available in English and Spanish.

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Fidelity measurement

Child First affiliate agencies must meet fidelity standards in three areas:

  1. Programmatic fidelity. Annually, affiliate sites must complete the Child First program fidelity checklist that lists all essential programmatic components. The state clinical director reviews benchmark reports monthly with each affiliate site. The state clinical director and the affiliate site use Plan Do Study Act cycles to proactively identify any areas of challenge and develop quality improvement plans.
  2. Assessment outcomes. Quarterly, the NPO Data and Quality Enhancement Department analyzes cumulative assessment outcome data to determine if each site is continuing to show expected child and family outcomes and if specific staff or affiliate sites need further training.
  3. Clinical intervention. The Child First Clinical Fidelity Framework (modified from CPP) is used to determine clinical fidelity. The framework is reviewed monthly by the affiliate site clinical director/supervisor and the clinician or care coordinator during reflective supervision. In addition, the affiliate site clinical director/supervisor reviews treatment plans at least quarterly and progress notes and videos of home visits regularly throughout treatment.

The state clinical director monitors model fidelity through biweekly reflective clinical consultation with each affiliate site clinical director.

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Fidelity standards

Programmatic, assessment outcomes, and clinical intervention fidelity standards are specified in the accreditation process. Programmatic fidelity is measured against Child First benchmarks related to number of visits, length of visits, length of service, goal completion, and supervision frequency. Outcome fidelity is based on the magnitude of change in assessment results, as measured by statistical significance, percentage improvement, and effect size. The Child First Clinical Fidelity Framework (modified from CPP) is used to determine clinical fidelity.

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Implementation notes

The information contained on this page was last updated in June 2020. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the Child First CEO on February 21, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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