DOI: 10.5061/dryad.1g1jwsv88
title: Staffing and supports for implementing cross-system interventions with peer mentors

description: The overdose and substance use disorder epidemic has had devasting
 consequences for families since parental substance use disorders put
 children at elevated risk of abuse and neglect To address this dual
 crisis, 53 Ohio county child welfare agencies are implementing Sobriety
 Treatment and Recovery Teams (START), an effective intervention for
 improving parents’ access to substance use disorder treatments (including
 Medication Assisted Treatment), sobriety, and reunification with their
 children. However, 1/3 of Ohio START teams (mostly rural or Appalachian)
 stopped serving families because of high turnover among case workers and
 family peer mentors. Family peer mentors are peer supporters with lived
 substance use disorder recovery and child welfare histories who help
 parents navigate across systems, but often leave their position after
 feeling unsupported and stigmatized within child welfare agencies.
 Supervision coaching has the potential to improve supportive supervision
 practices in child welfare agencies, and create healthy work environments
 that support staff retention, and continued implementation which is needed
 to address the overdose crisis among families. This project will test the
 effectiveness of a supervision coaching strategy to promote workforce
 stability and START implementation while also creating conditions for
 strategy sustainment in Ohio’s child welfare system. This Hybrid Type III
 implementation-effectiveness study will test the impact of CrOss System
 Technical Assistance for Retaining Staff (COSTARS), a supervision coaching
 strategy for child welfare supervisors focused on supportive supervision
 practices, destigmatizing substance use disorder, and improving
 collaboration between child welfare and substance use disorder treatment
 systems. Building on our earlier research and partnerships, the goal of
 the R61 phase is to refine and build the COSTARS model.
 R61 Aim 1: We will tailor COSTARS to local supervisor,
 family peer mentor and caseworker needs by convening a community
 workgroup, conducting a supervision needs assessment, and developing a
 manual and fidelity measure for COSTARS. R61 Aim 2: Through a
 series of in-person and virtual didactic training, coaching, and fidelity
 feedback sessions, we will train COSTARS coaches (a peer
 coach paired with an expert supervision coach) to competency. The goal of
 the R33 phase is to investigate the real-world effects
 of COSTARS. Using a stepped wedge cluster-randomized
 implementation trial design, COSTARS will be delivered
 to 40 Ohio START teams in 4 waves. R33 Aim 1: Drawing on annual survey
 data from all staff members, we will examine the effects
 of COSTARS on perceptions of their work environment, and
 retention. R33 Aim 2: We will analyze program records from 1300 parents
 expected to participate in START to examine the effects
 of COSTARS on service timeliness, implementation fidelity, and
 parental outcomes. The proposed study is significant because we will build
 child welfare system capacity to address the opioid epidemic and address
 treatment inequities in rural and Appalachian communities, where overdoses
 and child maltreatment are especially high. This study is part of the
 NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed
 scientific solutions to the national opioid public health crisis. The NIH
 HEAL Initiative bolsters research across NIH to improve treatment for
 opioid misuse and addiction.
description: # Staffing and supports for implementing cross-system interventions with
 peer mentors Dataset DOI:
 [10.5061/dryad.1g1jwsv88](10.5061/dryad.1g1jwsv88) ## Description of the
 data and file structure For the R61 phase of this project, we collected
 data Supervision Needs Assessment which assessed reasons for turnover
 among Ohio START staff, perceived acceptability of a supervision
 leadership institute, and preferred topics for supervision support. This
 included a survey of administrative leaders (n= 87, 49% response rate)
 administered between January 14 and February 4, 2025. We also completed
 three focus groups with Family Peer Mentors (n=16, out of 50) on January
 20, 2025 and three focus groups with Caseworkers (n=9, out of 60) on
 February 4, 2025. This data informed development of the COSTARS model for
 supervision support. ### Files and variables #### File:
 COSTARS_Focus_Group_Discussion_Guide.pdf **Description:** Questions asked
 in semi-structured focus groups with Ohio START family peer mentors and
 caseworkers. #### File: COSTARS_Supervision_Needs_Assessment_Survey.pdf
 **Description:** Questions asked of Ohio START supervisors and
 administrators in a Qualtrics survey. #### **File:
 COSTARS_Supervision_Needs_Assessment_Survey_Results.csv**
 **Description:** Responses received on the COSTARS Supervision Needs
 Assessment Survey between January 16 and February 5, 2025. All questions
 were displayed to all participants. Empty cells in the table indicate that
 the survey respondent chose to skip that question. This survey also
 collected demographic information and several verbatim text entry fields.
 These fields were removed from this submission due to the potential
 identifiability of respondents and the employees they described. Our
 research partners at the Public Children Services Association of Ohio
 request to be notified if you plan to use this data. Please contact Ohio
 START program administrators through the web form at
 [https://ohiostart.org/](https://ohiostart.org/ )  ## Code/software Files
 are presented in the widely accessible PDF and .csv formats. ## Access
 information Other publicly accessible locations of the data: * N/A Data
 was derived from the following sources: * N/A ## Human subjects data
 Participants in this research have consented to the sharing of
 de-identified data. In the interest of de-identification, we have removed
 all participant, county, and agency names.