Appendix C_Research Questions Addressed by Interview Protocols

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Touchpoints for Addressing Substance Use Issues in Home Visiting

Research Questions Addressed in Pilot Study Interview Protocols

February 2021

CHARLOTTE CABILI, STACIE FELDMAN, AND MELISSA AZUR

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Table 1 presents the interview question numbers that correspond to each research question for interviews with the following respondents: (1) local implementing agency (LIA) managers and data managers, home visiting supervisors, and home visitors, (2) state awardees, and (3) home visiting model representatives.

Table 1. Research questions addressed in respondent interview protocols

Research Question	Protocol Question Number
	LIA	State Awardee	Model Representative
What process do LIAs use to screen for SUDs? What tools do they use, and how do staff feel about the use of standardized, validated screening tools?	Section I: 3, 4, 5, 6, 7, 8, 18	NA	NA
What policies and procedures do state awardees and LIAs currently have in place on screening for substance use issues and follow up on referrals?	Section I: 9,10,22,23	Section I: 9,10, 23,24	NA
When do LIAs typically screen for substance use? What factors facilitate or hinder a home visitor’s ability to screen a caregiver for substance use within 30 days of enrollment?	Section I: 11, 12, 13, 14	NA	NA
At what point in enrollment should LIAs screen pregnant caregivers for substance use issues? Should pregnant caregivers be screened when they first enroll in the home visiting program and at some interval after giving birth?	Section I: 15, 16, 17	NA	NA
How long does it typically take for caregivers to receive an appointment with a behavioral health specialist? What factors facilitate and hinder a home visitor’s ability to connect caregivers with behavioral health specialists within 14 days?	Section I: 19, 20, 21	NA	NA
What kinds of resources and supports would enhance a home visitor’s ability to interpret and act on information collected through screening, refer caregivers with a positive screen to substance use services for assessment, and follow up on a referral outcome?	Section I: 24, 25, 26	Section III: 5, 6, 7	NA
What resources and supports would enhance a home visitor’s ability to provide services to families to address substance use (as in supporting behavior change, promoting positive social support, and providing information on the effects of maternal substance use)?	Section I: 27, 28, 29	Section III: 8, 9, 10	NA
How do LIAs currently measure a caregiver’s receipt of substance use screening and follow up?	Section II: 1, 2	NA	Section II: 1
How do SUD-1 and SUD-2 compare with the substance use measures LIAs have been using?	Section II: 1, 2	Section II: 2a-2e	NA
How do the SUD-1 and SUD-2 measures align with model requirements on substance use screening and follow up?	Section II: 2f	Section II: 2f	Section II: 2f
How feasible is it for state awardees and LIAs to collect data on screening for alcohol and drug use? For follow up care from a behavioral health provider?	Section II: 3	Section II: 3	NA
What infrastructure do state awardees and LIAs have in place to support reporting performance on SUD-1 and SUD-2?	Section II: 4	Section II: 4	Section II: 4
To what extent are the data elements to calculate SUD-1 and SUD-2 included in state awardees’ and LIAs’ record management systems?	Section II: 5	Section II: 5	NA
What changes will LIAs have to make to their record management systems to calculate SUD-1 and SUD-2 and to report SUD-1 and SUD-2 to the state?	Section II: 6	NA	NA
What changes will state awardees have to make to their record management systems to calculate SUD-1 and SUD-2?	NA	Section II: 6	NA
What do state awardees and LIAs see as the greatest barriers to home visiting programs measuring SUD-1 and SUD-2? What strategies can they use to help overcome the barriers?	Section II: 7, 8	Section II: 7,8	Section II: 7,8
How feasible would it be to implement SUD-1 and SUD-2 alongside the other MIEHCV performance measures?	Section II: 9, 10	Section II: 9,10	Section II: 9,10
What kinds of resources and supports at the state awardee and LIA levels would enhance their ability to collect the data necessary to report SUD-1 and SUD-2?	Section II: 11, 12	Section II:11	Section II: 11
Do SUD-1 and SUD-2 provide useful information to state awardees and LIAs for quality monitoring and improvement?	Section II: 13, 14	Section III: 1, 2	NA
How do state awardees and LIAs use information from MIECHV performance measures they report?	Section II: 14, 15	Section III: 3, 4	NA
Are there any unintended consequences at the state awardee and LIA levels to implementing SUD-1 and SUD-2?	Section II: 16	Section III: 11, 12	NA
What is the likely cost of calculating SUD-1 and SUD-2?	Section II: 17, 18	Section II: 12,13	NA

Note: The table excludes the research question, “What types of resources and supports do state awardees and LIAs ask for during the pilot to enhance their ability to collect the data necessary to report SUD-1 and SUD-2 and to report on those data?” because this research question will be answered through the provision of technical assistance during the pilot study.

LIA = Local Implementing Agency; MIEHCV = Maternal, Infant, and Early Childhood Home Visiting; NA = not asked; SUD-1 = Screening for Substance Misuse; SUD-2 = Follow up for Caregivers at Risk of Substance Misuse.