Perceptions of professionals about factors affecting the implementation of early childhood support systems: A case study evaluation from an ecological perspective.

This evaluation research looked at factors affecting collaboration across the various levels of implementation of early childhood support systems. An ecological conceptual framework was used to examine barriers and facilitators to implementing social and health care services from the perspective of the professionals involved at the national, state, and local level of government. A single case study following a qualitative research strategy was conducted with a total of 29 professionals from social development and health ministries, one municipality and a family health center responsible for implementing the Chile Grows with You system. The results show that at the national level, the main factors include socio-political aspects, funding, and the empathy that professional employees hold for peers who are at lower rungs in the hierarchy. At the state level workplace conditions play a key role. For the local level those factors include information system management and the political support of the local government. The discussion section emphasizes the relevance of considering the interdependence of such factors that influence implementation outcomes and the need to move away from a single program evaluation to a multilevel implementation analysis of public policy.

Transforming Social Regularities in a Multicomponent Community-Based Intervention: A Case Study of Professionals' Adaptability to Better Support Parents to Meet Their Children's Needs.

This paper presents an in-depth case study of the dynamic processes of mutual adjustment that occurred between two professional teams participating in a multicomponent community-based intervention (CBI). Drawing on the concept of social regularities, we focus on patterns of social interaction within and across the two microsystems involved in delivering the intervention. Two research strategies, narrative analysis and structural network analysis, were used to reveal the social regularities linking the two microsystems. Results document strategies and actions undertaken by the professionals responsible for the intervention to modify intersetting social regularities to deal with a problem situation that arose during the course of one intervention cycle. The results illustrate how key social regularities were modified in order to resolve the problem situation and allow the intervention to continue to function smoothly. We propose that these changes represent a transition to a new state of the ecological intervention system. This transformation appeared to be the result of certain key intervening mechanisms: changing key role relationships, boundary spanning, and synergy. The transformation also appeared to be linked to positive setting-level and individual-level outcomes: confidence of key team members, joint planning, decision-making and intervention activities, and the achievement of desired intervention objectives.