Assessment and Fidelity
The Wraparound Evaluation and Research Team (WERT) is the "accountability wing" of the National Wraparound Initiative. Using a collaborative process that involves NWI advisors, WERT develops, pilot tests, refines, and disseminates evaluation measures that support Wraparound implementation such as those of the Wraparound Fidelity Assessment System.
In the sections below, we provide a brief overview of the measures of the WFAS. For more information about the measures of the WFAS, please visit the website of the Wraparound Evaluation and Research Team (WERT), at the University of Washington.
Fidelity and Assessment
The NWI was borne of the need to better specify the principles and practice model of Wraparound so that it could be more consistently and effectively implemented. Since it has been more fully specified, researchers affiliated with the NWI, with the help of dozens of Wraparound experts and pilot sites nationwide, have developed several fidelity measures that can support Wraparound implementation as well as research. Together, these measures comprise the Wraparound Fidelity Assessment System (WFAS).
The WFAS is a multi-method approach to assessing the quality of individualized care planning and coordination for children and youth with complex needs and their families. WFAS instruments include interviews with multiple stakeholders, a team observation measure, a document review measure, and an instrument to assess the level of community and system support for Wraparound. The instruments that comprise the WFAS can be used individually or in combination with one another. These measures are also supported by an online data entry and reporting system that can produce customized reports for user sites.
WFAS measures include:
Wraparound Fidelity Index, version 4.0
The Wraparound Fidelity Index 4.0 (WFI-4) is a set of four interviews that measures the nature of the Wraparound process that an individual family receives. The WFI-4 is completed through brief, confidential telephone or face-to-face interviews with four types of respondents: caregivers, youth (11 years of age or older), Wraparound facilitators, and team members. It is important to gain the unique perspectives of all these informants to understand fully how Wraparound is being implemented. A demographic form is also part of the WFI-4 battery. The WFI-4 interviews are organized by the four phases of the Wraparound process (Engagement and Team Preparation, Initial Planning, Implementation, and Transition). In addition, the 40 items of the WFI interview are keyed to the 10 principles of the Wraparound process, with four items dedicated to each principle. In this way, the WFI-4 interviews are intended to assess both conformance to the Wraparound practice model as well as adherence to the principles of Wraparound in service delivery.
Wraparound Fidelity Index, Brief Version (WFI-EZ)
The WFI-EZ represents an attempt to provide sites and states with a comprehensive Wraparound fidelity assessment tool that is more user friendly and efficient than the interviews of the WFI-4. The WFI-EZ is completed through brief, self-report surveys with four types of respondents: parents or caregivers, youths 11 years of age or older, Wraparound facilitators, and team members. It is important to gain the unique perspectives of these four informants to understand fully how Wraparound is being implemented. The survey can be self-administered or administered by a program staff member. It can be completed via online survey or by hand on a piece of paper. The survey collects data on Wraparound implementation fidelity (25 items) as well as caregiver and youth satisfaction (4 items) and youth and family outcomes (9 items)
Team Observation Measure
The Team Observation Measure (TOM) is employed by external evaluators to assess adherence to standards of high-quality Wraparound during team meeting sessions. The TOM Version 1 consists of 20 items, with two items dedicated to each of the 10 principles of Wraparound. Each item consists of 3-5 indicators of high-quality Wraparound practice as expressed during a child and family team meeting. Working alone or in pairs, trained raters indicate the whether or not each indicator was in evidence during the Wraparound team meeting session. These ratings are translated into a score for each item as well as a total fidelity score for the session overall. A new version of the TOM, the TOM-2 provides a briefer and more efficient measure, reorganized into 8 domains and 44 total items.
The CSWI is a research and quality improvement tool intended to measure how well a local system supports the implementation of the Wraparound process. The CSWI is based on the framework of Necessary Conditions described by Walker, Koroloff and Schutte (2003), and presents 42 community or system variables that ideally are in place in communities that aim to implement the Wraparound process. The CSWI is somewhat unique from the other WFAS instruments in that it assesses the system context for Wraparound as opposed to the fidelity to the practice model for an individual child and family.
It results in a quantified assessment of community supports for Wraparound across multiple domains, so that researchers can determine the impact of these conditions on fidelity and outcomes. Results are structured so that local groups can assess system supports for Wraparound, respond to areas of strength and weakness, and monitor improvements over time.
Wraparound Structured Assessment and Review (WrapSTAR)
The Wraparound Structured Assessment and Review (WrapSTAR) provides an external, objective method for evaluating a site or system’s Wraparound implementation strengths and needs, allowing for a comprehensive approach to accountability and quality improvement across all implementation drivers for Wraparound. Bringing together a range of WFAS tools and implementation measures, the WrapSTAR process goes above merely measuring a site’s adherence to the Wraparound model (aka, “fidelity”) to also assess key implementation drivers rooted in years of implementation science research, as well as community and system supports found to be essential for sustaining a Wraparound Initiative. This holistic approach allows for a robust understanding of not only how, but why Wraparound is functioning within an organization or community, leading to greater insight about what can be done to improve outcomes for families and staff and the degree to which locally sustainable infrastructure for workforce development and implementation has successfully yielded high-quality practice.
For more information about the measures of the WFAS, please visit the website of the Wraparound Evaluation and Research Team (WERT), at the University of Washington.
The Community Supports for Wraparound Inventory was produced through the full NWI consensus process. Other products referenced here have been peer reviewed through the NWI. See our Resource Review Standards for more information.