There are pre-implementation materials to measure organizational or provider readiness for SafeCare® as listed below:

The National SafeCare® Training and Research Center (NSTRC) conducts an implementation planning process to facilitate an agency's readiness to implement SafeCare®. NSTRC collects information about the agency via conversations and an agency application, disseminates Implementation Planning Guides and discusses steps agencies should take prior to SafeCare® training. Agencies are provided with appropriate documents, asked to review, and then the documents are reviewed jointly during a phone call with NSTRC prior to initiating a training contract. The documents focus on four main areas:

• Population/systems - ensuring that the population targeted is appropriate for SafeCare®, and that the system in which SafeCare® will be implemented can support it (i.e., does it allow for an appropriate number of sessions, can coaching be paid for?)
• Agency issues - ensuring that agency leadership and staff are all in support of SafeCare® implementation, and have communicated about why SafeCare® is being adopted, the importance of model fidelity, concerns that have arisen, caseloads, etc.
• Staff to be trained - ensuring that the staff to be trained have been vetted and are in support of the model and comfortable with its approach, and have been briefed on training processes and expectations regarding implementation
• Resources - detailing the resources needed for SafeCare® implementation.

Additionally, NSTRC staff conducts an in-person orientation for every agency trained. NSTRC expects agency leadership and trainees to be present, and recommends referral agents and other stakeholders attend as well. The site visit will provide an overview of SafeCare®, and typically includes breakout sessions with agency management/funders and providers to discuss and problem solve typical implementation challenges. For more information, email safecare@gsu.edu.

There is formal support available for implementation of SafeCare® as listed below:

Certified SafeCare Coaches provide support for Providers. Home sessions are observed or listened to by the Coach to assess fidelity and guide feedback to the Provider in a coaching call or meeting. SafeCare Trainers support SafeCare Coaches by assessing the reliability of Coaches' fidelity, as well as the quality of the coaching session with the provider. NSTRC also provides technical assistance to agencies during the first year of implementation.

The SafeCare Portal is a web-based platform that assists in trainee certification and fidelity monitoring, as well as facilitating support for Providers from their Coach and Coaches from their trainer. The Portal also collects data on Provider demographics and certification progress.

There are fidelity measures for SafeCare® as listed below:

There are three fidelity assessment forms that are used for each SafeCare® module to assess the Provider's delivery of the program to a family. Each assesses approximately 30 behaviors that should be performed during the SafeCare® session (e.g., opens session, observes parent behavior during practice, provides positive and corrective feedback). Each item is rated as "implemented," "not implemented," or "not applicable" to that session. Coaching sessions are also rated for fidelity using a coach fidelity assessment form. The measures can be requested at safecare@gsu.edu.

There are implementation guides or manuals for SafeCare® as listed below:

Manuals and implementation tools are provided with each training and implementation. Manuals include tools for SafeCare® delivery including a session outline for each of the SafeCare® sessions, all handouts that are to be provided to parents (e.g., health manual, home safety handouts), and all clinical tools to be used by the provider (e.g., assessment tools for parenting, health, and safety). The Coach Manual includes fidelity monitoring tools and discussion of fidelity monitoring processes. The Trainer Manual includes guidelines and recommendations for training SafeCare® Coaches and Trainers. Samples of the materials are available either by visiting http://safecare.publichealth.gsu.edu/training/curriculum/ or by emailing safecare@gsu.edu.

Research has been conducted on how to implement SafeCare® as listed below:

• Aarons, G., Fettes, D., Flores, L., & Sornmerfeld, D. (2009). Evidence-based practice implementation and staff emotional exhaustion in children's services. Behaviour Research and Therapy, 47(11), 954-960. https://doi.org/10.1016/j.brat.2009.07.006
• Aarons, G., & Palinkas, L. (2007). Implementation of evidence-based practice in child welfare: Service provider perspectives. Administration and Policy in Mental Health and Mental Health Services Research, 34, 411-419. https://doi.org/10.1007/s10488-007-0121-3
• Aarons, G. A., Sommerfeld, D. H., Hecht, D. B., Silovsky, J. F., & Chaffin, M. J. (2009). The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: Evidence for a protective effect. Journal of Consulting & Clinical Psychology, 77(2), 270-280. https://doi.org/10.1037/a0013223
• Palinkas, L., Aarons, G., Chorpita, B., Hoagwood, K., Landsverk, J., & Weisz, J. (2009). Cultural exchange and the implementation of evidence-based practices. Research on Social Work Practice, 19(5), 602-612. https://doi.org/10.1177/1049731509335529
• Self-Brown, S., Frederick, K., Binder, S., Whitaker, D., Lutzker, J., Edwards, A., & Blankenship, J. (2011). Examining the need for cultural adaptations to an evidence-based parent training program targeting the prevention of child maltreatment. Children & Youth Services Review, 33(7), 1166-1172. https://doi.org/10.1016/j.childyouth.2011.02.010
• Self-Brown, S. R., Osborne, M. C., Rostad, W., & Feil, E. (2017). A technology-mediated approach to the implementation of an evidence-based child maltreatment prevention program. Child Maltreatment, 22(4), 344-353. https://doi.org/10.1177/1077559516678482
• Whitaker, D. J., Ryan, K. A., Wild, R. C., Self-Brown, S., Lutzker, J. R., Shanley, J. R., Edwards, A. M., McFry, E. A., Moseley, C. N., & Hodges, A. E. (2012). Initial implementation indicators from a statewide rollout of SafeCare within a child welfare system. Child Maltreatment, 17(1), 96-101. https://doi.org/10.1177/1077559511430722