The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) is a risk assessment instrument for adolescents that estimates the risk of multiple adverse outcomes. Prior research into its predictive validity is limited to a handful of studies conducted with the START:AV pilot version and often by the instrument’s developers. The present study examines the START:AV’s field validity in a secure youth care sample in the Netherlands. Using a prospective design, we investigated whether the total scores, lifetime history, and the final risk judgments of 106 START:AVs predicted inpatient incidents during a 4-month follow-up. Final risk judgments and lifetime history predicted multiple adverse outcomes, including physical aggression, institutional violations, substance use, self-injury, and victimization. The predictive validity of the total scores was significant only for physical aggression and institutional violations. Hence, the short-term predictive validity of the START:AV for inpatient incidents in a residential youth care setting was partially demonstrated and the START:AV final risk judgments can be used to guide treatment planning and decision-making regarding furlough or discharge in this setting.
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Risk assessment instruments are widely used to predict risk of adverse outcomes, such as violence or victimization, and to allocate resources for managing these risks among individuals involved in criminal justice and forensic mental health services. For risk assessment instruments to reach their full potential, they must be implemented with fidelity. A lack of information on administration fidelity hinders transparency about the implementation quality, as well as the interpretation of negative or inconclusive findings from predictive validity studies. The present study focuses on adherence, a dimension of fidelity. Adherence denotes the extent to which the risk assessment is completed according to the instrument’s guidelines. We developed an adherence measure, tailored to the ShortTerm Assessment of Risk and Treatability: Adolescent Version (START:AV), an evidence-based risk assessment instrument for adolescents. With the START:AV Adherence Rating Scale, we explored the degree to which 11 key features of the instrument were adhered to in 306 START:AVs forms, completed by 17 different evaluators in a Dutch residential youth care facility over a two-year period. Good to excellent interrater reliability was found for all adherence items. We identified differences in adherence scores on the various START:AV features, as well as significant improvement in adherence for those who attended a START:AV refresher workshop. Outcomes of risk assessment instruments potentially impact decision-making, for example, whether a youth’s secure placement should be extended. Therefore, we recommend fidelity monitoring to ensure the risk assessment practice was delivered as intended.
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An effective implementation approach is crucial for successful integration of structured risk assessment instruments into practice. This qualitative study explored barriers and facilitators to the implementation of the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) in a Dutch residential youth care service. Perceptions of staff members from various disciplines were gathered through focus group interviews at three consecutive occasions. After inductive coding of the interview extracts using thematic analysis, the identified codes were linked to the consolidated framework for implementation research. Through this framework, factors that influence an implementation project can be organized into multiple domains and constructs. In the present study, staff members described implementation barriers related to characteristics of the risk assessment instrument, staff, and the implementation process. In addition, features of the setting were frequently mentioned as hindering the implementation, such as hierarchy, culture, communication, as well as implementation climate and readiness for change. Staff members also identified multiple facilitators, such as experienced advantages of the START:AV compared to the previous risk assessment practice and positive beliefs about the instrument. The article concludes with recommendations for successful implementation of structured risk assessment instruments in forensic-clinical practice.
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There is emerging evidence that the performance of risk assessment instruments is weaker when used for clinical decision‐making than for research purposes. For instance, research has found lower agreement between evaluators when the risk assessments are conducted during routine practice. We examined the field interrater reliability of the Short‐Term Assessment of Risk and Treatability: Adolescent Version (START:AV). Clinicians in a Dutch secure youth care facility completed START:AV assessments as part of the treatment routine. Consistent with previous literature, interrater reliability of the items and total scores was lower than previously reported in non‐field studies. Nevertheless, moderate to good interrater reliability was found for final risk judgments on most adverse outcomes. Field studies provide insights into the actual performance of structured risk assessment in real‐world settings, exposing factors that affect reliability. This information is relevant for those who wish to implement structured risk assessment with a level of reliability that is defensible considering the high stakes.
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De meeste risicotaxatie-instrumenten voor jongeren in de jeugdzorg beoordelen het risico op één schadelijke uitkomst, zoals gewelddadig gedrag. Maar er zijn meer soorten risicovol gedrag. De Short-Term Assessment of Risk and Treatability: Adolescenten Versie (START:AV) beoordeelt zowel het risico op dader- als slachtofferschap.
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Currently, implementation research in the field of forensic risk assessment is limited and consensus on “implementation success” is lacking. This study applies outcomes of success from implementation science to the implementation evaluation of the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) in a residential youth care facility in the Netherlands. Staff perceptions on the implementation and the instrument were assessed using 5 implementation outcomes in a longitudinal multimethod design: acceptability, adoption, appropriateness, feasibility, and penetration. As anticipated, the majority of staff perceived START:AV core constructs as useful for treatment (appropriateness). However, satisfaction with the instrument decreased over time (acceptability). This was likely due to an increased workload (feasibility). Despite this dissatisfaction, the completion rate was acceptable (adoption). Lastly, staff reported a lack of integration of the START:AV findings in clinical case conferences (penetration). The implementation outcomes aid in identifying areas for improvement, which in turn can lead to an increased and more consistent uptake of structured risk assessment into routine practice
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Leraar worden en leraar blijven is een belangrijke focus binnen het lectoraat. De complexiteit van het beroep van leraar vraagt om een ontwikkeling die niet stopt na de diplomering. Goed starten focust op een doorgaande opleiding en professionalisering van initiële- tot en met inductiefase, waarin de leraar doorgroeit tot vakbekwame professional. Aanleiding voor ons onderzoek zijn maatschappelijke vraagstukken, zoals het structurele en toenemende lerarentekort en hoe eigentijds is op te leiden in een steeds veranderende en multiculturele samenleving. We laten de belangrijkste resultaten over Goed starten uit onderzoeksprojecten van Werken in Onderwijs de revue passeren.
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Infosheet met tips voor nieuwe studenten om ze te ondersteunen bij de start van hun nieuwe studie. De tips zijn gebaseerd op uitkomsten van diverse onderzoeken van het lectoraat, maar ook op tips van studenten zelf, die hierover hebben meegedacht.
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Een goed team kan elk project aan en een slecht team kan elk project verprutsen. Dat weten we in de bouw al jaren. Maar hoe realiseer je een goed team? We weten dat een goede start een belangrijke voorwaarde is. En toch slagen we er altijd weer in om deze wetenschap te negeren. Een team is: 30 mensen die elkaar niet kennen, 15 in de keet van de opdrachtgever en 15 in de keet van de bouwer en gaan met die banaan. Een slechte start leidt tot een minder presterend team en dus tot een matig project. Waarom is een projectstartup zo belangrijk en hoe pak je dat aan? In een studie door het A2 convenant is deze materie op een praktische wijze behandeld.
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Deze toolkit bevat gesprekskaarten, een poster en een werkkaart en is bedoeld om vrijwilligers te uit te nodigen tot reflectie en gesprek over het toepassen van de 4 principes van Home-Start.
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