Factor Structure, Reliability, and Validity of the Wraparound Fidelity Index Short Form (WFI-EZ)

• Published in: Journal of child and family studies Vol. 32; no. 6; pp. 1855 - 1868
• Main Authors: Bruns, Eric J., Olson, Jonathan R., Parigoris, Ryan M., Parker, Elizabeth M., Walker, Janet S.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-06-2023; Springer Nature B.V
• Subjects: Assets; Behavior disorders; Behavioral Science and Psychology; Care coordinators; Caregivers; Child and School Psychology; Clinical outcomes; Coordination; Coordinators; Factor Structure; Family (Sociological Unit); Fidelity; Health status; Leadership; Membership; Mental health; Morale; Original Paper; Psychology; Self report; Social Sciences; Sociology; Support services; Teams; Test-Retest reliability; Validity; Wraparound programmes; care coordination; fidelity; validity; children and youth; Wraparound; reliability
• ISSN: 1062-1024; 1573-2843
• DOI: 10.1007/s10826-023-02597-x

Wraparound care coordination has been demonstrated to promote positive mental health, residential, and cost outcomes for children and youth with serious emotional and behavioral disorders (SEBD) and their families. However, research also shows that positive outcomes are dependent on adequacy of Wraparound fidelity. The current study presents results from a series of studies that collectively assessed the factor structure, reliability, and validity of the Wraparound Fidelity Index, Short Form (WFI-EZ), a four section, multi-informant, self-report measure. Analyses of a sample of 10,955 caregivers of youth who received Wraparound and completed the WFI-EZ found a four-factor solution that aligned well with previous theories of change for Wraparound, with factors focused on team membership, team process, inclusion of natural supports, and intermediate outcomes, including increased family assets and more effective services and supports. Cronbach’s alpha was 0.90 for the full index and acceptable for all four empirically derived factors (α = 0.61–0.91); preliminary test-retest reliability data for the composite WFI-EZ fidelity index drawn from two small samples was found to be high for caregivers (r = 0.94) and moderate for care coordinators (r = 0.72). Results of known-groups analyses found that WFI-EZ scores discriminated groups theoretically expected to differ on Wraparound fidelity, including whether basic elements of Wraparound were provided and whether provider organizations were measured as having high versus low supports for Wraparound. Results indicate the WFI-EZ is a reliable and valid measure of Wraparound fidelity, while also pointing to opportunities for future refinement, further research, and opportunities for improving Wraparound training and implementation support.
Highlights
The Wraparound Fidelity Index, Short Form (WFI-EZ) was shown to be a reliable and valid fidelity measure.
An underlying factor structure of the WFI-EZ was found that aligns with past theory on Wraparound that emphasizes the importance of Wraparound team membership, team process, and two routes to positive family outcomes: increased family assets and more effective services and supports.
Wraparound provider factors such as leadership and staff morale were found to be associated with practice fidelity and caregiver satisfaction.
The current study points to potential future refinements, including reduction in the number of items and revision of scoring rules.