Connecting the Dots: Stages of Implementation, Wraparound Fidelity and Youth Outcomes

Several necessary system and organizational support conditions for wraparound have been identified (Walker et al. 2003). Yet, the relationship between these necessary system level conditions and wraparound fidelity has only recently begun to
be examined. Similarly, few studies have included a measure of wraparound fidelity when examining the relationship between
wraparound implementation and youth outcomes. The statewide implementation of a wraparound demonstration grant offers the
opportunity to explore these relationships and to identify factors that predict improvement in functioning for youth receiving
wraparound. Findings suggest that significant relationships exist between (1) the stage of development of necessary support
conditions for wraparound and wraparound fidelity and (2) wraparound fidelity and improvement in youth outcomes. Specific
elements of wraparound (i.e., outcomes based and community based) and baseline needs and strengths (e.g., high levels of anxiety
and conduct issues, poor functioning at home and in school, judgment, and risks) were found to predict a reduction in youth
needs. Other unexpected relationships between youth outcomes and the cultural competence element of wraparound and being multi-racial
were also discovered. These findings reinforce the importance of supporting high fidelity wraparound for youth and their families
in a recovery focused behavioral health system.