Introducing the START:AV in Secure Youth Care: Illustration of a Structured Risk Assessment Implementation Process

Figures & data

Figure 1. Key ingredients of a risk assessment implementation.

Note. CFIR = Consolidated framework of implementation research (Damschroder et al., 2009), ERIC = Expert recommendations for implementing change (Powell et al., 2015), IOF: Implementation outcomes framework (Proctor et al., 2011). Adapted from Risk assessment with the START:AV in Dutch secure youth care. From implementation to field evaluation, by De Beuf (2022), p. 161.

Table 1. List of publications on the implementation of the START or START:AV and the implementation elements they address.

Reference	Instrument	Implementation Determinants	Implementation Strategies	Implementation Outcomes	Implementation Steps
De Beuf et al. (2019)	START:AV			x	(summary)
De Beuf, de Ruiter, et al. (2020)	START:AV	x	(recommendations)		(summary)
De Beuf, de Vogel, et al. (2020)	START:AV			x
Sher and Gralton (2014)	START:AV		(recommendations)	x	(partially)
Crocker et al. (2011)	START	x		x
Doyle et al. (2008)	START	(x)		x
Kroppan et al. (2011)	START	(x)		x	(partially)
Kroppan et al. (2017)	START			x	(partially)
Levin et al. (2018)	START	x			(partially)
Webster, Martin, et al. (2006)	START		x
Webster, Nicholls, et al. (2006)	START		x

Note. Brackets indicate that the information was mentioned, but was not central to the publication.

Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science : IS, 4, 50–66. https://doi.org/10.1186/1748-5908-4-50

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Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., Proctor, E. K., & Kirchner, J. E. (2015). A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Science : IS, 10, 21–34. https://doi.org/10.1186/s13012-015-0209-1

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Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., & Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health, 38(2), 65–76. https://doi.org/10.1007/s10488-010-0319-7

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De Beuf, T. L. F. (2022). Risk assessment with the START:AV in Dutch secure youth care. From implementation to field evaluation [dissertation]. Maastricht University. https://doi.org/10.26481/dis.20220404td

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De Beuf, T. L. F., de Vogel, V., & de Ruiter, C. (2019). Implementing the START:AV in a Dutch residential youth facility: Outcomes of success. Translational Issues in Psychological Science, 5(2), 193–205. https://doi.org/10.1037/tps0000193

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De Beuf, T. L. F., de Ruiter, C., & de Vogel, V. (2020). Staff perceptions on the implementation of structured risk assessment: Identifying barriers and facilitators in a residential youth care setting. International Journal of Forensic Mental Health, 19(3), 297–314. https://doi.org/10.1080/14999013.2020.1756994

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De Beuf, T. L. F., de Vogel, V., & de Ruiter, C. (2020). Adherence to structured risk assessment: Development and preliminary evaluation of an adherence scale for the START:AV. Journal of Forensic Psychology: Research and Practice, 20(5), 413–435. https://doi.org/10.1080/24732850.2020.1756676

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Sher, M. A., & Gralton, E. (2014). Implementation of the START:AV in a secure adolescent service. Journal of Forensic Practice, 16, 184–193. https://doi.org/10.1108/JFP-04-2013-0021

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Crocker, A. G., Braithwaite, E., Laferrière, D., Gagnon, D., Venegas, C., & Jenkins, T. (2011). START changing practice: Implementing a risk assessment and management tool in a civil psychiatric setting. The International Journal of Forensic Mental Health, 10(1), 13–28. https://doi.org/10.1080/14999013.2011.553146

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Doyle, M., Lewis, G., & Brisbane, M. (2008). Implementing the Short-Term Assessment of Risk and Treatability (START) in a forensic mental health service. Psychiatric Bulletin, 32, 406–408. https://doi.org/10.1192/pb.bp.108.019794

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Kroppan, E., Nesset, M. B., Nonstad, K., & Pedersen, T. W. (2011). Implementation of the Short-Term Assessment of Risk and Treatability (START) in a forensic high-secure unit. International Journal of Forensic Mental Health, 10(1), 7–12. https://doi.org/10.1080/14999013.2011.552368

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Kroppan, E., Nonstad, K., Iversen, R. B., & Søndenaa, E. (2017). Implementation of the Short-Term Assessment of Risk and Treatability over two phases. Journal of Multidisciplinary Healthcare, 10, 321–326. https://doi.org/10.2147/JMDH.S133514

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Levin, S. K., Nilsen, P., Bendtsen, P., & Bülow, P. (2018). Staff perceptions of facilitators and barriers to the use of a short- term risk assessment instrument in forensic psychiatry. Journal of Forensic Psychology Research and Practice, 18(3), 199–228. https://doi.org/10.1080/24732850.2018.1466260

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Webster, C. D., Martin, M. L., Brink, J., Nicholls, T. L., & Middleton, C. (2006). Manual for the Short-Term Assessment of Risk and Treatability (START). (version 1.1) St. Joseph’s Healthcare Hamilton; Forensic Psychiatric Services Commission.

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Webster, C. D., Nicholls, T. L., Martin, M. L., Desmarais, S. L., & Brink, J. (2006). Short-Term Assessment of Risk and Treatability (START): The case for a new structured professional judgment scheme. Behavioral Sciences & the Law, 24(6), 747–766. https://doi.org/10.1002/bsl.737

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