# Team training in the real world: A cluster-randomized hybrid effectiveness-implementation trial of TeamTRACS in rural Children’s Advocacy Centers

## TL;DR

This study tested a team training program for rural child abuse response teams and found positive reactions but limited effectiveness due to implementation challenges.

## Contribution

The study evaluates a self-guided implementation process for team training in rural multidisciplinary teams and identifies barriers to successful adoption.

## Key findings

- TeamTRACS received positive feedback and improved teamwork knowledge but had no impact on skill use or work outcomes.
- Only one team completed the self-guided implementation process due to challenges like turnover and competing priorities.
- Positive reactions to both the training and implementation process suggest potential for improvement with more support and time.

## Abstract

Children’s Advocacy Centers (CACs) use multidisciplinary teams to respond to child abuse allegations. These fluid teams can benefit from team training to enhance team functioning and performance and strengthen the workforce, but they need guidance and resources to support the implementation of team training.

We conducted a cluster-randomized hybrid effectiveness-implementation trial to test the effectiveness of team training and evaluate a self-guided implementation process. Six rural CACs (N = 172 team members) were randomized to TeamTRACS (Team Training in Roles, Awareness, Communication, & Support; n = 4) or a waitlist comparison (n = 2). Simultaneous mixed methods evaluated the effectiveness of TeamTRACS (QUAN + qual) and the implementation process (quan + QUAL).

Reactions to TeamTRACS were positive (mean ratings > 4.5 on 1–5 scale), and TeamTRACS significantly increased teamwork knowledge (estimated marginal means = 80% vs. 75% [intent-to-treat]; 85% vs. 76% [training attendance]). There were no effects on skill use or work-related outcomes. Changes in team-level outcomes were small and inconsistent; one TeamTRACS team made substantial improvements. Reactions to self-guided implementation were positive (mean ratings > 4 on 1–5 scale). However, only one team completed the implementation process. Challenges included difficulty forming and maintaining a change team, turnover and understaffing, and competing priorities and a short timeframe.

Overall, TeamTRACS and its self-guided implementation process were positively received. Incomplete implementation may have limited TeamTRACS’ effectiveness. Longer timeframes and external support may improve the implementation of team training in low-resource settings.