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Randomized Controlled Trial
. 2012 Mar;129(3):509-15.
doi: 10.1542/peds.2011-1840. Epub 2012 Feb 20.

A statewide trial of the SafeCare home-based services model with parents in Child Protective Services

Mark Chaffin  1 , Debra Hecht, David Bard, Jane F Silovsky, William Howard Beasley
Affiliations
Randomized Controlled Trial

A statewide trial of the SafeCare home-based services model with parents in Child Protective Services

Mark Chaffin et al. Pediatrics. 2012 Mar.

Abstract

Objectives: In this trial, we compared Child Protective Services (CPS) recidivism outcomes between the home-based SafeCare (SC) model for child neglect and comparable home-based services, but without SC modules, for parents in the CPS system across 2 quality control strategies: coached (C) and uncoached implementation. SC is a home-based behavioral skills training model designed for neglecting or maltreating parents. The study was conducted in a scaled-up, statewide implementation setting.

Methods: Two thousand one hundred seventy-five maltreating parents, treated by 219 home visitors, were enrolled and treated in a 2 × 2 (SC versus services as usual × C versus uncoached implementation strategy) randomized cluster experiment. Cases were followed for an average of 6 years for CPS recidivism events. Subpopulation analyses were conducted for parents meeting customary SC inclusion criteria.

Results: Consistently significant main effects in favor of SC were found across simple and more complex modeling approaches (hazard ratios = 0.74-0.83). Larger effects were found among the subpopulation meeting customary SC inclusion criteria. C implementation yielded smaller and occasionally significant effects in analyses that included more diverse cases falling outside customary SC inclusion criteria.

Conclusions: Findings support the adoption and use of SC within CPS home-based services systems. C implementation may be especially valuable for cases where the client-model fit is less strong.

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Figures

FIGURE 1
FIGURE 1
Plots of 2-level CPS recidivism survival models with propensity stratification and covariates. Full sample and customary SC inclusion subpopulation survival for first child maltreatment recidivism report.
See this image and copyright information in PMC

References

    1. US Department of Health and Human Services, Administration on Children, Youth and Families, Children’s Bureau. Child Maltreatment 2009 Washington, DC: US Department of Health and Human Services; 2010
    1. Chaffin M. The changing focus of child maltreatment research and practice within psychology. J Soc Issues. 2006;62(4):663–684
    1. US Department of Health and Human Services. In: US Department of Health and Human Services, Youth and Families, eds. Child Maltreatment 2003 Washington, DC: US Government Printing Office; 2005
    1. Bell JA. A review of family preservation and family reunification programs. In: US Department of Health and Human Services, ed. Washington, DC: US Department of Health and Human Services, Administration for Children and Families; 1995
    1. Littell J, Schuerman JR. A synthesis of research on family preservation and family reunification programs. In: AfCaF, US Department of Health and Human Services, ed. Washington, DC: Westat; 1995

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