Citation

Chaffin M, Hecht D, Bard D, Silovsky JF, Beasley WH. Pediatrics 2012; 129(3): 509-515.

Affiliation

Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Copyright

(Copyright © 2012, American Academy of Pediatrics)

DOI

10.1542/peds.2011-1840

PMID

22351883

PMCID

PMC3289527

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.

Language: en