TY - JOUR PY - 2018// TI - Preventing child maltreatment: examination of an established statewide home-visiting program JO - Child abuse and neglect A1 - Chaiyachati, Barbara H. A1 - Gaither, Julie R. A1 - Hughes, Marcia A1 - Foley-Schain, Karen A1 - Leventhal, John M. SP - 476 EP - 484 VL - 79 IS - N2 - Although home visiting has been used in many populations in prevention efforts, the impact of scaled-up home-visiting programs on abuse and neglect remains unclear. The objective of this study was to assess the impact of voluntary participation in an established statewide home-visiting program for socially high-risk families on child maltreatment as identified by Child Protective Services (CPS). Propensity score matching was used to compare socially high-risk families with a child born between January 1, 2008 and December 31, 2011 who participated in Connecticut's home-visiting program for first-time mothers and a comparison cohort of families who were eligible for the home-visiting program but did not participate. The main outcomes were child maltreatment investigations, substantiations, and out-of-home placements by CPS between January 1, 2008 and December 31, 2013. In the unmatched sample, families who participated in home-visiting had significantly higher median risk scores (P < .001). After matching families on measured confounders, the percentages of families with CPS investigations (21.1% vs. 20.9%, P = .86) were similar between the two groups. However, there was a 22% decreased likelihood of CPS substantiations (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.64-0.95) for families receiving home visiting. First substantiations also occurred later in the child's life among home-visited families. There was a trend toward decreased out-of-home placement (HR 0.73, 95% CI 0.53-1.02, P = .06). These results from a scaled-up statewide program highlight the potential of home visiting as an important approach to preventing child abuse and neglect.

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Language: en

LA - en SN - 0145-2134 UR - http://dx.doi.org/10.1016/j.chiabu.2018.02.019 ID - ref1 ER -