Child Abuse
Conditions
Keywords
Child abuse, Neglect, Home visitation, Program evaluation
Brief summary
This study will assess the effectiveness of early home visitation by a professional in preventing child maltreatment, promoting healthy family functioning, and promoting child health and development. The investigators will test the following hypotheses regarding the effectiveness of early paraprofessional home visiting for at-risk families * Actual home visiting services adhere to HFAK standards. * HFAK promotes healthy family functioning, promotes child health and development, and prevents child abuse and neglect. * Adherence to HFAK process standards is positively associated with achievement of outcomes.
Detailed description
Healthy Families Alaska (HFAK) is a well-established child abuse prevention program targeted to at-risk families. HFAK is based on the Healthy Families America initiative promoted by Prevent Child Abuse America. The State Department of Health and Social Services (DHSS) administers the HFAK program. In 1998, the Alaska State Legislature requested a controlled study of HFAK to determine its effectiveness in preventing child maltreatment, promoting healthy family functioning, and promoting child health and development. DHSS awarded the Johns Hopkins University School of Medicine a contract to conduct the study from July 1999 through June 2004. The study is a randomized trial of six HFAK sites throughout Alaska. It aims to compare services actually provided to HFAK standards, assess program success in achieving intended outcomes, and relate program impact to service delivery. Families are enrolled over 21 months beginning in January 2000. Families are randomized to either the HFAk group or the control group. Baseline data on family attributes are collected from HFAK files and maternal interviews. HFAK service data are collected from the program's management information system, record reviews, surveys of staff, and staff focus groups. Outcome data are collected when the children were two years old through maternal interview, home-based observations, child developmental testing, review of medical records, and review of OCS child welfare records.
Interventions
BEHAVIORALHome Visiting
Sponsors
State of Alaska Department of Health and Social Services
Johns Hopkins University
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
Yes
Inclusion criteria
* Family resides in a community served by one of six HFAK programs participating in the study * Family identified as at-risk by HFAK staff following the usual HFAK protocol
Exclusion criteria
* Family was previously enrolled in HFAK * Mother unable to speak English well enough to complete study activities. * Family unwilling to enroll in the HFAK program.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Child Abuse and Neglect | From child's birth (baseline) to 24 months of age | Substantiated and unsubstantiated reports of abuse; maternal self-report of harsh discipline |
| Child Development | 24 months | Child cognitive, motor and psychosocial development |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maternal Psychosocial Functioning | At time of study follow-up (child 24 months of age) | Mental health, substance use, intimate partner violence |
| Parenting Knowledge | At time of study follow-up (child 24 months of age) | Knowledge of child development; recognition of child delay |
| Child Health | From child's birth (baseline) to 24 months of age | Hospitalizations, ED use, injuries requiring medical care, adequate well child care, immunizations |
| Parenting Behavior | At time of study follow-up (child 24 months of age) | Observational measures of parent/child interaction and quality of the home environment, use of corporal punishment, use of nonviolent discipline |
| Parenting Attitudes | At time of study follow-up (child 24 months of age) | Use of corporal punishment, infant caregiving, expectations of children, empathy towards child's needs |
| Maternal Life Course | At time of study follow-up (child 24 months of age) | Educational attainment, employment, social support, rapid repeat birth |
Countries
United States
Outcome results
None listed