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Family Connections: Promoting safety & well-being in families at risk for neglect

Family Connections: Promoting safety & well-being in families at risk for neglect. Diane DePanfilis Howard Dubowitz University of Maryland Center for Families Helfer Society Annual Meeting Montebello, Canada, September 2003. Funding.

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Family Connections: Promoting safety & well-being in families at risk for neglect

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  1. Family Connections: Promoting safety & well-being in families at risk for neglect Diane DePanfilis Howard Dubowitz University of Maryland Center for Families Helfer Society Annual Meeting Montebello, Canada, September 2003

  2. Funding 5-year U.S. DHHS, Children’s Bureau grant to demonstrate a model intervention to prevent child neglect

  3. Why neglect prevention? • Neglect is common • Neglect can result in serious harm • Prevention should protect children, & lead to other benefits for children, families & society

  4. Study Objective • To examine the relationship between length of service & child & family outcomes of a community-based project to help families prevent neglect

  5. Research Question 1 • Is there change over time in: • risk factors? • protective factors? • child safety & well being?

  6. Research Question 2 • Does length of services affect change in: • risk factors? • protective factors? • child safety & well being?

  7. Constructs in this Analysis • Decrease Risk Factors: • Caregiver depression • Parenting stress • Life stress • Enhance Child Safety • CPS reports • Physical Care • Psychological care • Enhance Protective Factors: • Parenting attitudes • Parenting competence • Family functioning • Social support • Enhance Child Well-Being • Child behavior

  8. West Baltimore Empowerment Zone At least one child 5 - 11 years in the household Presence of > 1 risk factor No current CPS involvement Voluntary Target Population

  9. Caregivers • 154 families • 86% African American • Mean age: 39 years • 98% female • 58% unemployed • 5% married, 65% never married, 30% separated, divorced, or widowed • 62% < high school

  10. Children • Average no. of children per family: 3 • 31% > 3 children • Mean age: 9 yrs. (1 month - 21 yrs) • 49% female • Relationship to caregiver • 78% children • 14% grandchildren • 8% other relative

  11. Intervention:Random assignment • 3 months • 9 months

  12. Guiding Principles toIncrease Capacity & Reduce Risk • Ecological developmental framework • Community outreach • Family assessment & tailored intervention • Helping alliance with family • Empowerment/strengths-based • Cultural competence • Outcome-driven service plans

  13. Interventionists • SW interns • initial & ongoing training • supervision • manual

  14. Intervention Elements • Emergency assistance • Family assessment • Home-based counseling • Referrals • Service coordination & facilitation

  15. Data Collection Methods • Computer Assisted Self-Interview • Baseline • Case closure • 6-month follow-up • Standardized self-report & observational measures • At 30 days, 3 & 6 months, & at closure • Intern driven  integrated with intervention

  16. Data Analysis Repeated Measures Analysis 1. Assess change over time Baseline  Closing  6-month F/U • Comparison of length of service 3 vs. 9 months

  17. Results: Risk Factors • Comparing all caregivers baseline to 6 months post intervention, significant in: • Risk Factors • Caregiver depressive symptoms • Parenting stress • Life stress

  18. Results: Parenting Stress

  19. Results: Protective Factors • Comparing all families baseline to 6 months post intervention, significant in: • Protective Factors • Parenting attitudes • Parenting satisfaction • Social support

  20. Results: Parenting Attitudes (N=125) STEN Scores 7-10 Exceeds expectations 5-6 Norm 3-4 Low 1-2 High risk

  21. Results: Child Safety • Significantly Improved Physical Care • Household furnishings • Overcrowding • Household sanitation • Significantly Improved Psychological Care • Mental health care • Caregiver teaching stimulation of children • CPS reports & CPS indicated reports

  22. Child Safety: Physical Care • Household Sanitation* • Measure: CWBS Household Sanitation subscale • Score: • 100 = Adequate • 71 = Mildly inadequate • 38 = Moderately Inadequate • Score increased from baseline (M= 81.57) to Closing (M= 85.05, p= .038) *N = 100; 3 mos = 50; 9 mos = 50

  23. Child Safety: Psychological Care • Caregiver Teaching/Stimulation of Children* • Measure: CWBS Teaching/Stimulation of Children subscale • Score: • 100 = High activity • 84 = Moderate activity • 70 = Passive approach, some deprivation • Score increased from baseline (M= 86.63) to Closing (M= 90.21, p= .004) *N = 60; 3 mos = 33; 9 mos =27

  24. Child Safety: Indicated CPS Reports • No significant group differences • Logistic regression: Did length of service predict CPS reports? NS

  25. Results: Child Well Being • Comparing all families baseline to 6 months post intervention, significant in: • Total behavior problems • Internalizing behavior problems • Externalizing behavior problems

  26. Child Internalizing & Externalizing Behavior Main Effects of Time (N=111)

  27. Results: 3 vs. 9 Month Group Comparison • 9 month intervention demonstrated greater improvement than the 3 month group in: • Child behavior • Caregiver depressive symptoms • No differences between groups in other domains (eg, parenting stress, life stress, parenting attitudes, social support, household safety)

  28. Child Internalizing Behavior (N=111)

  29. Depressive Symptoms (N=125) 6 mo f/u for 3 mo 6 mo f/u for 9 mo

  30. Limitations • Relatively small sample • Intervention delivered mostly by MSW interns • Questions about fidelity of intervention • Short follow-up (6 months)

  31. Conclusions Intervention helped: • Reduce Risk Factors • depressive symptoms • parenting stress • life stress • Increase Protective Factors • parenting attitudes & satisfaction • social support

  32. Conclusions • Results suggest improved targeted outcomes: • Child Safety • housing problems • mental health care • parental teaching of children • Child Well Being (Behavior) • externalizing & internalizing behavior • Most positive effects endured 6 months post intervention

  33. Conclusions • 9 mos. intervention more effective than 3 mos. • Child behavior • Caregiver depressive symptoms • No group differences in other domains (eg, parenting stress, life stress, parenting attitudes, social support, household safety).

  34. Conclusions • Family Connections appears to be a promising model intervention • Promoting caregiver & child functioning • Helping ensure children’s basic needs are met • Helping preventing child neglect

  35. DOWNLOAD A COPY OF THIS PRESENTATION and other materials at: http://www.family.umaryland.edu Click on Research Click on PowerPoint Presentations

  36. Family Connections: Mission To promote the safety & well-being of children & families through family & community services, professional education & training, & research & evaluation

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