American Indian or Alaska Native
11%
Source
Silovsky, J. F., Bard, D., Chaffin, M., Hecht, D., Burris, L., Owora, A., Beasley, L., Doughty, D., & Lutzker, J. (2011). Prevention of child maltreatment in high-risk rural families: A randomized clinical trial with child welfare outcomes. Children and Youth Services Review, 33, 1435-1444.
Model(s) Reviewed
Funding Sources
Not specified.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Established on race, SES, and baseline outcomes | None |
Notes
In 2020, HomVEE updated findings from this review to move findings from the Social Provision Scale from the Family Economic Self-Sufficiency domain to the Maternal Health domain because ACF determined that HomVEE should place outcomes measuring social support for the mother in the Maternal Health domain. Similarly, based on ACF determination in 2021, HomVEE placed the finding about referral to child welfare for domestic violence in the Reductions in Juvenile Delinquency, Family Violence, and Crime domain, updated from its earlier placement in the Reductions in Child Maltreatment domain.
In a general review of the HomVEE website in 2018, it was determined that two outcomes did not meet the original review criteria requiring that all reports of child maltreatment be substantiated: post-enrollment referral to child welfare and post-enrollment referral to child welfare for neglect. Those two outcomes are no longer included in the review.
Study Participants
Eligible families had a caregiver at least 16 years of age, at least one child aged 5 or younger, and at least one of the following risk factors: parental substance abuse, mental health issues, or intimate partner violence (IPV). Eligible participants who consented to be a part of the study completed the baseline assessment and were randomized to the intervention or control condition. African Americans and American Indians were over-represented relative to their rates in the general population for the county. In the treatment group, the sample was 74 percent white, 14 percent African American, 4 percent Latino, 7 percent American Indian or Alaska Native, and 1 percent Asian.
Setting
The study took place in a rural county in the American Southwest, with a population of fewer than 100,000 people and fewer than 30,000 households.
Home Visiting Services
SafeCare Augmented (SC+) consists of SC and two additional components: (1) motivational interviewing (MI) (not described) and (2) training of home visitors on identification and response to risk factors of substance abuse, depression, IPV, and impending child maltreatment. For this study, SC+ was adapted for use in a rural setting, including selection of providers who are established in the community and knowledgeable about local resources.
Comparison Conditions
The comparison group received standard home-based mental health services, including individual and family therapy and case management services.
Study Participants
Eligible families had a caregiver at least 16 years of age, at least one child aged 5 or younger, and at least one of the following risk factors: parental substance abuse, mental health issues, or intimate partner violence (IPV). Eligible participants who consented to be a part of the study completed the baseline assessment and were randomized to the intervention or control condition. African Americans and American Indians were over-represented relative to their rates in the general population for the county. In the treatment group, the sample was 74 percent white, 14 percent African American, 4 percent Latino, 7 percent American Indian or Alaska Native, and 1 percent Asian.
Setting
The study took place in a rural county in the American Southwest, with a population of fewer than 100,000 people and fewer than 30,000 households.
Home Visiting Services
SafeCare Augmented (SC+) consists of SC and two additional components: (1) motivational interviewing (MI) (not described) and (2) training of home visitors on identification and response to risk factors of substance abuse, depression, IPV, and impending child maltreatment. For this study, SC+ was adapted for use in a rural setting, including selection of providers who are established in the community and knowledgeable about local resources.
Comparison Conditions
The comparison group received standard home-based mental health services, including individual and family therapy and case management services.
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| CAPI | 10 months | High | 0.04 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| CTS-PC, nonviolent discipline | 10 months | High | 0.16 | Statistically significant, p < 0.05 | 105 families | Rural Southwest | ||
| CAPI | 17 months | High | 0.38 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| CTS-PC, nonviolent discipline | 17 months | High | 0.01 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| CTS-PC, psychological aggression | 10 months | High | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | |||
| CTS-PC, psychological aggression | 17 months | High | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | |||
| CTS-PC, physical assault | 10 months | High | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | |||
| CTS-PC, physical assault | 17 months | High | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | |||
| Referral to child welfare where child was removed from the home | 716 days | High | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| CTS2 victimization, partnered | 10 months | High | 0.75 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| CTS2 victimization, partnered | 17 months | High | 0.28 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| CTS2 victimization, negotiation | 10 months | High | 0.08 | Statistically significant, p < 0.001 | 105 families | Rural Southwest | ||
| CTS2 victimization, negotiation | 17 months | High | 0.08 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| Referral to child welfare for domestic violence | 716 days | High | Statistically significant, p < 0.05 | 105 families | Rural Southwest |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| BDI-2 | 10 months | High | 0.05 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| BDI-2 | 17 months | High | 0.31 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| SPS | 10 months | High | 0.24 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| SPS | 17 months | High | 0.14 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| DIS alcohol module | 10 months | High | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | |||
| DIS drug module | 10 months | High | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | |||
| DIS alcohol module | 17 months | High | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | |||
| DIS drug module | 17 months | High | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| FRS-R | 10 months | High | 0.11 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest | ||
| FRS-R | 17 months | High | 0.40 | Not statistically significant, p ≥ 0.05 | 105 families | Rural Southwest |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Referrals/linkages to additional services | 10 months | High | Statistically significant, p < 0.05 | 105 families | Rural Southwest |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- State not reported or international