American Indian or Alaska Native
7%
Peer reviewed?
Yes
Spieker, S. J., Oxford, M. L., & Fleming, C. B. (2014). Permanency outcomes for toddlers in child welfare two years after a randomized trial of a parenting intervention. Children & Youth Services Review, 44, 201-206.
Model(s) Reviewed
Navigate to model page for more information about the home visiting model.
Study Registration
Funding Sources
This research was supported by Award Number R01 MH077329 from the National Institute of Mental Health and Award Number P30 HD02274 from the National Institute of Child Health and Human Development.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Not assessed for randomized controlled trials with low attrition |
No |
Yes, details reported below for findings on valid, reliable outcomes |
The author’s analyses controlled for the baseline measures of commitment to the child, age of child at randomization, time in child welfare, number of placement changes, multiple removals, and caregiver type (biologically-related or foster). Additional information describing the study setting and home visiting intervention was based on information reported in Spieker et al. (2012).
Findings that rate moderate or high in this manuscript
Reductions in child maltreatment
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Stability | Two years post randomization | High | 0.11 | Not statistically significant, p ≥ 0.05 | 210 children | PFR vs. EES, one county in Washington state, 2007-2010, full sample | ||
| Permanency | Two years post randomization | High | 0.33 | Not statistically significant, p ≥ 0.05 | 210 children | PFR vs. EES, one county in Washington state, 2007-2010, full sample |
Study Participants
Study participants were caregiver and child dyads residing in and recruited from one county in Washington State. The study authors recruited eligible dyads through referrals from the Department of Child and Family Services. To be eligible, the child in the dyad had to be between the ages of 10 and 24 months with a court-ordered placement that resulted in a change in primary caregiver within the prior 7 weeks. The caregivers all spoke English, and caregivers were foster parents or biological parents (or adult kin). More than one-quarter (27 percent) of caregivers were biological parents, 31 percent were kin, and 42 percent were foster parents. Of 427 dyads contacted to participate in the study, 210 were eligible and randomly assigned to either the Promoting First Relationships – Home Visiting Intervention Model (105 dyads) or to the comparison group (105 dyads). Some children (29 in total) experienced a placement change within four months of study enrollment. However, these children and their caregivers remained in the intervention condition they were first assigned to. Children were an average of 18 months old at the time of enrollment. A majority of the children were White (55 percent); 15 percent were Black, and 10 percent were Hispanic or Latino. About one-quarter of households reported household incomes less than $20,000 per year. Caregivers reported an average of about 13 years of education.
Setting
The study took place in one county in Washington State.
Home Visiting Services
Promoting First Relationships – Home Visiting Intervention Model consisted of 10 weekly sessions, each 60 to 75 minutes long. The home visit content was informed by attachment theory and aimed to increase parenting sensitivity. All sessions took place in the families' homes. During weekly home visits, home visitors covered the activities and instructional content in the Promoting First Relationships manual, tailoring the pace of delivery for each caregiver. Home visitors videotaped five caregiver-child interactions; they reviewed these videos with the caregivers and guided a discussion about the strengths demonstrated by the caregiver and the caregiver’s interpretation of the child's cues. Additional activities during the home visits included the review of handouts on topics related to attachment theory.
Model(s) Reviewed
Navigate to model page for more information about the home visiting model.
Comparison Conditions
The comparison group members were not offered intervention services through Promoting First Relationships. Dyads assigned to the comparison group received Early Education Support, which consisted of three monthly 90-minute home visits conducted by home visitors with bachelor’s degrees. The home visitor helped connect families to resources such as Early Head Start, early intervention, housing, mental health services, and child care; and suggested activities to promote the child's growth and development.
Were any subgroups examined?
No
Subgroups examined
- Children enrolled in the study with a birth parent
- Children enrolled in the study with a foster/kin caregiver
This study included participants from the following locations:
- Washington