A Statewide Trial of the SafeCare Home-based Services Model With Parents in Child Protective Services
Open accessAbstract
OBJECTIVES: In this trial, we compared Child Protective Services (CPS) recidivism outcomes between the home-based SafeCare (SC) model for child neglect and comparable home-based services, but without SC modules, for parents in the CPS system across 2 quality control strategies: coached (C) and uncoached implementation. SC is a home-based behavioral skills training model designed for neglecting or maltreating parents. The study was conducted in a scaled-up, statewide implementation setting. METHODS: Two thousand one hundred seventy-five maltreating parents, treated by 219 home visitors, were enrolled and treated in a 2 × 2 (SC versus services as usual × C versus uncoached implementation strategy) randomized cluster experiment. Cases were followed for an average of 6 years for CPS recidivism events. Subpopulation analyses were conducted for parents meeting customary SC inclusion criteria. RESULTS: Consistently significant main effects in favor of SC were found across simple and more complex modeling approaches (hazard ratios = 0.74–0.83). Larger effects were found among the subpopulation meeting customary SC inclusion criteria. C implementation yielded smaller and occasionally significant effects in analyses that included more diverse cases falling outside customary SC inclusion criteria. CONCLUSIONS: Findings support the adoption and use of SC within CPS home-based services systems. C implementation may be especially valuable for cases where the client-model fit is less strong.
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SafeCare is a manualized curriculum-based EBI that aims to reduce child maltreatment through home-based skills training and education for caregivers of children aged zero to five who are at risk for or reported for child neglect.
“SafeCare is a manualized curriculum-based EBI to reduce child maltreatment through home-based skills training and education for caregivers of children, ages zero to five, who are at-risk for, or reported for, child neglect (Chaffin et al., 2012; Lutzker & Edwards, 2009).”
From The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study (2016) · cites this paper as Chaffin et al., 2012
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Shen, A. C., Feng, J. Y., Feng, J., Wei, H.-S., Hsieh, Y., Huang, C., & Hwa, H. (2016) · Journal of Interpersonal Violence · doi:10.1177/0886260516670885 · Cited by 25 · see citing works
Schein, S. S., Roben, C. K. P., Costello, A. H., & Dozier, M. (2022) · Child Maltreatment · doi:10.1177/10775595211072516 · Cited by 27 · see citing works
Morris, A. S., Hays-Grudo, J., Kerr, K. L., & Beasley, L. O. (2021) · Development and Psychopathology · doi:10.1017/s0954579420001595 · Cited by 27 · see citing works
Lengnick-Hall, R., Willging, C. E., Hurlburt, M. S., & Aarons, G. A. (2020) · Implementation Science · doi:10.1186/s13012-020-01031-w · Cited by 24 · see citing works
Bentovim, A., & Elliott, I. A. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.869748 · Cited by 21 · see citing works
Finno-Velasquez, M., Fettes, D. L., Aarons, G. A., & Hurlburt, M. S. (2014) · Journal of Children s Services · doi:10.1108/jcs-06-2014-0030 · Cited by 23 · see citing works
Ondersma, S. J., Martin, J. B., Fortson, B. L., Whitaker, D. J., Self‐Brown, S., Beatty, J. R., Loree, A. M., Bard, D., & Chaffin, M. J. (2017) · Child Maltreatment · doi:10.1177/1077559517729890 · Cited by 23 · see citing works
Self-citationSelf‐Brown, S., Osborne, M. C., Boyd, C., Brown, N. D. V., Rostad, W. L., Patterson, A., Baker, E., Thomas, A. N., McAdam, E. M., Jackson, M., et al. (2018) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2018.06.014 · Cited by 23 · see citing works
Sedlar, G. R., Bruns, E. J., Walker, S. C., Kerns, S. E. U., & Negrete, A. (2015) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-015-0663-8 · Cited by 22 · see citing works
Brown, S., Osborne, M. C., Rostad, W. L., & Feil, E. G. (2016) · Child Maltreatment · doi:10.1177/1077559516678482 · Cited by 22 · see citing works
Álvarez, M., Padilla, S., & Máiquez, M.-L. (2016) · Psychosocial Intervention · doi:10.1016/j.psi.2016.03.006 · Cited by 20 · see citing works
Turner, C. W., Robbins, M. S., Rowlands, S., & Weaver, L. R. (2017) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2017.04.005 · Cited by 21 · see citing works
Dad2K: An Adaptation of SafeCare to Enhance Positive Parenting Skills With At-Risk Fathers
Self‐Brown, S., Cowart-Osborne, M., Baker, E., Thomas, A. N., Boyd, C., Chege, E., Jackson, M., Meister, E. R., & Lutzker, J. R. (2015) · Child & Family Behavior Therapy · doi:10.1080/07317107.2015.1035992 · Cited by 20 · see citing works
SafeCare in Israel: The challenges of implementing an evidence-based program
Oppenheim‐Weller, S., & Zeira, A. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2017.12.031 · Cited by 20 · see citing works
Hubel, G. S., Rostad, W. L., Brown, S., & Moreland, A. D. (2018) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2018.02.005 · Cited by 20 · see citing works
Aarons, G. A., Askew, R. A., Green, A. E., Yalon, A. J., Reeder, K., & Palinkas, L. A. (2019) · Journal of Children s Services · doi:10.1108/jcs-02-2018-0003 · Cited by 20 · see citing works
Implementation of an Early Preventive Intervention Programme for Child Neglect: SafeCare
Arruabarrena, I., de Paúl, J., & Cañas, M. (2019) · Psicothema · doi:10.7334/psicothema2019.190 · Cited by 19 · see citing works
Do home visiting programmes improve children's language development? A systematic review
Henwood, T., Channon, S., Penny, H., Robling, M., & Waters, C. S. (2020) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2020.103610 · Cited by 18 · see citing works
Whitaker, D. J., Rogers-Brown, J. S., Cowart-Osborne, M., Self‐Brown, S., & Lutzker, J. R. (2015) · Psychosocial Intervention · doi:10.1016/j.psi.2015.06.001 · Cited by 21 · see citing works
Thomas, R., Zimmer‐Gembeck, M. J., & Chaffin, M. J. (2013) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-013-0471-y · Cited by 18 · see citing works
Self-citationTiwari, A., Self-Brown, S., Lai, B., McCarty, C., & Carruth, L. (2018) · Social work in health care · doi:10.1080/00981389.2017.1371096 · Cited by 21 · see citing works
Implementation readiness for evidence-based autism practices in school systems
Stahmer, A. C., Suhrheinrich, J., Yu, Y., Melgarejo, M., Schetter, P. L., & Young, G. (2023) · Implementation Research and Practice · doi:10.1177/26334895231199465 · Cited by 17 · see citing works
Technology-Based Innovations in Child Maltreatment Prevention Programs: Examples from SafeCare®
Cowart-Osborne, M., Jackson, M., Chege, E., Baker, E., Whitaker, D. J., & Self‐Brown, S. (2014) · Social Sciences · doi:10.3390/socsci3030427 · Cited by 17 · see citing works
COVID-19 and Caregiver Risk Factors for Child Maltreatment: The Pandemic in Review
Garner, J. B., Self‐Brown, S., Emery, V., Wootten, K., & Tiwari, A. (2023) · Trauma Violence & Abuse · doi:10.1177/15248380231158609 · Cited by 17 · see citing works
Stahlschmidt, M. J., Jonson‐Reid, M., Pons, L., Constantino, J. N., Kohl, P. L., Drake, B., & Auslander, W. (2017) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2017.10.001 · Cited by 29 · see citing works
Bullinger, L. R., Marcus, S., Reuben, K. E., Whitaker, D. J., & Self‐Brown, S. (2021) · Infant Mental Health Journal · doi:10.1002/imhj.21968 · Cited by 16 · see citing works
Implementing a braided home-based parent-support curriculum: Lessons learned
Guastaferro, K., Miller, K., Lutzker, J. R., Whitaker, D. J., Shanley, J. R., Lai, B. S., & Kemner, A. L. (2017) · Psychosocial Intervention · doi:10.1016/j.psi.2017.03.001 · Cited by 15 · see citing works
Service engagement and retention: Lessons from the Early Childhood Connections Program
Chiang, C.-J., Jonson‐Reid, M., Kim, H., Drake, B., Pons, L., Kohl, P. L., Constantino, J. N., & Auslander, W. (2018) · Children and Youth Services Review · doi:10.1016/j.childyouth.2018.02.028 · Cited by 15 · see citing works
Behavior change across implementations of the SafeCare model in real world settings
Rogers-Brown, J. S., Self‐Brown, S., Romano, E., Weeks, E. A., Thompson, W., & Whitaker, D. J. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105284 · Cited by 15 · see citing works
Chartier, M., Enns, J. E., Nickel, N. C., Campbell, R., Phillips-Beck, W., Sarkar, J., Lee, J. B., Burland, E., Chateau, D. G., Katz, A., et al. (2019) · Children and Youth Services Review · doi:10.1016/j.childyouth.2019.104675 · Cited by 14 · see citing works
Silovsky, J. F., Bard, D., Owora, A. H., Milojevich, H. M., Jorgensen, A. G., & Hecht, D. B. (2022) · Child Maltreatment · doi:10.1177/10775595221100723 · Cited by 14 · see citing works
Self-citationRostad, W. L., Self‐Brown, S., Boyd, C., Osborne, M. C., & Patterson, A. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2017.07.001 · Cited by 14 · see citing works
Gallitto, E., Romano, E., & Whitaker, D. J. (2020) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-020-00672-6 · Cited by 14 · see citing works
Whitaker, D. J., Self‐Brown, S., Weeks, E. A., O’Connor, M. H., Lyons, M., Willging, C. E., Lee, N. H., Kumar, J. L., Joseph, H. L., Reidy, D. E., et al. (2021) · BMC Public Health · doi:10.1186/s12889-021-11148-2 · Cited by 14 · see citing works
Family-Based Prevention of Child Traumatic Stress
Goodrum, N. M., & Prinz, R. (2022) · The Pediatric clinics of North America · doi:10.1016/j.pcl.2022.04.011 · Cited by 12 · see citing works
Sullivan, K. S., Ancharski, K., Wortham, W. K., Okosi, M., Kaplan, D., Urquiza, A. J., Timmer, S. G., Cloître, M., Chemtob, C. M., & Lindsey, M. A. (2023) · Journal of Child and Family Studies · doi:10.1007/s10826-023-02534-y · Cited by 13 · see citing works
Pitpitan, E. V., Chavarin, C. V., Semple, S. J., Mendoza, D. V., Magis-Rodríguez, C. L., Staines, H., Aarons, G. A., & Patterson, T. L. (2016) · Annals of Behavioral Medicine · doi:10.1007/s12160-016-9861-1 · Cited by 13 · see citing works
- Authors
- Chaffin, M., Hecht, D., Bard, D., Silovsky, J. F., & Beasley, W. H.
- Affiliations
- University of Oklahoma Health Sciences Center (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2012-03-01
- Volume
- 129
- Issue
- 3
- Pages
- 509-515
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3289527
- OpenAlex
- W2017274897
- Cited by
- 272
- References
- 36
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 17 · 2023: 21 · 2022: 25 · 2021: 23 · 2020: 31 · 2019: 16 · 2018: 13 · 2017: 25 · 2016: 16 · 2015: 19 · 2014: 23 · 2013: 13 · 2012: 8
- FWCI
- 52.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Centers for Disease Control and Prevention (R01MH072961)
- National Institute of Mental Health (R01MH065667, R01MH072961)
- Topics
- Social Sciences › Safety Research › Child Welfare and Adoption
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- SafeCare, child protection services, child neglect, child abuse, home-based services, home visitors, behavioral skills training, parent intervention, statewide implementation
- MeSH terms
- Child, Child Abuse, Child Care, Child Rearing, Child Welfare, Child, Preschool, Female, Home Care Services, House Calls, Humans, Male, Parent-Child Relations, Parents, United States, Urban Population, Incidence, Confidence Intervals, Proportional Hazards Models, Risk Assessment, Needs Assessment
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