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Ahn E, An R, Jonson-Reid M, Palmer L. Leveraging machine learning for effective child maltreatment prevention: A case study of home visiting service assessments. CHILD ABUSE & NEGLECT 2024; 151:106706. [PMID: 38428267 DOI: 10.1016/j.chiabu.2024.106706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Early identification of children and families who may benefit from support is crucial for implementing strategies that can prevent the onset of child maltreatment. Predictive risk modeling (PRM) may offer valuable and efficient enhancements to existing risk assessment techniques. OBJECTIVE To evaluate the PRM's effectiveness against the existing assessment tool in identifying children and families needing home visiting services. PARTICIPANTS AND SETTING Children born in hospitals affiliated with the Bridges Maternal Child Health Network in Orange County, California, from 2011 to 2016 (N = 132,216). METHODS We developed a PRM tool by integrating a machine learning algorithm with a linked dataset of birth records and child protection system (CPS) records. To align with the existing assessment tool (baseline model), we limited the predicting features to the information used by the existing tool. The need for home visiting services was measured by substantiated maltreatment allegation reported during the first three years of the child's life. RESULTS Of the children born in Bridges Network hospitals between 2011 and 2016, 2.7 % experienced substantiated maltreatment allegations by the age of three. Within the top 30 % of children with high-risk scores, the PRM tool outperformed the baseline model, accurately identifying 75.3 %-84.1 % of all children who would experience maltreatment substantiation, surpassing the baseline model's performance of 46.2 %. CONCLUSIONS Our study underscores the potential of PRM in enhancing the risk assessment tool used by a prevention program in a child welfare center in California. The findings provide valuable insights to practitioners interested in utilizing data for PRM development, highlighting the potential of machine learning algorithms to generate accurate predictions and inform targeted preventive services.
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Affiliation(s)
- Eunhye Ahn
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, United States of America.
| | - Ruopeng An
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, United States of America
| | - Melissa Jonson-Reid
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, United States of America
| | - Lindsey Palmer
- College of Social Work, University of Utah, 395 S 1500 E, Salt Lake City, UT 84112, United States of America
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Holland ML, Esserman D, Taylor RM, Flaherty S, Leventhal JM. Estimating Surveillance Bias in Child Maltreatment Reporting During Home Visiting Program Involvement. CHILD MALTREATMENT 2024; 29:82-95. [PMID: 36054017 PMCID: PMC10722865 DOI: 10.1177/10775595221118606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
It is unclear if surveillance bias (increased reports to Child Protective Services [CPS] related to program involvement) has a substantial impact on evaluation of home visiting (HV) prevention programs. We estimated surveillance bias using data from Connecticut's HV program, birth certificates, CPS, and hospitals. Using propensity score matching, we identified 15,870 families similar to 4015 HV families. The difference-in-differences approach was used to estimate surveillance bias as the change in investigated reports from the last 6 months of program involvement to the next 6 months. The median age of the children at program exit was 1.2 years (range: 60 days, 5 years). We estimated that 25.6% of investigated reports in the HV group resulted from surveillance bias. We reviewed CPS reports of 194 home-visited families to determine if a home visitor made the report and found that 10% were directly from home visitors. Program evaluations should account for surveillance bias.
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Affiliation(s)
- Margaret L. Holland
- School of Nursing, Yale University, Orange, CT, USA
- Child Study Center, Yale University, New Haven, CT, USA
- Margaret Holland is now at Department of Population Health & Leadership, University of New Haven, West Haven, CT, USA
| | - Denise Esserman
- School of Public Health, Yale University, New Haven, CT, USA
| | - Rose M. Taylor
- School of Nursing, Yale University, Orange, CT, USA
- Rose Taylor is now a mathematics teacher at Northside College Preparatory High School, Chicago, IL, USA
| | - Serena Flaherty
- School of Nursing, Yale University, Orange, CT, USA
- Serena Flaherty is now a postdoctoral fellow of Primary Care Research in Medicine at Weill Cornell Medicine, New York, NY, USA
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Brown SM, McConnell L, Zelaya A, Doran M, Swarr V. Tailored Nurse Support Program Promoting Positive Parenting and Family Preservation. Nurs Res 2023; 72:E164-E171. [PMID: 37104683 PMCID: PMC10415074 DOI: 10.1097/nnr.0000000000000662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Public health nurse home visiting is a promising approach for addressing the complex needs of families at risk of child maltreatment. The Colorado Nurse Support Program advances service provision by using evidence-based practices to provide tailored assessment and intervention to low-income, primiparous, and multiparous families with children under 18 years of age identified as high risk by county human service systems. OBJECTIVES This study aimed to test the effects of the Nurse Support Program on child protective services case characteristics between Nurse Support Program families and a demographically comparable reference group of families and evaluate changes in parenting outcomes from pre- to postprogram involvement for Nurse Support Program families. METHODS We used a matched comparison group quasi-experimental design in which families in the Nurse Support Program ( n = 48) were compared to families ( n = 150) who were identified using administrative data from Colorado's Comprehensive Child Welfare Information System. Outcomes were child protective case characteristics (child protection referrals, open assessments, founded assessments, open cases, and children's placement in out-of-home care) and parenting outcomes. RESULTS Nurse Support Program families were less likely to have a child protection case opened or have their child placed in out-of-home care. There were no significant between-group differences in child protection referrals, open assessments, or founded assessments. Families in the Nurse Support Program showed improvements in parenting outcomes over time. DISCUSSION Findings suggest that the Nurse Support Program is a successful public health nurse home-visiting approach to promote positive parenting and family preservation among families with complex needs. Implementing tailored public health nurse home-visiting programs, such as the Nurse Support Program, should continue to be evaluated and supported to mitigate the public health risk of child maltreatment.
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Affiliation(s)
| | | | | | - Mary Doran
- Tri-County Health Department, Westminster, CO
| | - Vicki Swarr
- Tri-County Health Department, Westminster, CO
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O'Donnell R, Savaglio M, Halfpenny N, Morris H, Dunbar A, Sharman C, Williams R, Miller R, Skouteris H. Evaluating the implementation of Cradle to Kinder: An intensive home-visitation support program for families experiencing disadvantage. CHILD ABUSE & NEGLECT 2022; 133:105855. [PMID: 36087476 DOI: 10.1016/j.chiabu.2022.105855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Australian evidence supporting the effectiveness of home visitation programs for families experiencing disdavantage is mixed. These inconsistent findings could be attributed to the varied ways in which home visitation programs are implemented, and a lack of evaluation. OBJECTIVE This qualitative paper explores the barriers and facilitators to the implementation of Cradle to Kinder - a long-term, intensive, home visitation family support program for vulnerable young caregivers at risk of child removal across Victoria, Australia. METHOD Semi-structured interviews and focus groups were conducted with 37 stakeholders from all levels of intervention delivery (i.e., clients, internal staff, external stakeholders). Data collection and thematic analysis were informed by the Consolidated Framework for Implementation Research (CFIR). RESULTS According to stakeholders, four key CFIR constructs facilitated the implementation of Cradle to Kinder: Effective Engagement, Relative Advantage, Organisational Culture, and Learning Climate. Implementation was challenged by factors within the Peer Pressure construct, which involved managing expectations and push-back from external organisations and services. CONCLUSION The current findings highlight the importance of organisational commitment to successful implementation. The next phase of this research is to establish the effectiveness of Cradle to Kinder. Indeed, greater implementation-effectiveness evaluations of family support programs are required to ensure that such programs effectively meet the needs of families and improve their outcomes.
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Affiliation(s)
- Renee O'Donnell
- Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Melissa Savaglio
- Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Nick Halfpenny
- MacKillop Family Services, 237 Cecil Street, South Melbourne, VIC 3205, Australia.
| | - Heather Morris
- Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Andrea Dunbar
- MacKillop Family Services, 237 Cecil Street, South Melbourne, VIC 3205, Australia.
| | - Christine Sharman
- MacKillop Family Services, 237 Cecil Street, South Melbourne, VIC 3205, Australia.
| | - Rebecca Williams
- MacKillop Family Services, 237 Cecil Street, South Melbourne, VIC 3205, Australia.
| | - Robyn Miller
- MacKillop Family Services, 237 Cecil Street, South Melbourne, VIC 3205, Australia.
| | - Helen Skouteris
- Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia; Warwick Business School, University of Warwick, Scarman Road, Coventry CV4 7AL, UK.
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Morello L, Caputi M, Scaini S, Forresi B. Parenting Programs to Reduce Recurrence of Child Maltreatment in the Family Environment: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013283. [PMID: 36293863 PMCID: PMC9603684 DOI: 10.3390/ijerph192013283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 05/15/2023]
Abstract
Physical maltreatment is a public health issue affecting millions of children in their lifetime, with a high risk of recurrency. Although there are several parenting programs (PPs) available, existing reviews on their effectiveness in preventing physical abuse recurrences have many limitations. The current systematic review aims at (1) providing a summary of evidence on the effectiveness of behavioral/cognitive-behavioral PPs in preventing physical re-abuse; (2) extending previous reviews by including reduction of child maltreatment recurrence as the main outcome but also focusing on the effect of PPs on maltreatment risk, parent and child psychopathology, and parent-child relationship; and (3) including only RCT with at least one follow-up. A PRISMA-compliant systematic review was performed in the EBSCOhost and PUBMED databases. In total, 93 articles were identified, of which 8 were included in the review. Among them, three reported a significant reduction in recidivism rates and maltreatment risk, and five improvements in parent-child relationships. Although limitations arise from methodological heterogeneity across studies, there is some evidence that some brief and manualized cognitive behavioral PPs can reduce the recurrence of child physical maltreatment and improve parent-child relationships. More studies are needed to give further support to PP effectiveness in protecting children from recurrent maltreatment.
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Affiliation(s)
- Luisa Morello
- Child and Youth Lab, Sigmund Freud University of Milan, Ripa di Porta Ticinese 77, 20143 Milano, Italy
- Correspondence:
| | - Marcella Caputi
- Department of Life Sciences, University of Trieste, Via Weiss 21, 34128 Trieste, Italy
| | - Simona Scaini
- Child and Youth Lab, Sigmund Freud University of Milan, Ripa di Porta Ticinese 77, 20143 Milano, Italy
| | - Barbara Forresi
- Child and Youth Lab, Sigmund Freud University of Milan, Ripa di Porta Ticinese 77, 20143 Milano, Italy
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A realist model for home visitation program evaluation. J Pediatr Nurs 2022; 64:e6-e14. [PMID: 35177363 DOI: 10.1016/j.pedn.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 12/28/2021] [Accepted: 01/20/2022] [Indexed: 11/20/2022]
Abstract
Increased attention on home visitation as a strategy to reduce child maltreatment and increased funding to support home visitation programs has led to their rapid and widespread adoption in the United States and internationally. The rapid adoption of home visitation programs has occurred without an adequate understanding of the underlying mechanisms of influence on child maltreatment. Consequently, there is a lack of consistency in structures and processes across programs. The variability in structures and processes within and across programs has contributed to the inconsistent findings related to the effectiveness of home visitation as a strategy to constrain child maltreatment. Identifying the underlying mechanisms that are facilitating or constraining program success or failure is essential for informing policy and practice. We propose the use of realist theory to identify the underlying mechanisms of home visitation programs. While realist theory has been used broadly in the social sciences, its uptake in nursing has been slow. Despite its limited use in nursing, realism's primary function, seeking to identify the underlying mechanisms in complex social programs, makes it suitable for investigating many complex phenomena that are of interest to nurse scientists. Here we discuss the theoretical foundations for home visitation programs, the recent evidence for program effectiveness, significant home visitation program components, and we propose a realist model for home visitation program evaluation that may aid in identifying how, for whom, and under what conditions home visitation programs work when these programs are implemented to address child maltreatment.
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Hornor G. Child Maltreatment Prevention: Essentials for the Pediatric Nurse Practitioner. J Pediatr Health Care 2022; 36:193-201. [PMID: 34627666 DOI: 10.1016/j.pedhc.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/31/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022]
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Han K, Oh S. The effectiveness of home visiting programs for the prevention of child maltreatment recurrence at home: a systematic review and meta-analysis. CHILD HEALTH NURSING RESEARCH 2022; 28:41-50. [PMID: 35172079 PMCID: PMC8858785 DOI: 10.4094/chnr.2022.28.1.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/21/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose This systematic review aimed to investigate the effectiveness of home visiting programs targeting parents who have maltreated their children on the prevention of child maltreatment recurrence. Methods Major databases were searched (Ovid-Medline, PubMed, Cochrane Library, CINAHL, and RISS). The frequency of maltreatment was measured for the meta-analysis, which was conducted using Review Manager 5.2 software. The effect size was measured using odds ratios (ORs). Results Six studies were included in the analysis, none of which were conducted in South Korea. The meta-analysis demonstrated that the risk of child maltreatment recurrence significantly decreased after a home visiting program was implemented (OR=0.45, 95% confidence interval [CI]=0.29-0.68). Nurses were the most common intervention providers. Conclusion Home visiting programs should be provided for families in which maltreatment has already occurred to prevent the recurrence of maltreatment and foster a home environment in which children can live safely. Since the rate of child maltreatment in Korea is increasing, further research is needed to develop and implement home visiting programs in which nurses play a major role in preventing the recurrence of child maltreatment.
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Affiliation(s)
- Kyeongji Han
- Registered Nurse, Jeju National University Hospital, Jeju ‧ Graduate Student, College of Nursing, Jeju National University, Jeju, Korea
| | - Sumi Oh
- Assistant Professor, College of Nursing · Health and Nursing Research Institute, Jeju National University, Jeju, Korea
- Corresponding author Sumi Oh College of Nursing · Health and Nursing Research Institute, Jeju National University, 102 Jejudaehak-ro, Jeju 63243, Korea TEL: +82-64-754-3756 FAX: +82-64-702-2686 E-MAIL:
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Stith SM, Topham GL, Spencer C, Jones B, Coburn K, Kelly L, Langston Z. Using systemic interventions to reduce intimate partner violence or child maltreatment: A systematic review of publications between 2010 and 2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:231-250. [PMID: 34697816 DOI: 10.1111/jmft.12566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
This systematic review seeks to understand the effectiveness of systemic interventions to reduce Intimate Partner Violence (IPV) or child maltreatment published between January 2010 and December 2019. We found nine studies reviewing systemic interventions for IPV and 12 studies reviewing systemic interventions for child maltreatment. In our discussion, we added relevant articles published before 2010 to determine the overall state of the evidence for these interventions. We determined that parent training programs with in vivo coaching components for child maltreatment meet the criteria for well-established interventions. Relationship education approaches are probably efficacious. Parent education and family therapy programs to reduce child maltreatment, and cognitive behavioral couples treatment to reduce IPV are possibly efficacious interventions. Programs based on "naturalistic" couples therapy for IPV are experimental interventions. This review also highlights limitations in this research in addressing the needs of marginalized couples and families.
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Affiliation(s)
| | | | | | | | | | - Lorin Kelly
- Kansas State University, Manhattan, Kansas, USA
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Giallo R, Rominov H, Fisher C, Jones A, Evans K, O'Brien J, Fogarty A. A mixed-methods feasibility study of the Home Parenting Education and Support Program for families at risk of child maltreatment and recurrence in Australia. CHILD ABUSE & NEGLECT 2021; 122:105356. [PMID: 34634523 DOI: 10.1016/j.chiabu.2021.105356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Efforts to prevent child maltreatment and its recurrence in infancy and early childhood are critical to disrupting pathways to poor physical and mental health and interpersonal relationships across the life course. The Home Parenting Education and Support (HoPES) program is an intensive 8-week home-visiting intervention for families of infants and young children (0-4 years) receiving child protection services or welfare services. OBJECTIVE The aims of this feasibility study were to: (a) explore parents' and clinicians' perceptions of the outcomes related to participation in HoPES, and (b) obtain preliminary data about potential intervention outcomes related to parent-child interactions, parent mental health, and parenting self-efficacy. PARTICIPANTS AND SETTING HoPES was delivered to 30 families by a child and family health service. Seven mothers and eight HoPES clinicians also participated in qualitative interviews. METHODS A mixed-methods evaluation was conducted incorporating qualitative interviews and self-report pre-post intervention data was conducted. RESULTS Interviews with mothers identified perceived benefits for parent mental health and wellbeing, parenting, and relationships with children. This was further supported by clinician interviews and by the analysis of pre-post assessment data which revealed moderate to large decreases in maternal stress (d = 0.35) and increases in parental self-efficacy (0.76). CONCLUSIONS The findings of this study have important implications for further development of HoPES, and the design of a rigorous evaluation in next stage of evaluation research.
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Affiliation(s)
- Rebecca Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; School of Psychology and Public Health, La Trobe University, Bundoora, Australia.
| | - Holly Rominov
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Australia
| | | | - Andi Jones
- Tweddle Child and Family Health Service, Footscray, Australia
| | - Kirsty Evans
- Tweddle Child and Family Health Service, Footscray, Australia
| | - Jacquie O'Brien
- Tweddle Child and Family Health Service, Footscray, Australia
| | - Alison Fogarty
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Australia
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Ma Y, Lu H, Zhang Y, Wang Y, Li S, Yan F, Han L. Effectiveness of home visiting on patients with hypertension: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24072. [PMID: 33725818 PMCID: PMC7969236 DOI: 10.1097/md.0000000000024072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 11/09/2020] [Accepted: 12/03/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Blood pressure lowering treatments can help prevent cardiovascular disease. However, little is known about the possibility of home visiting programs for hypertension. This study aims to evaluate the effectiveness of home visiting programs on hypertensive patients. METHODS We systematically reviewed the medical literature and performed a meta-analysis. Five electronic databases were systematically searched from their inception to September 2019. Two reviewers independently assessed the risk of bias of the studies included in the review using tools developed by the Cochrane Collaboration. The meta-analysis was performed using Review Manager software (version 5.3). RESULTS Thirteen RCTs with 2674 participants were identified. The home visiting program demonstrated a greater reduction in systolic blood pressure (MD = -5.63, 95% confidence interval (CI): -8.32 to -2.94), diastolic blood pressure (MD = -4.14, 95% CI: -6.72 to -1.56) and waist circumference (MD = -2.61, 95% CI: -3.5, -1.72) during a 6 month intervention. However, there were no significant differences between the groups in terms of body mass index, weight, or blood lipids. CONCLUSION Home visiting programs were associated with improved BP control and reduced blood pressure, which indicate that it might be an effective method for management of hypertension.
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Affiliation(s)
- Yuxia Ma
- The First School of Clinical Medicine, Lanzhou University
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University
| | - Hongmei Lu
- Delivery Center, Gansu Provincial Maternity and Child-care Hospital
| | - Yuanyuan Zhang
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University
| | - Yutan Wang
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University
| | - Sijun Li
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University
| | - Fanghong Yan
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University
| | - Lin Han
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, China
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Giallo R, Rominov H, Fisher C, Evans K, Fogarty A. Preservation and reunification for families of young children: case file review of a home-visiting program. J Reprod Infant Psychol 2020; 40:311-323. [PMID: 33103927 DOI: 10.1080/02646838.2020.1836335] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The Home Parenting Education and Support (HoPES) programme is a new intensive 8-week home-visiting intervention supporting the preservation and reunification of families with young children (aged 0-4 years) receiving child protection services following child abuse and/or neglect in Australia. The aims of the study were to (a) describe families who had participated in HoPES, (b) describe the key education content and support activities of the programme, and (c) identify the enablers and challenges in implementing HoPES. BACKGROUND Intensive home-based family preservation programs are designed to improve parenting skills, reduce specific abusive behaviours, and address child, parent and contextual risk factors for child maltreatment and its recurrence. METHODS A casefile review and document analysis of 34 families who enrolled in HoPES was conducted. RESULTS Families enrolled in HoPES were experiencing significant parent and child risk factors for child maltreatment and recurrence. Despite challenges in supporting families experiencing many complex social health issues and stressful life circumstances, there was evidence of intervention tailoring and use of strengths-based approaches to meet the needs of families. CONCLUSION This casefile review gathered rich evidence to inform further development of a trauma informed and culturally sensitive intervention to support family preservation and reunification, and to guide the next stage of evaluation research to generate a more robust level of evidence.
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Affiliation(s)
- Rebecca Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Holly Rominov
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Kirsty Evans
- Tweddle Child and Family Health Service, Melbourne, Australia
| | - Ali Fogarty
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Australia
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Sustained Impact on Parenting Practices: Year 7 Findings from the Healthy Families New York Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:498-507. [PMID: 32162174 DOI: 10.1007/s11121-020-01110-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Prevention of maltreatment and harsh parenting are the primary goals of evidence-based home visiting programs, but rigorous studies demonstrating long-term outcomes are limited despite widespread implementation. The current study examines data from a 7-year follow-up study of a randomized controlled trial of Healthy Family New York (HFNY). Specifically, the study examines whether HFNY participation predicts lower rates of harsh and abusive parenting 7 years after enrollment. The data include both maternal self-report of parenting behaviors as well as the target child's report of harsh parenting. The year 7 sample included 942 mother interviews (83.5% retention from baseline) and 800 child interviews. At the 7-year follow-up, maternal-reported behaviors measured by CTS-PC showed a significantly increased use of positive parenting strategies and lower levels of serious physical abuse in the HFNY group compared with the control group. Significant group differences were observed for the frequency with which mothers engaged in severe or very severe physical assault (control group = .16, compared with .03 in the intervention group, p < .001). In addition, fewer children reported that their parents used minor physical assault. There was no intervention impact on indicated child protective service records. The current study indicates that home visiting participation reduces harsh and abusive parenting and promotes positive parenting behaviors that endure and may strengthen later development.
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Easterbrooks MA, Kotake C, Fauth R. Recurrence of Maltreatment After Newborn Home Visiting: A Randomized Controlled Trial. Am J Public Health 2019; 109:729-735. [PMID: 30896990 DOI: 10.2105/ajph.2019.304957] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate whether a newborn home visiting program for primiparous adolescent mothers (aged 16-20 years at childbirth) reduced recurrence of child maltreatment in child protective services (CPS) reports. METHODS We conducted a randomized controlled trial of Healthy Families Massachusetts, a statewide home visiting program for young parents. A total of 704 first-time young mothers were randomly assigned to a home visiting group, or to a control group who we referred to other services and who received child development and parenting information. The outcome variable was CPS reports (2008-2016) available for 688 families-specifically, rereports following an initial report (up to mean child age of 7 years). RESULTS Of the 52% of families who experienced initial CPS reports, 53% experienced additional CPS reports. Children of mothers in the home visiting group were less likely to receive a second report and had a longer period of time between initial and second reports. CONCLUSIONS The home visiting program reduced the recurrence of CPS maltreatment report by 32% and increased the length of time between initial and additional CPS reports. Home visiting parenting support and prevention programs may reduce the likelihood of recurrent maltreatment following completion of program services.
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Affiliation(s)
- M Ann Easterbrooks
- M. Ann Easterbrooks, Chie Kotake, and Rebecca Fauth are with Tufts Interdisciplinary Evaluation Research, Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, MA
| | - Chie Kotake
- M. Ann Easterbrooks, Chie Kotake, and Rebecca Fauth are with Tufts Interdisciplinary Evaluation Research, Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, MA
| | - Rebecca Fauth
- M. Ann Easterbrooks, Chie Kotake, and Rebecca Fauth are with Tufts Interdisciplinary Evaluation Research, Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, MA
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