A Descriptive Study Of The Relationship Between HOME-Based Prevention Services and Family NEEDS
In 2011, child protective services (CPS) agencies across the U.S. received more than 3 million reports of alleged abuse or neglect involving an estimated 6.2 million children. Of these children, 3.3 million received home-based prevention services (HBPS) because they were at risk of abuse and neglect. HBPS are provided after a child abuse investigation if it is determined that a child can safely remain at home without an open CPS case but is still at risk of future maltreatment. HBPS are intended to prevent future maltreatment by addressing family needs with an array of services such as education, parenting, housing, and referrals to additional services. The little research that exists examining needs and services suggests that family needs are often unmet by services and are frequently mismatched to the services they receive. In response, this study investigated whether needs in different domains of family functioning predicted different types of HBPS received.
The sample consisted of 2,122 at-risk families with children five and younger referred to (HBPS) after an initial CPS investigation between July 1, 2006 and December 2010. Need was measured using the Family Assessment Form (FAF) to indicate need across the following domains: (A) living conditions, (B) financial conditions, (C) caregiver support, (D) caregiver/child interactions, (E) developmental stimulation, (F) interactions between caregivers, (G) caregiver history, and (H) caregiver personal characteristics. The FAF indicated problem functioning on a five-point scale with half-points, which indicated higher problem functioning with higher scores. Adjustments were made for eight caregiver demographic control variables: (1) gender; (2) ethnicity; (3) age (4) relationship status; (5) level of education; (6) socioeconomic status; (7) number of children; and (8) number of caregivers. One separate logistic regression model was conducted per service type—(1) concrete, (2) parenting, (3) clinical, and (4) case management.
Controlling for all other covariates, a one unit increase in financial stress was associated with increased odds of receiving concrete services (OR=1.38; 95% CI=1.10-1.73) as were increases in the severity of childhood and adult victimization (OR=1.20; 95%CI=1.04-1.38) and (OR=1.15; 95% CI=1.01-1.30), respectively. A one unit increase in transportation difficulties was associated with increased odds of receiving case management services (OR=1.23; 95%CI=1.01-1.50). Being of low SES was associated with decreased odds of receiving clinical services (OR=.58; 95%CI=.36-.92) as was being African-American relative to Hispanic (OR=.11; 95%CI=.05-.22). In contrast, a history of substance abuse was significantly associated with increased odds of receiving clinical services (OR=1.69; 95% CI=1.26-2.27). Having two caregivers in the home was significantly associated with increased odds of parenting services (OR=5.03; 95% CI=3.02-8.39) as was having increases in problems meeting emotional needs (OR=1.80; 95% CI=1.20-2.70). In contrast, being African-American relative to Hispanic was associated with decreased odds of receiving parenting services (OR=.15; 95% CI=.08-.29)
Having financial needs appears to be appropriately targeted with concrete services as was having a history of substance abuse for clinical services and having difficulty meeting emotional needs for parenting services. Questions remain regarding why being African-American was associated with lower likelihood of receiving services.