Home-Based, Postresponse Services: An Analysis of Demographics, Areas of Need, and Service Receipt
In 2012, nearly 1.2 million children received home-based, postresponse services (HBPS; AKA post-investigation services) across the U.S. because they were at risk of abuse and neglect (USDHHS, 2013). Child Protective Services (CPS) agencies provide HBPS after a CPS investigation if a child can safely remain at home but is still at risk of future maltreatment. In theory, HBPS respond to family need via concrete, educational, and clinical services. The scant research that exists on HBPS indicates that family need is often unmet and frequently mismatched to service receipt. Research also suggest that service receipt is influenced by factors other than need, such as ethnicity. The present study examines the impact of family demographics and three areas of need (concrete, individual, and family need) on the receipt of concrete, educational, and clinical services among culturally-diverse families at risk for maltreatment.
Method:
The sample consisted of 2,364 families who received HBPS after an initial CPS investigation between July 1, 2006 and December 2010. Eligible families had a child 5 or younger, a CPS investigation resulting in an unfounded or inconclusive finding, and a risk assessment indicating moderate to high risk of future maltreatment. Need was measured using the Family Assessment Form (FAF) in three areas of need: (1) Concrete Need measuring living conditions, financial conditions, and caregiver support; (2) Individual Need measuring caregiver personal characteristics; and (3) Family Need measuring caregiver/child interactions, developmental stimulation, and interactions between caregivers. Caregiver demographics included ethnicity, age, education, household income, number of caregivers, number of children, and history of abuse. Bivariate regression analyses were utilized to identify significant demographics and areas of need for inclusion in a final multivariate model. One separate logistic regression model was conducted per HBPS—(1) Concrete, (2) Educational, and (3) Clinical Services.
Results:
Having concrete need (financial need) was associated with increased odds of receiving concrete services (OR=2.71; 95% CI=2.19, 3.37) but individual need (emotional stability) and family need (caregiver/child interactions) was associated with decreased odds of receiving concrete services (OR=.71; 95%; CI=.57, .89) and (OR=.77; 95%; CI=.61, .97), respectively. Ethnicity varied by HBPS as being African-American, relative to not being African-American, was associated with increased odds of receiving concrete services (OR=2.31; 95% CI=1.65, 3.24) but decreased odds of receiving educational services (OR=.66; 95%; CI=.49, .90) and clinical services (OR=.25; 95%; CI=.18, .34). A history of abuse was significantly associated with increased odds of receiving concrete, educational, and clinical services.
Conclusions/Implications:
A complex relationship emerged among family demographics, need, and service receipt. Concrete need related to financial conditions was most often met with concrete services. However, different areas of need were not significantly associated with other HBPS. Demographics such as ethnicity and history of abuse were strong predictors of receiving HBPS. These findings suggest that demographics continue to be important determinants of receiving HBPS in some instances, perhaps regardless of need, and raises important questions about the cultural responsiveness of particular services. The findings also have important implications for understanding racial disparities in child maltreatment and child welfare services.