Prevention and Service Delivery in Child Maltreatment Practice: An Inter-Organizational Network Comparison

Background

The scope of child maltreatment practice has broadened in recent decades to include the funding and implementation of prevention strategies, yet much remains unknown about how preventive efforts are enacted by and among organizations at the community-level. Using network analysis and qualitative interviews, this study sought to a) measure the scope of prevention activity among organizations at the community-level, b) examine distinctions in structure between the network formed for prevention compared to service delivery, and c) more fully understand the community-level experience of navigating each.

Methods

Data were gathered via a mixed-methods design. Snowball sampling began with a county’s child protective services agency and grew to include 105 organizations identified as contributing to community child maltreatment prevention and service delivery efforts. Key informants from each organization completed a survey (n = 80, 76%) indicating their organization’s interactions with other organizations across activities designated as preventive (i.e., fundraising, advocacy, community awareness/education, shared resources, and joint programs for prevention), and activities designated as service delivery (e.g., referrals, case coordination, shared training, evaluation, shared resources, and joint programs for service delivery). Semi-structured interviews were conducted with 67 of the 80 organizations (84%) to deepen understanding of community-level experiences working across each domain. UCINET and NETDRAW were utilized for network data analysis and visualizations, and Atlas. Ti for qualitative data management and thematic analysis.

Results

Findings revealed differences in structure and prominent actors across domains. Organizations were significantly more likely to share resources for service delivery than for prevention (avg bootstrap difference = - 0.012, 95% boot-strap CI [-0.024, -0.001], p < .05), and were more likely to have a joint program for service delivery compared to a joint program for prevention (avg bootstrap difference = 0.014, 95% boot-strap CI [0.005, 0.023], p < .001). Service delivery activities (density = .11) slightly outpaced interaction on prevention activities (density = .09) when referral links were excluded, yet service delivery connections were highly centralized (.509) compared to prevention (.247). Qualitative analysis also revealed contrasts, whereby prevention activities were perceived to be exploratory vs. having set-criteria, unfunded vs. funded, focused on the big picture vs. being case-specific, and always taking a backseat vs. urgent. Concurrent with contrasts, data revealed similarities across domains, including evidence that organizations do not work in silos of prevention or service delivery singularly, and perceptions that service delivery is preventive.

 Conclusions

Findings suggest that while organizations are active in prevention, and often view direct services as preventative, prevention efforts are substantially less-defined, relationships around prevention are less-mutually recognized per reciprocity scores, and prevention relationships occur in a structure of more dispersed rather than centralized control and/or messaging. The differences are compounded by the identification of different prominent actors across domains. Qualitative data offer insight into the experiences and perceptions of organizations and suggest additional contrasts in how prevention works compared to service delivery in practice. Practice, policy and research implications are numerous, and will be discussed with an emphasis on advancing how child welfare practice can gain traction as a preventive system.