Maltreatment Prevention By Strengthening Protective Factors Using a Home Visiting Intervention Model

Background/Purpose: In recent decades, child maltreatment prevention efforts have broadened the scope of their primary and secondary prevention efforts to focus on bolstering protective factors in vulnerable families. Various programs for families with very young children (nearly 25% of all maltreatment cases occur within the first 3 years of life), target factors such as parental resilience, social connections, parental knowledge of child development and access to support while facilitating child social and emotional competence and have demonstrated promising results. More recently, some prevention programs are reaching even further by integrating services that aim to stabilize and improve parental mental health, intimate partner relationships, and means for economic viability. As these are recent trends, the question of how to best reach and serve these vulnerable families remains largely unanswered

This study examines the effectiveness of an ecologically-driven home visiting program delivered by social work professionals who promote a range of protective factors for low income mothers with young children. The Early Childhood Initiative (ECI) uses a strengths-based model to provide services in five domains expected to reduce risk for child maltreatment: family economic stability, parental mental health, parenting competence, social support, and the use of services/benefit programs.

Methods: The intervention group in this quasi-experimental study consisted of 71 low income mothers who were pregnant and/or had infant children under age 12 months. ECI participants were matched with control group mothers with similar family and demographic characteristics recruited from the Women, Infant and Children Nutrition Program (WIC) in the same large Wisconsin county (n=221). All participants were observed over a 12 month period using baseline and follow-up surveys eliciting data pertaining to the five domains noted above. Administrative data on child protective services transactions from the Department of Children and Families were used to capture maltreatment outcomes. Propensity score matching and difference-in-difference analyses were used to identify program effects.

Results: We found significant differences between treatment (ECI) and control (WIC) groups at the 12-month follow-up for five of nine outcome indicators. PSM analyses found that ECI families demonstrated decreases in severe financial distress, food security issues, and maternal depression (p<.05). Results from difference-in-difference modeling additionally indicated significant improvements in public program participation and reductions in perceived stress for ECI participants. We found no program effects with respect to child protective services involvement, social support, quality of intimate partner relationship, or parenting competence.

Conclusions and Implications: The results of this study indicate the promise of home visiting programs developed and delivered using a social work lens for promoting protective factors in families. Although the study did not demonstrate an impact on maltreatment outcomes, limitations with respect to statistical power and the duration of the follow-up interval are considered. This research demonstrates the importance of understanding and addressing family vulnerability from a protective or strengths-based framework. Further exploration into the long-term impacts of such programming will serve to better inform intervention and prevention methods.