Abstract: Navigating Risk in Home Visitation: An Examination of the Predictive Validity of the Healthy Families Parenting Inventory (Society for Social Work and Research 24th Annual Conference - Reducing Racial and Economic Inequality)

663P Navigating Risk in Home Visitation: An Examination of the Predictive Validity of the Healthy Families Parenting Inventory

Sunday, January 19, 2020
Marquis BR Salon 6 (ML 2) (Marriott Marquis Washington DC)
* noted as presenting author
Cara Kelly, PhD, Faculty Associate, Arizona State University, Phoenix, AZ
Background and Purpose: Given the scale and scope of child maltreatment and the potential for long-term negative consequences, identifying factors that may prevent it is imperative. Designed as a strategy to address risk factors for maltreatment among families with young children, home visitation programs have emerged as the primary approach to preventing child maltreatment and improving child well-being among at-risk families in the United States. However, although there is substantial multidisciplinary literature that investigates the utility of standardized instruments to measure clinical outcomes among families enrolled in home visitation programs, there has been minimal inquiry into the validity of early childhood home visitation instruments to classify children and their families by level of risk for future child abuse and neglect. This study addresses this dearth in the literature by investigating the predictive capacity of a widely used assessment instrument in home visitation, the Healthy Families Parenting Inventory (HFPI) to predict a family’s risk for future maltreatment.
Methods: We performed a retrospective review of data from families enrolled in a statewide Healthy Families intervention (N = 2,088) over the course of two years. Enrolled families met programmatic criteria for the Healthy Families intervention after identification of family challenges including single parenthood; low income; adverse child experiences; and current or previous issues related to substance abuse; mental health issues, and/or domestic violence. The participating families completed the HFPI at the time of enrollment, and were matched with data from the state’s public child welfare agency to determine whether the family experienced maltreatment within one year.
Results: Logistic regression analyses revealed that families whom were classified as at-risk on the HFPI were 48% more likely to experience maltreatment (AOR = 1.48, [p = .007]). Further, as a family’s score on the HFPI increased, significant relationships were found between a family’s score on individual subscales measuring personal care (AOR = .99, [p = .003]), mobilizing resources (AOR = 1.07, [p = .000]), home environment (AOR = 1.03, [p = .029]) and parenting efficacy(AOR = .94, [p = .005]) and child maltreatment. In further analysis, at the mean, the subscales measuring a parent’s ability to mobilize resources (AOR = .93, p = .039) and prepare their home environment (AOR = .94, [p = .014]) for their child moderated the relationship between parental role satisfaction and maltreatment.
Conclusions: Among families enrolled in a state-wide home-visitation program, a family’s score on the HFPI successfully predicted whether the family would experience future maltreatment in the absence of involvement of the public child welfare system. Considering the potential for home visitation services to serve as an efficacious strategy for reducing maltreatment among at-risk families; enhancing home visitor’s capacity to predict child maltreatment through standardized assessment can improve practice by identifying families early, prioritizing services to at-risk families, and targeting predictive protective factors to meet family’s most salient risks. This data can then be used in real time to drive treatment plan development in the prioritization of family and community risks, and mobilization of family and system-wide strengths and supports.