Mapping Critical Services for Connecticut Differential Response Cases

Background/Purpose: The Connecticut Department of Children and Families provides family preservation-type services through Family Assessment Response (FAR). FAR seeks to reduce the likelihood that at-risk families experience maltreatment re-report through early needs assessments and linkage to indicated services (e.g., for parenting, substance use, and poverty). Although the FAR protocol is consistent throughout the state, maltreatment re-report rates differ across zip codes with similar average risk assessment scores. One possible reason for this disparity is a lack of accessible service providers for common service needs. To address this hypothesis, the study aimed to (1) identify service providers by service type across two demographically similar Hartford zip codes areas with different maltreatment re-report rates, (2) pilot test a measurement instrument for capturing attributes of community asset strength with the identified service providers, and (3) estimate the effect of service accessibility on maltreatment re-report rates.

Methods: This cross-sectional study design relied on existing data and key informant methods (Witkin, 1994) to evaluate community assets relevant to maltreatment prevention in two Hartford zip codes (A and B) areas. A survey was developed and distributed via Qualtrics to a key informants from each identified agency. The Area Deprivation Index (ADI) Average Rank for each zip code was used to contextualize the data which were analyzed with basic univariate and bivariate statistics.

Results: Zip code A had higher risk assessment scores, subsequent report rates, and FAR re-report rates than zip code B. Zip code A also had twice as many assets as zip code B (71 versus 29 service providers), contrary to the hypothesis. However, these raw numbers do not reflect per-capita rates. Zip code B had a slightly higher proportion of block groups within it with high disadvantage scores, 99.58% compared with 99.13%: ADI did not appear to account for the findings.

Conclusion/Implications: These descriptive findings suggest that services availability is positively associated with maltreatment re-report rates, with more service-rich communities having higher re-report rates. However, this may be due to the impact of surveillance on re-reporting, rather than actual maltreatment prevalence. Alternatively, the prevalence of services and the high maltreatment re-report rates may reflect a third, unmeasured variable, such as higher levels of vulnerability among parents due possibly to other factors such as more prevalent substance use disorders, mental health diagnoses, or domestic violence. The average risk level among families in the zip code with higher re-report percentages was higher, although not considerably so (2.24 vs. 2.15). The lack of more comprehensive parent- and family-level information prevented the mediating effect of services availability on pre-existing risks for maltreatment to be explored. Factors such as utilization, and quality should also be considered. Further, structural and community factors such as income, level of education and employment, and housing quality should be included to allow for a more nuanced view of the environmental context.