Methods: Primary data collection for the study followed a multi-stage sampling procedure. First, we selected a stratified random sample of nine states using a national sampling frame. Second, we randomly sampled and enrolled three counties from within each of the nine states. All APS clients in participating counties who received at least an APS investigation, and whose case closed between March 1 and September 30, 2021, were eligible to participate in the study.
Data collection occurred from March 1 through September 30, 2021. During this time, APS workers completed the Client Data Form (CDF) and distributed the Client Questionnaire (CQ) to all eligible clients. The CQ, a one-page self-administered survey completed by the client or their proxy, captured client opinions about their experience with APS and the impact APS had on their life using a five-point Likert scale. The CDF, a one-page survey completed by the APS worker, captured additional information about the APS client and their case (e.g., demographics, maltreatment type and disposition, case status, engagement level). Both surveys were completed and submitted anonymously. Each CDF and CQ were paired for analysis using a matching, de-identified form number. The study also collected and incorporated data on COVID-related changes to APS services in these counties during this time.
Results: During the data collection period, APS workers completed and submitted a total of 2,669 CDF responses and APS clients or proxies submitted a total of 299 CQ responses, for an overall response rate of about 11.2%. About 71.1% of all clients who responded indicated that they were satisfied with the help they received from APS, 56.1% indicated they felt safer because of the help they received from APS, and 56.9% reported that their life was better because of the help they received from APS. Results from multivariate analyses indicated that, across the multivariate models, four key factors independently predicted positive client outcomes: (1) the client agreeing that they received all the services they needed, (2) the client agreeing they needed help from APS when they first met the worker, (3) the client agreeing they helped decide what type of help they received from APS, and (4) the client agreeing the worker respected their wishes.
Conclusions/Implications: The findings emphasize the importance of services, client readiness to participate in APS, client self-determination and involvement in the APS process, and the role of the client-worker relationship in achieving successful client outcomes. Based on these key findings, future efforts to improve APS client outcomes should focus on addressing these four factors.