Raising Family Perspectives: Assessing Needs and Barriers to Accessing Services for Primary Prevention

Background and Purpose: Community-based services that apply a family-centered model of prevention and early intervention must be “need-based” (proactive) rather than “incident-based” (reactive); requiring a well-developed infrastructure of services in communities that are not only timely, but also affordable. This primary prevention approach reduces risk for removals by supporting families to meet their basic needs such as housing or medical care, thus ensuring children can thrive in their homes.

According to a systematic problem exploration of child and family outcomes in a Midwestern state, researchers found that the service array was not meeting the needs of children and families in the child welfare (CW) system. However, limited data was available to understand where the system was failing. The Parent Survey was therefore developed as a comprehensive instrument to assess 1) the service needs of families and 2) identify gaps or inconsistencies in the availability of services by region or population subgroups and 3) identify barriers to accessing services.

Methods: The Parent Survey was administered as a paper and online survey to 647 participants from 56 counties (50%) in one Midwestern state. The purpose of the survey was to assess caregivers’ experience with the CW system including needs and gaps in the service array. Incentives ($10 gift cards) were provided to participants on survey completion. Participants were recruited by a partner agency providing family advocacy services in the community. Adult caregivers with or without involvement in the CW system were eligible to participate in the survey.

Results: Although many participants reported confidence in accessing standard services for their family, such as medical and dental care, parents were least confident that they could access services critical for maintaining safety and wellbeing in difficult times, including respite care, emergency housing and financial assistance. Of those who reported needing these services, many experienced barriers to receiving them (i.e., 40% seeking respite care, 34% seeking emergency housing, and 57% seeking rental assistance reported barriers to receiving these services). In each of these service areas, the most common reason parents reported that they were unable to access the service is that they were “unsure where to go.” These findings reveal a critical gap in the prevention services system suggesting that information about available services may not be reaching the families that need it.

Conclusions: The Parent Survey incorporates parents’ perspectives to measure service needs and gaps in the community. The survey has identified state-level and regional service needs suggesting that respite care, emergency housing and financial assistance are the least accessible services to the families that need them. Only parents can describe how they perceive and access the services in their local community. In this study, the findings suggest more work is needed to make families aware of the services available to them when they experience hardships. Incorporating family perspectives, systems can uncover such barriers to service use, and ensure a robust, context-specific service array that prevents unnecessary removals of children by helping families meet their own needs within their communities.