Multidimensional Model of Caregiver Engagement in Child Maltreatment Prevention Studies: A Scoping Review of Engagement Measures

Background/Purpose: Prevention services can promote public health by building protective factors and reducing maltreatment risk, particularly among socio-economically disadvantaged families. Yet, engaging caregivers in prevention services presents a unique set of challenges. Measurement studies are important first steps to increase the knowledge of caregiver engagement in prevention services. The purpose of this scoping review was to investigate how parent engagement has been measured and operationalized in the studies of child maltreatment prevention programs.

Methods: The review examined quantitative and mixed methods studies conducted in the U.S. since 2000, which measured multiple dimensions of caregiver engagement in maltreatment prevention programs, including behavioral, attitudinal, and relational domains. Inclusion criteria and search strategies were developed in consultation with a librarian who specialized in systematic reviews. A total of 88 studies were selected from Pubmed, CINAHL, ERIC, PsychInfo, Social Work Abstracts, Academic Search Premier, and Web of Science. At least two reviewers conducted the title and abstract screening as well as the full-text screening of all included articles. The screening was conducted using PICO Portal, a web-based systematic review platform that leverages Artificial Intelligence (AI). Inter-reviewer reliability was assessed throughout and any conflicts were resolved through team discussions.

Results: Studies examined engagement constructs in all three domains with a primary focus on the behavioral domain such as attendance, program utilization, active participation, recall, compliance, and service completion. The attitudinal and relational engagement was mostly assessed through general satisfaction surveys. Attitudinal engagement constructs included 1) acceptability; 2) beliefs and interests in the interventions, and 3) perceptions and opinions regarding the interventions as well as provider cultural competence. Relational engagement constructs included provider support, relationship with providers, facilitator positive engagement, working alliance, trust, and beliefs about providers. A limited number of studies utilized validated measures to assess attitudinal and relational engagement. While most studies reported acceptable internal reliabilities for the attitudinal and relational measures, only two studies reported other dimensions of psychometric qualities. Finally, only one validated measure was found, which assessed client perceptions of provider cultural competence in the attitudinal domain.

Conclusion and Implications: This study points to the gaps in the literature regarding validated measures that can be used to assess multiple dimensions of parent engagement in maltreatment prevention programs, particularly in the attitudinal and relational domains. More measurement studies are needed to further promote engagement studies that are informed by a multidimensional model of parent engagement. Such studies can inform the effort to develop tailored implementation strategies to fully engage various groups of marginalized parents in maltreatment prevention programs.