Session: Infants, Risk, and Well-Being: Prevention Science at Work (Society for Social Work and Research 30th Annual Conference Anniversary)

In 2019, Allegheny County's Department of Human Services (ACDHS) was awarded a grant from the Administration for Children and Families to plan, implement, and evaluate the outcomes of Hello Baby. Hello Baby is a countywide initiative designed to offer differentiated service tiers, matching families at greatest risk of out-of-home placement with individualized supportive services to mitigate their needs and support their parenting. The evaluation seeks to understand how Hello Baby was rolled out and whether its impact followed what county leaders intended. To answer that question, we collected two types of data: data that tell us whether Hello Baby was a network of sufficient scale to generate a public health benefit and data that can demonstrate evidence that there has been a change in contact with the child protection system. The first paper addresses the question of operational scale, for which we have two data sources: the process study captures the evolution of Hello Baby from process, quality, and capacity perspectives between 2020 and 2024 from key informant interviews and parent focus groups; while the administrative (encounter) data captures year-over-year changes in service outreach, referral, and uptake -- measured as both enrollment in Hello Baby and level of engagement with service providers. The second paper describes the outcome study. To test Hello Baby's impact, we considered contact with the child protection system, which was measured in three ways: the number of first investigations, the number of first substantiated investigations, and the number of first foster care placements. Each of the three outcomes was measured as probabilities within one year of birth using the number of births each year as the denominator. The paper reports the outcome study design and the statistical model used to establish a "plausible causal model". The third paper addresses the lessons learned about large-scale evaluations and their place in supporting evidence-based interventions. Did Hello Baby work? The question has to be asked and answered with an understanding that Hello Baby exists in a multi-cause, multi-effect world. Whether infants and their families are in touch with the child welfare system is no simple calculus on anyone's part. The answer starts by asking whether, with concerted effort, it is possible, as a community, to reduce investigations as the way families are introduced to a system that is supposed to support them and protect children. The answer to that question opens up all the other questions that need an answer before we can say the County has its arms around a very big problem. The process of improvement starts with small gains. The work in Allegheny leads the way through one of America's toughest social problems.