Oklahoma High Risk Child Abuse Prevention
The Oklahoma High-Risk Abuse Prevention Pilot Study (OHRAPPS) was funded by the state of Oklahoma to evaluate the feasibility and outcome of a home-based service for young children who are at high risk of abuse and neglect due to such factors as, but not limited to, parental drug and/or alcohol abuse, mental illness, mental and/or physical disability, and domestic violence. The OHRAPPS service model is a home-based intervention, SafeCare, which has been well researched and been found to reduce child maltreatment in child welfare populations (Lutzker, 1984; Lutzker & Bigelow, 2002; Lutzker, Bigelow, Doctor, Gershater, & Greene, 1998; Lutzker & Rice, 1984, 1987). SafeCare is behaviorally oriented and addresses changes in specific parent behaviors proximal to child maltreatment (child health, home safety, home cleanliness, and parent-child interactions). The service model for the OHRAPPS is an enhancement of SafeCare (SafeCare+) that includes Motivational Interviewing to address parents' motivation to change, a structured Problem-Solving Program to improve caregivers problem-solving skills, and Safety-planning for Intimate Partner Violence. The research design for the OHRAPPS is a randomized-controlled design. Families were randomly assigned to SafeCare+ or to "Services As Usual", which are the services that would have been provided if the family had called the community mental health center on their own requesting services and are often home-based mental health services.
Evidence-Based Child Maltreatment Prevention for High Risk Families: Expanding to Latino Communities, Enhancing Family Violence Prevention, and Sustaining Prevention Programs - 90CA1764
The Center on Child Abuse and Neglect (CCAN) of the University of Oklahoma Health Sciences Center (OUHSC) is developing, implementing, evaluating, and expanding evidence-based home visiting programs serving high-risk populations. CCAN is currently evaluating SafeCare®, an in- home eco-behavioral model, augmenting it to address risks of intimate partner violence, substance abuse, and depression with Motivational Interviewing, safety planning, and problem solving (SafeCare+). Through a Children's Bureau grant which begun in October 2008, we are expanding the SafeCare+ model by selecting an evidence-based augmentation to promote non-violent intimate partner violence and conflict resolution skills, and implementing adaptations for receptivity and cultural congruency for the Oklahoma Latino communities. A rigorous experimental design will be used to compare SafeCare+ to another home-based service approaches offered at the Latino Community Development Agency. The outcomes evaluation will focus on reduction of the likelihood of child maltreatment, increasing protective factors and reducing risk factors. This project will also examine private, municipal, state, and federal funding streams and carry out a cost analysis to help plan and guide the continuation and expansion of evidence-based high risk child maltreatment prevention in Oklahoma.
Prevention of Child Maltreatment in High Risk Rural Families
Child maltreatment is a substantial risk factor for adolescent and adult criminal activity (Widom, 1989).
Thus, prevention of early child neglect and physical abuse is an important effort for thwarting future criminal
activity. Some defined subpopulations are vastly more at risk than others for committing child maltreatment
(Gomby et al., 1999). It is among this highest risk group where the potential benefits of stopping maltreatment
before it starts are greatest. Rural communities and populations have unique strengths, levels of risks, and
barriers to services that impact service delivery and outcome. Results of urban trial may not translate to
rural communities, and efforts to directly examine rural culture are recommended. SafeCare (SC) is a promising
home-based model for child maltreatment prevention in high risk families because it addresses imminent
child maltreatment by utilizing a skills-based approach to changing those parenting behaviors most proximal
to child maltreatment. SC targets parenting behavior related to child health, home safety and cleanliness,
and parent-child bonding. A substantial body of literature exists on the SC model including case studies,
multiple baseline studies of behavior change, quasi-experimental recidivism studies, and randomized trials
of behavior change.
The overarching goal of the project was to conduct a full-scale randomized efficacy trial of an adapted
and augmented SC protocol with a rural high-risk child maltreatment prevention population.
The project exaimined the feasibility and outcome of SC+ services for rural high-risk populations. The
feasibility of recruiting and retaining a high risk rural population to a voluntary home-based service was
examined. The modified SC protocol ("SC+") was compared to standard home-based mental health services
(SAU) with a randomized control trial (RCT) for efficacy in reducing future maltreatment reports and malleable
maltreatment risk factors.
|Funded by Oklahoma Department of Human Services and the Office of Juvenile Justice and Delinquency |
Prevention (2006 JP FX 0067)
|Prevention of Child Maltreatment in High Risk Rural Families - Final Report |
|Supplemental Figure for High Risk Rural Families |
|Supplemental Table 1 |
|Supplemental Table 2 |
|Supplemental Table 3 |