Initial Findings from a Feasibility Trial Examining the SafeCare Dad to Kids Program with Marginalized Fathers

Engagement Measures in Maltreatment Prevention Studies: A Scoping Review

Prevention services can promote public health by building protective factors and reducing maltreatment risk. 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 family engagement has been measured and operationalized in the studies of maltreatment prevention/positive parenting programs. The review examined quantitative and mixed methods studies conducted in the U.S., which measured multiple dimensions of client engagement, including behavioral, attitudinal, and relational domains. A total of 88 studies selected from PubMed, CINAHL, ERIC, PsycINFO, Social Work Abstracts, Academic Search Premier, and Web of Science were included in this review. Results indicated that studies examine engagement constructs in all three domains of engagement with a primary focus on behavioral engagement. The attitudinal and relational engagement was mostly assessed through general satisfaction surveys, and a limited number of studies utilized validated measures to assess those constructs. While most studies reported acceptable internal reliabilities, only two studies reported other dimensions of psychometric qualities. Only one validated measure was found, which assessed client perceptions of provider cultural competence. More measurement studies are needed to further incorporate multiple dimensions of engagement into the studies of maltreatment prevention programs, which can inform the effort to develop tailored implementation strategies to fully engage various groups of parents in maltreatment prevention programs.

Systematic braiding of Smoke-Free Home SafeCare to address child maltreatment risk and secondhand smoke exposure: findings from a pilot study

BACKGROUND

Exposure to secondhand tobacco smoke (SHS) and child maltreatment are preventable threats to child health. Few evidence-based interventions target both SHS and child maltreatment risk. The purpose of this paper is to describe the systematic braiding process of two evidence-based programs to address child SHS in the home and maltreatment perpetration risk, and present results from the formative work and pilot study.

METHODS

The first 4 steps of the systematic braiding process were completed, including the following: (1) the identification of core elements of both programs, (2) the development of an initial draft of the braided curriculum (Smoke-Free Home SafeCare - SFH-SC), (3) an acceptability and feasibility pilot of SFH-SC with caregivers of young children who reported a smoker living in the home (N = 8), and (4) feedback collection on the braided curriculum from SafeCare Providers (N = 9).

RESULTS

Experts identified common pedagogical and theoretical underpinnings for the two programs and braided Smoke-Free Homes: Some Things Are Better Outside into two SafeCare modules. Caregiver feedback from the pilot demonstrated that participants were engaged with SFH-SC and felt supported and comfortable discussing SHS intervention content with the SFH-SC Provider. Caregiver self-reports indicated a slight increase in smoke-free home rules from baseline to follow-up and a notable reduction in parent stress on the Parent Stress Index of 5.9 points (SD = 10.2). SafeCare Provider feedback following intensive review of the curriculum indicated high feasibility for SFH-SC delivery.

CONCLUSIONS

Parent and Provider findings suggest SFH-SC is a viable intervention that has potential to reduce the public health impact of SHS and child maltreatment for at-risk families.

PROTOCOL

The protocol for the pilot is not published elsewhere; however, the full protocol for the hybrid trial can be found here: https://clinicaltrials.gov/ct2/show/NCT05000632 .

TRIAL REGISTRATION

NCT, NCT05000632. Registered 14 July 2021, there is not a separate registration number for the pilot.

Examining an In-Home Behavioral Parent Training Protocol Among Parents Who Use Substances Involved Child Welfare: Effectiveness of SafeCare

Given the detrimental impact of substance use (SU) on both parent and child outcomes including child maltreatment, research and service efforts have focused on incorporating parenting resources into integrated SU treatment programs. While promising, it is imperative to examine and test parenting programs in a variety of settings. This study examined whether SU moderated the relationship between treatment condition and parenting outcomes among parents who participated in SafeCare, and parent ratings of engagement, service satisfaction, and perceived cultural competency of services. Results indicated that SU did not moderate the relationship between treatment condition and abuse potential, but did moderate this relationship for depression and parental distress such that parents with higher levels of SU reported less improvement in depression and parental distress. Results underscore that SU problems may impact the effectiveness of SC on specific risk factors, such as depression and parental distress, potentially indicating unique treatment needs and the need to adapt interventions to ensure treatment success. In addition, this study found that SafeCare was not found to be beneficial for parents with SU problems above and beyond the treatment as usual condition. Finally, results indicated that parents with SU concerns and without SU concerns engaged very similarly in SafeCare.

The Effects of Father-Perpetration of Maltreatment on Adolescent Health Risk

Maltreatment perpetrated by fathers may entail distinct characteristics and threats, and therefore differing effects from maltreatment perpetrated by mothers alone. This study examines the extent to which father perpetration of maltreatment is associated with variability in subsequent adolescent health outcomes relative to mother-alone maltreatment. A sample of youth (N = 377) with recently completed Child Protective Services investigations concerning reports of maltreatment attributed to fathers and/or mothers was drawn from the second National Survey of Child and Adolescent Well-being. Youth were 11-17 years old (M = 13.8, SD = 2) at 18-month follow-up. Predictor variables (baseline) included caseworker-reported perpetrator (father vs mother alone), maltreatment type and severity, and co-occurring risk factors (prior reports of maltreatment, caregiver substance use, serious mental health problems, and recent arrest or detention, and intimate partner violence). Outcome measures were youth-reported sexual risk behavior (the number of past-year sexual partners), substance use severity (use of illicit drugs other than marijuana, number of substances used, and CRAFFT raw scores), and parent-to-adolescent physical aggression (minor, moderate, and severe) at 18-month follow-up. Structural equation modeling assessed the effects of father perpetration on outcomes. Father perpetration was prospectively associated with more parent-to-adolescent aggression (β = 0.16, p = .034) and less sexual risk behavior (β = -0.17, p = .017) than mother-alone perpetration. Findings suggest protective effects of father perpetration relative to mother-alone perpetration on sexual risk taking but greater risk on further victimization by parents. Future research is needed to replicate findings and examine potential youth gender differences.

Incorporators, Early Investors, and Learners: a longitudinal study of organizational adaptation during EBP implementation and sustainment

BACKGROUND

The majority of literature on evidence-based practice (EBP) adaptation focuses on changes to clinical practices without explicitly addressing how organizations must adapt to accommodate a new EBP. This study explores the process of organizational-rather than EBP-adaptation during implementation and sustainment. To the authors' knowledge, there are no previous implementation studies that focus on organizational adaptation in this way.

METHODS

This analysis utilizes a case study approach to examine longitudinal qualitative data from 17 community-based organizations (CBOs) in one state and seven county-based child welfare systems. The CBOs had sustained a child-neglect intervention EBP (SafeCare®) for 2 to 10 years. The unit of analysis was the organization, and each CBO represented a case. Organizational-level profiles were created to describe the organizational adaptation process.

RESULTS

Three organizational-level adaptation profiles were identified as follows: incorporators (n = 7), early investors (n = 6), and learners (n = 4). Incorporators adapted by integrating SafeCare into existing operations to meet contractual or EBP fidelity requirements. Early Investors made substantial organizational adaptations during the early implementation period, then operated relatively consistently as the EBP became embedded in the organization and service system. Learners were characterized by steady and continuous attention to new ways that the organization could adapt to support the EBP.

CONCLUSION

The profiles demonstrated that there can be multiple effective paths to EBP sustainment. Organizational adaptation was calibrated to fit a CBO's operations (e.g., size of the program) and immediate environmental constraints (e.g., funding levels). Additionally, organizations fulfilled different functional roles in the network of entities involved in EBP implementation. Knowing organizational roles and adaptation profiles can guide implementation planning and help to structure contract designs that bridge the outer (system) and inner (organizational) contexts. Adaptation profiles can also inform the intensity of the implementation strategy tailoring process and the way that strategies are marketed to organizations.

Fatherhood Matters: An Integrative Review of Fatherhood Intervention Research

Positive father involvement is critical to the healthy social, emotional, and academic outcomes of children at all stages of development. The purpose of this integrative review was to identify, categorize, and evaluate the potential impact of fatherhood interventions on father and child outcomes. A systematic search of four major research databases yielded 44 studies published between 1988 and 2018 that met study inclusion criteria. The most effective interventions were delivered in the community, with fathers convened in groups. Content focused on promoting positive parenting, co-parenting, and father/child relationships. Consequently, father involvement and child cognitive and socioemotional development were improved. Academic settings were underutilized in the fatherhood interventions in this review. We conclude that in order to optimize healthy child development, school officials must adopt a more inclusive stance toward the involvement of fathers in their children's education. Future randomized trials of fatherhood interventions delivered within school-based settings are warranted.