Title

A Mixed Methods Evaluation of Early Childhood Abuse Prevention Within Evidence-Based Home Visiting Programs

Date

2018

Author(s)

Meredith Matone, Katherine Kellom, Heather Griffis, William Quarshie, Jennifer Faerber, Peter Gierlach, Jennifer Whittaker, David M. Rubin, and Peter F. Cronholm

Type of Product

Journal publication

Model(s)

  • Early Head Start Home-Based Option
  • Nurse-Family Partnership (NFP)
  • Parents as Teachers (PAT)

Description

Objectives: In this large scale, mixed methods evaluation, we determined the impact and context of early childhood home visiting on rates of child abuse-related injury. Methods: Entropy-balanced and propensity score matched retrospective cohort analysis comparing children of Pennsylvania Nurse-Family Partnership (NFP), Parents As Teachers (PAT), and Early Head Start (EHS) enrollees and children of Pennsylvania Medicaid eligible women from 2008 to 2014. Abuse-related injury episodes were identified in medical assistance claims with ICD-9 codes. Weighted frequencies and logistic regression odds of injury within 24 months are presented. In-depth interviews with staff and clients (n = 150) from 11 programs were analyzed using a modified grounded theory approach. Results: The odds of a healthcare encounter for early childhood abuse among clients were significantly greater than comparison children (NFP: 1.32, 95% CI [1.08, 1.62]; PAT: 4.11, 95% CI [1.60, 10.55]; EHS: 3.15, 95% CI [1.41, 7.06]). Qualitative data illustrated the circumstances of and program response to client issues related to child maltreatment, highlighting the role of non-client caregivers. All stakeholders described curricular content aimed at prevention (e.g. positive parenting) with little time dedicated to addressing current or past abuse. Clients who reported a lack of abuse-related content supposed their home visitor’s assumption of an absence of risk in their home, but were supportive of the introduction of abuse-related content. Approach, acceptance, and available resources were mediators of successfully addressing abuse. Conclusions for Practice: Home visiting aims to prevent child abuse among high-risk families. Adequate home visitor capacity to proactively assess abuse risk, deliver effective preventive curriculum with fidelity to caregivers, and access appropriate resources is necessary. (author abstract)

Data Collection Methods

  • Program administrative record reviews

Status

Finished

For More Information

Matone, M., Kellom, K., Griffis, H., Quarshie, W., Faerber, J., Gierlach, P., ... & Cronholm, P. F. (2018). A mixed methods evaluation of early childhood abuse prevention within evidence-based home visiting programs. Maternal and Child Health Journal, 22(1), 79-91.  https://doi.org/10.1007/s10995-018-2530-1
Author Contact Information:
Meredith Matone
matonem@email.chop.edu

Topics

  • Participant, Family, and Program Outcomes