Preventing Child Maltreatment: Examination of an Established Statewide Home-Visiting Program




Barbara H. Chaiyachati, Julie R. Gaither, Marcia Hughes, Karen Foley-Schain, and John M. Leventhal

Brief Type

Journal publication


  • Parents as Teachers (PAT)


Although home visiting has been used in many populations in prevention efforts, the impact of scaled-up home-visiting programs on abuse and neglect remains unclear. The objective of this study was to assess the impact of voluntary participation in an established statewide home-visiting program for socially high-risk families on child maltreatment as identified by Child Protective Services (CPS). Propensity score matching was used to compare socially high-risk families with a child born between January 1, 2008 and December 31, 2011 who participated in Connecticut’s home-visiting program for first-time mothers and a comparison cohort of families who were eligible for the home-visiting program but did not participate. The main outcomes were child maltreatment investigations, substantiations, and out-of-home placements by CPS between January 1, 2008 and December 31, 2013. In the unmatched sample, families who participated in home-visiting had significantly higher median risk scores (P < .001). After matching families on measured confounders, the percentages of families with CPS investigations (21.1% vs. 20.9%, P = .86) were similar between the two groups. However, there was a 22% decreased likelihood of CPS substantiations (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.64–0.95) for families receiving home visiting. First substantiations also occurred later in the child’s life among home-visited families. There was a trend toward decreased out-of-home placement (HR 0.73, 95% CI 0.53–1.02, P = .06). These results from a scaled-up statewide program highlight the potential of home visiting as an important approach to preventing child abuse and neglect. (author abstract)

Data Collection Methods

  • Program administrative record reviews


For More Information

Chaiyachati, B. H., Gaither, J. R., Hughes, M., Foley-Schain, K., & Leventhal, J. M. (2018). Preventing child maltreatment: Examination of an established statewide home-visiting program. Child Abuse & Neglect, 79, 476–484. https://doi.org/10.1016/j.chiabu.2018.02.019
Author Contact Information:
Barbara H. Chaiyachati


  • Participant, Family, and Program Outcomes