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Randomized trial of a statewide home visiting program to prevent child abuse: impact in reducing parental risk factors.
Child Abuse Negl. 2004 Jun; 28(6):623-43.CA

Abstract

OBJECTIVES

To assess the impact of a home visiting program in reducing malleable parental risk factors for child abuse in families of newborns identified, through population-based screening, as at-risk of child abuse.

METHODS

This randomized trial focused on Healthy Start Program (HSP) sites operated by three community-based organizations on Oahu, HI, USA. From 11/94 to 12/95, 643 families were enrolled and randomly assigned to intervention and control groups. Mothers in both groups were interviewed annually for 3 years (88% follow-up each year) to measure mental health, substance use, and partner violence. HSP records were reviewed to measure home visiting services provided. Home visitors were surveyed annually to measure their perceived competence.

RESULTS

Malleable parental risks for child abuse were common at baseline. There was no significant overall program effect on any risk or on at-risk mothers' desire for and use of community services to address risks. There was a significant reduction in one measure of poor mental health at one agency and a significant reduction in maternal problem alcohol use and repeated incidents of physical partner violence for families receiving > or =75% of visits called for in the model. Home visitors often failed to recognize parental risks and seldom linked families with community resources. HSP training programs were under-developed in preparing staff to address risks and to link families with community resources.

CONCLUSIONS

Overall, the home visiting program did not reduce major risk factors for child abuse that made families eligible for service. Research is needed to develop and test strategies to improve home visiting effectiveness in reducing parental risks for child abuse.

Authors+Show Affiliations

Johns Hopkins University School of Medicine, 1620 McElderry Street, Baltimore, MD 21205-1903, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15193852

Citation

Duggan, Anne, et al. "Randomized Trial of a Statewide Home Visiting Program to Prevent Child Abuse: Impact in Reducing Parental Risk Factors." Child Abuse & Neglect, vol. 28, no. 6, 2004, pp. 623-43.
Duggan A, Fuddy L, Burrell L, et al. Randomized trial of a statewide home visiting program to prevent child abuse: impact in reducing parental risk factors. Child Abuse Negl. 2004;28(6):623-43.
Duggan, A., Fuddy, L., Burrell, L., Higman, S. M., McFarlane, E., Windham, A., & Sia, C. (2004). Randomized trial of a statewide home visiting program to prevent child abuse: impact in reducing parental risk factors. Child Abuse & Neglect, 28(6), 623-43.
Duggan A, et al. Randomized Trial of a Statewide Home Visiting Program to Prevent Child Abuse: Impact in Reducing Parental Risk Factors. Child Abuse Negl. 2004;28(6):623-43. PubMed PMID: 15193852.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized trial of a statewide home visiting program to prevent child abuse: impact in reducing parental risk factors. AU - Duggan,Anne, AU - Fuddy,Loretta, AU - Burrell,Lori, AU - Higman,Susan M, AU - McFarlane,Elizabeth, AU - Windham,Amy, AU - Sia,Calvin, PY - 2002/12/09/received PY - 2003/07/24/revised PY - 2003/08/07/accepted PY - 2004/6/15/pubmed PY - 2004/9/24/medline PY - 2004/6/15/entrez SP - 623 EP - 43 JF - Child abuse & neglect JO - Child Abuse Negl VL - 28 IS - 6 N2 - OBJECTIVES: To assess the impact of a home visiting program in reducing malleable parental risk factors for child abuse in families of newborns identified, through population-based screening, as at-risk of child abuse. METHODS: This randomized trial focused on Healthy Start Program (HSP) sites operated by three community-based organizations on Oahu, HI, USA. From 11/94 to 12/95, 643 families were enrolled and randomly assigned to intervention and control groups. Mothers in both groups were interviewed annually for 3 years (88% follow-up each year) to measure mental health, substance use, and partner violence. HSP records were reviewed to measure home visiting services provided. Home visitors were surveyed annually to measure their perceived competence. RESULTS: Malleable parental risks for child abuse were common at baseline. There was no significant overall program effect on any risk or on at-risk mothers' desire for and use of community services to address risks. There was a significant reduction in one measure of poor mental health at one agency and a significant reduction in maternal problem alcohol use and repeated incidents of physical partner violence for families receiving > or =75% of visits called for in the model. Home visitors often failed to recognize parental risks and seldom linked families with community resources. HSP training programs were under-developed in preparing staff to address risks and to link families with community resources. CONCLUSIONS: Overall, the home visiting program did not reduce major risk factors for child abuse that made families eligible for service. Research is needed to develop and test strategies to improve home visiting effectiveness in reducing parental risks for child abuse. SN - 0145-2134 UR - https://www.unboundmedicine.com/medline/citation/15193852/Randomized_trial_of_a_statewide_home_visiting_program_to_prevent_child_abuse:_impact_in_reducing_parental_risk_factors_ DB - PRIME DP - Unbound Medicine ER -