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May 2012Vol. 13 No. 4Statewide Child Neglect Prevention

A new study in the journal Pediatrics presents positive outcomes for a statewide home visiting program in Oklahoma aimed at reducing future child protective services (CPS) reports for families involved with child welfare due to neglect. Home visitors used the SafeCare model, which takes a structured approach to training caregivers on effective parenting skills and helping them address home safety and child health. While SafeCare has shown promise at local levels, this is the first study to demonstrate effectiveness when implemented statewide.

The study not only compared SafeCare to standard home-based services, but it also examined whether coaching home visitors improved families' outcomes. Programs often lose effectiveness when implemented at larger levels; coaching is one way to try to prevent those losses. Home visitors who were coached received regular supervision and were monitored during visits monthly using a fidelity checklist to ensure they provided services according to the SafeCare model.

Oklahoma CPS referred nearly 2,200 at-risk caregivers with children age 12 and under to community-based services, where they were randomly assigned to one of four study clusters. Researchers gathered State data on each family in the study for an average of 6 years to determine if a future CPS report was made. Among the study's findings:

  • Recidivism rates for families receiving SafeCare services were significantly lower than families receiving standard services.
  • More positive outcomes were experienced by families with young children—the target of the original SafeCare model.
  • Coaching only affected outcomes for complex cases, indicating families in need of multifaceted services benefit more from intensive interventions.

Although the authors noted the need to improve the effectiveness of SafeCare for families with older children, they nonetheless encourage interested programs to learn from these findings in their efforts to reduce rates of future CPS reports for families involved with child welfare. Given the challenges faced by those trying to implement programs with fidelity across wide service areas, the study's results are promising for improving families' outcomes on a larger scale.

"A Statewide Trial of the SafeCare Home-based Services Model With Parents in Child Protective Services," by M. Chaffin, D. Hecht, D. Bard, J. F. Silovsky, and W. H. Beasley, was published in Pediatrics, 129(3), 2012, and is available on the American Academy of Pediatrics website: