A Statewide Trial of the SafeCare Home-based Services Model With Parents in Child Protective Services
A Statewide Trial of the SafeCare Home-based Services Model With Parents in Child Protective Services
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DOI：
10.1542/peds.2011-1840
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发表时间：
2012-03-01
期刊：
影响因子：
8
通讯作者：
Beasley, William Howard
中科院分区：
文献类型：
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作者：
Chaffin, Mark;Hecht, Debra;Beasley, William Howard
目的：在这项试验中，我们比较了儿童保护服务（CPS）累犯的结果之间的家庭为基础的安全护理（SC）模式的儿童忽视和可比的家庭为基础的服务，但没有SC模块，在CPS系统的父母在2个质量控制策略：教练（C）和未经教练的实施。SC是一种以家庭为基础的行为技能培训模式，旨在忽视或虐待父母。这项研究是在一个规模扩大，全州范围内的实施setting.METHODS：二千一百七十五虐待的父母，由219家访治疗，被招募和治疗在2 X 2（SC与服务，如往常X C与未经指导的实施策略）随机集群实验。CPS累犯事件的病例平均随访6年。亚群分析进行了父母满足习惯的SC inclusion criterions.RESULTS：一致的显着的主效应，有利于SC被发现在简单和更复杂的建模方法（风险比= 0.74-0.83）。在符合传统SC纳入标准的亚群中发现了更大的影响。C的实施产生了较小的，偶尔显着的影响，包括更多样化的情况下落在习惯的SC inclusion criteria.CONCLUSIONS：调查结果支持CPS家庭为基础的服务系统内的SC的通过和使用的分析。C实现对于客户端模型拟合不太强的情况可能特别有价值。儿科2012; 129：509-515
OBJECTIVES: In this trial, we compared Child Protective Services (CPS) recidivism outcomes between the home-based SafeCare (SC) model for child neglect and comparable home-based services, but without SC modules, for parents in the CPS system across 2 quality control strategies: coached (C) and uncoached implementation. SC is a home-based behavioral skills training model designed for neglecting or maltreating parents. The study was conducted in a scaled-up, statewide implementation setting.METHODS: Two thousand one hundred seventy-five maltreating parents, treated by 219 home visitors, were enrolled and treated in a 2 X 2 (SC versus services as usual X C versus uncoached implementation strategy) randomized cluster experiment. Cases were followed for an average of 6 years for CPS recidivism events. Subpopulation analyses were conducted for parents meeting customary SC inclusion criteria.RESULTS: Consistently significant main effects in favor of SC were found across simple and more complex modeling approaches (hazard ratios = 0.74-0.83). Larger effects were found among the subpopulation meeting customary SC inclusion criteria. C implementation yielded smaller and occasionally significant effects in analyses that included more diverse cases falling outside customary SC inclusion criteria.CONCLUSIONS: Findings support the adoption and use of SC within CPS home-based services systems. C implementation may be especially valuable for cases where the client-model fit is less strong. Pediatrics 2012; 129:509-515