Evaluation of APA?s ACT Program: Engaging Fathers to Prevent Adverse Childhood Experiences

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Project Summary This proposed study addresses Objective #3 of RFA-CE-21-004, “Effectiveness research to evaluate primary prevention strategies that incorporate a dual-generation approach for caregivers and their children that breaks the cycle of violence and adversity”. Child maltreatment (CM), a form of violence exposure most often perpetrated by caretakers, is a serious public health issue that results in health inequity across the lifespan and predisposes youth to violence perpetration. There is increasing evidence for early intervention efforts targeting child maltreatment prevention via parent training programs. However, major limitations of this research involve the paucity of male caregivers included in outcome evaluations and the failure to look at other associated violence outcomes. In particular, exposure to adult intimate partner violence (IPV), which frequently co-occurs in families with CM, has the same adverse behavioral and health outcomes for youth including youth violence (YV). Given the significant number of shared risk and protective factors among CM, IPV, and YV, there are reasons to suspect that efficacious CM prevention programs will prevent these multiple forms of violence. The purpose of this proposed study is to explore this potential in an evidence-based, parent training program for CM prevention, ACT Raising Safe Kids. This project builds on domestic on international evaluations of the ACT program by implementing a rigorous quasi-experimental design with male caregivers. For the proposed project, 500 male caregivers will be recruited from 4 service provider sites that provide an armamentarium of services to families, including the ACT program. Inverse probability of treatment weighting will be used to balance the intervention group and the control group on potential confounding covariates. Assessments will be collected at baseline, 10 weeks (i.e., immediately post-intervention), 6 months post-intervention, and 12 months post- intervention. Outcome measures include CM perpetration risk, IPV, and youth aggression (a risk factor for more severe forms of YV in adolescence). Additionally, we will assess a number of mediating variables including parenting behaviors, parental stress, family conflict, and anger regulation. For the final primary AIM, we will also collect cost diary data from ACT participants, facilitators, and administrators so we may a cost- utility analysis. Data collection will be web-based via caregiver report. It is hypothesized that male caregivers in the ACT condition will report less CM risk, IPV, and YV risk over time. This research is innovative as it has potential to demonstrate the ability of a single program to eliminate risk for multiple forms of violence typically addressed not only by different programs, but in different silos of the scientific literature. Such findings could have substantial public health impact providing evidence for the consolidation of resources to, and broad dissemination of, single cross-cutting prevention programs. Given that, ACT is currently implemented in 13 countries and 80 U.S. communities, the public health impact would be substantial.