abstract - texas institute for child & family wellbeing...• data collected from pei must be...
TRANSCRIPT
Abstract
References
Methods
Introduction
• Findings presented from the analysis of
retrospective data from the Texas Prevention and
Early Intervention project designed to reduce
rates of child maltreatment
• Results indicate the need for a comparison group
included from the beginning of the intervention
and the utility of case-worker identified risk factors
in predicting maltreatment
Abstract
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Findings from the Retrospective Data Analysis of the
Texas Prevention and Early Intervention Project
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Patrick S. Tennant, Ph.D., LMFT-Associate Monica Faulkner, Ph.D., LMSW Beth Gerlach, Ph.D., LCSW
University of Texas School of Social Work
Background: The state of Texas Prevention and Early Intervention project
funded the implementation of a variety of evidence-based child-maltreatment
prevention programs throughout the state and tracked client services and
outcomes across time. The aim of the current project was to evaluate both
general trends in child maltreatment in the state of Texas and to assess the
effectiveness of this wide-ranging effort to prevent child maltreatment.
Methods: Data from the state of Texas Prevention and Early Intervention
project that was collected from 2008 to 2015 was used in this evaluation.
The sample consists of the primary caregivers from 137,068 families and
over 162,000 total observations The primary outcome measure of interest is
the presence of a confirmed case of child maltreatment. A secondary
outcome measure that was examined was the change in scores on the
Protective Factors Survey.
Results: The absence of an assigned comparison group prevents precise
statistical testing of program effectiveness, but comparison to similar state-
level programs suggests a comparable level of effectiveness. Protective
Factor Survey scores were not reliably related to the likelihood of a
confirmed case of child maltreatment, but caseworker identified risk factors
were. Significant differences in the likelihood of a confirmed case of child
maltreatment by primary caregiver age, income, marital status, were also
indicated.
Conclusions: The results of this evaluation indicate a need to:
1) Establish evaluation procedures going forward that will allow for direct
testing of program effectiveness
2) Review tools used to identify families at risk for maltreatment
3) Consider individual and context-level factors when utilizing these
programs.
Conclusions
Results
• Child maltreatment is matter of immediate
national concern and efforts to better understand
and address it have resulted in a variety of
evidence-based prevention programs
• The state of Texas Prevention and Early
Intervention (PEI) funds the implementation for
such programs for at-risk families.
• Data collected from PEI must be analyzed to
assess program effectiveness
• Independent data from Texas Child Protective
Services (CPS) and Prevention and Early
Intervention (PEI) were merged and analyzed for
patterns of maltreatment and effectiveness of
prevention programs
• Data from over 137,000 primary caregivers
(PCGs) were included
• Examined predictors include PCG demographics
and protective and risk factor scores
1Counts, J. M., Buffington, E. S., Chang-Rios, K.,
Rasmussen, H. N., & Preacher, K. J. (2010). The
development and validation of the protective factors
survey: A self-report measure of protective factors
against child maltreatment. Child Abuse & Neglect,
34(10), 762-772.
Fewer than 3% of PCGs enrolled in a PEI program
(including STAR) were implicated in a confirmed
case of maltreatment during the sample period.
Variables meaningfully related to the presence of a
confirmed case include:
• PCG age
• PCG household income level
• Number of caseworker-identified risk factors
content.
• State of Texas PEI programs are reaching at-risk
families and (when compared to similar state-level
programs across the country) are moderately
effective at preventing maltreatment
• Caseworker-identified risk factors should be
implemented as a primary predictive
measurement for maltreatment, while additional
testing of the PFS Is needed
• Future implementations of prevention programs
should be carried-out with a ‘built-in’ comparison
group for establishing effectiveness
There is a need to better understand the precipitating factors of child
maltreatment and to increase our ability to prevent it through early
intervention. Efforts to do so have resulted in both an increased knowledge-
base about maltreatment and a variety of evidence-based programs
designed to intervene with at-risk families.
While progress made in this area should hearten advocates and policy
makers, our knowledge-base and the programs designed from it must be
systematically evaluated for continued accuracy and effectiveness. The state
of Texas Prevention and Early Intervention (PEI) project funded the
implementation of a variety of these evidence-based programs throughout
the state and tracked client services and outcomes across time. The aim of
the current project was to evaluate both general trends in child maltreatment
in the state of Texas and to assess the effectiveness of this wide-ranging
effort to understand and prevent child maltreatment.
Abstract
References
Methods
Introduction
Introduction
Click headings to further view content
• Child maltreatment is matter of immediate
national concern and efforts to better understand
and address it have resulted in a variety of
evidence-based prevention programs
• The state of Texas Prevention and Early
Intervention (PEI) funds the implementation for
such programs for at-risk families.
• Data collected from PEI must be analyzed to
assess program effectiveness
Conclusions
Results
• Findings presented from the analysis of
retrospective data from the Texas Prevention and
Early Intervention project designed to reduce
rates of child maltreatment
• Results indicate the need for a comparison group
included from the beginning of the intervention
and the utility of case-worker identified risk factors
in predicting maltreatment
1Counts, J. M., Buffington, E. S., Chang-Rios, K.,
Rasmussen, H. N., & Preacher, K. J. (2010). The
development and validation of the protective factors
survey: A self-report measure of protective factors
against child maltreatment. Child Abuse & Neglect,
34(10), 762-772.
Fewer than 3% of PCGs enrolled in a PEI program
(including STAR) were implicated in a confirmed
case of maltreatment during the sample period.
Variables meaningfully related to the presence of a
confirmed case include:
• PCG age
• PCG household income level
• Number of caseworker-identified risk factors
content.
• State of Texas PEI programs are reaching at-risk
families and (when compared to similar state-level
programs across the country) are moderately
effective at preventing maltreatment
• Caseworker-identified risk factors should be
implemented as a primary predictive
measurement for maltreatment, while additional
testing of the PFS Is needed
• Future implementations of prevention programs
should be carried-out with a ‘built-in’ comparison
group for establishing effectiveness
• Independent data from Texas Child Protective
Services (CPS) and Prevention and Early
Intervention (PEI) were merged and analyzed for
patterns of maltreatment and effectiveness of
prevention programs
• Data from over 137,000 primary caregivers
(PCGs) were included
• Examined predictors include PCG demographics
and protective and risk factor scores
Findings from the Retrospective Data Analysis of the
Texas Prevention and Early Intervention Project
Patrick S. Tennant, Ph.D., LMFT-Associate Monica Faulkner, Ph.D., LMSW Beth Gerlach, Ph.D., LCSW
University of Texas School of Social Work
Abstract
References
Methods
Introduction
Methods
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The current analyses utilized data collected from both CPS and PEI from
2008 to 2015.
Conclusions
Results
Assigned a Common ID by
DFPS and Merged by
TXICFW
Data from CPS
Primary caregivers with a
confirmed case of abuse
Type of abuse
Data from PEI
Primary caregiver demographic
information
Service data from PEI and STAR
Protective Factors Survey (PFS1;
2011 – 2015 only) and Risk Factor
(PEI only) scores
Final Data Set
137,068 Primary caregivers
(PCG) and 162,986
observations
236 counties with at least 10
served PCGs present
PFS scores for 48,604
PCGs and Risk Factors for
23,705 PCGs
Analyzed to Examine
• Overall rates of child
maltreatment in the sample
• Differential rates of
maltreatment by PCG
demographics (e.g., age,
income level, and marital
status) and county or service
area
• PEI and STAR program
effectiveness
• Temporal patterns of service
provision and confirmed cases
of maltreatment
• Predictive power of PFS and
case-worker identified risk
factors
• Findings presented from the analysis of
retrospective data from the Texas Prevention and
Early Intervention project designed to reduce
rates of child maltreatment
• Results indicate the need for a comparison group
included from the beginning of the intervention
and the utility of case-worker identified risk factors
in predicting maltreatment
• Child maltreatment is matter of immediate
national concern and efforts to better understand
and address it have resulted in a variety of
evidence-based prevention programs
• The state of Texas Prevention and Early
Intervention (PEI) funds the implementation for
such programs for at-risk families.
• Data collected from PEI must be analyzed to
assess program effectiveness
1Counts, J. M., Buffington, E. S., Chang-Rios, K.,
Rasmussen, H. N., & Preacher, K. J. (2010). The
development and validation of the protective factors
survey: A self-report measure of protective factors
against child maltreatment. Child Abuse & Neglect,
34(10), 762-772.
Fewer than 3% of PCGs enrolled in a PEI program
(including STAR) were implicated in a confirmed
case of maltreatment during the sample period.
Variables meaningfully related to the presence of a
confirmed case include:
• PCG age
• PCG household income level
• Number of caseworker-identified risk factors
content.
• State of Texas PEI programs are reaching at-risk
families and (when compared to similar state-level
programs across the country) are moderately
effective at preventing maltreatment
• Caseworker-identified risk factors should be
implemented as a primary predictive
measurement for maltreatment, while additional
testing of the PFS Is needed
• Future implementations of prevention programs
should be carried-out with a ‘built-in’ comparison
group for establishing effectiveness
• Independent data from Texas Child Protective
Services (CPS) and Prevention and Early
Intervention (PEI) were merged and analyzed for
patterns of maltreatment and effectiveness of
prevention programs
• Data from over 137,000 primary caregivers
(PCGs) were included
• Examined predictors include PCG demographics
and protective and risk factor scores
Findings from the Retrospective Data Analysis of the
Texas Prevention and Early Intervention Project
Patrick S. Tennant, Ph.D., LMFT-Associate Monica Faulkner, Ph.D., LMSW Beth Gerlach, Ph.D., LCSW
University of Texas School of Social Work
Abstract
References
Methods
Introduction Conclusions
ResultsResults
Click headings to further view content
Click Here to insert full content.
1Counts, J. M., Buffington, E. S., Chang-Rios, K.,
Rasmussen, H. N., & Preacher, K. J. (2010). The
development and validation of the protective factors
survey: A self-report measure of protective factors
against child maltreatment. Child Abuse & Neglect,
34(10), 762-772.
Results indicated that 3,581 (or 2.6%) of PCGs in this sample were, at some
point during the sample period, implicated in a confirmed case of child
maltreatment. While a suitable comparison group (i.e., a group of PCGs with
a comparable level of risk but without enrollment in a maltreatment
prevention program) has not yet been identified to definitively establish
program effectiveness, comparison to similar state-level programs across
the country indicates that PEI programs (excluding STAR) are well within the
range of effectiveness reported by others and are approximately equal to the
majority of near comparables.
• Findings presented from the analysis of
retrospective data from the Texas Prevention and
Early Intervention project designed to reduce
rates of child maltreatment
• Results indicate the need for a comparison group
included from the beginning of the intervention
and the utility of case-worker identified risk factors
in predicting maltreatment
• Child maltreatment is matter of immediate
national concern and efforts to better understand
and address it have resulted in a variety of
evidence-based prevention programs
• The state of Texas Prevention and Early
Intervention (PEI) funds the implementation for
such programs for at-risk families.
• Data collected from PEI must be analyzed to
assess program effectiveness
FIGURE 1. SUBSTANTIATED CHILD MALTREATMENT CASES IN FAMILIES RECEIVING
PREVENTION SERVICES 2008-2015
Of those families with a
confirmed case:
Fewer than 3% of PCGs enrolled in a PEI program
(including STAR) were implicated in a confirmed
case of maltreatment during the sample period.
Variables meaningfully related to the presence of a
confirmed case include:
• PCG age
• PCG household income level
• Number of caseworker-identified risk factors
content.
• State of Texas PEI programs are reaching at-risk
families and (when compared to similar state-level
programs across the country) are moderately
effective at preventing maltreatment
• Caseworker-identified risk factors should be
implemented as a primary predictive
measurement for maltreatment, while additional
testing of the PFS Is needed
• Future implementations of prevention programs
should be carried-out with a ‘built-in’ comparison
group for establishing effectiveness
• Independent data from Texas Child Protective
Services (CPS) and Prevention and Early
Intervention (PEI) were merged and analyzed for
patterns of maltreatment and effectiveness of
prevention programs
• Data from over 137,000 primary caregivers
(PCGs) were included
• Examined predictors include PCG demographics
and protective and risk factor scores
Findings from the Retrospective Data Analysis of the
Texas Prevention and Early Intervention Project
Patrick S. Tennant, Ph.D., LMFT-Associate Monica Faulkner, Ph.D., LMSW Beth Gerlach, Ph.D., LCSW
University of Texas School of Social Work
Abstract
References
Methods
Introduction Conclusions
ResultsResults
Click headings to further view content
Click Here to insert full content.
1Counts, J. M., Buffington, E. S., Chang-Rios, K.,
Rasmussen, H. N., & Preacher, K. J. (2010). The
development and validation of the protective factors
survey: A self-report measure of protective factors
against child maltreatment. Child Abuse & Neglect,
34(10), 762-772.
Results also indicated that effective predictors of future maltreatment include
primary caregiver age and household income level.
• Findings presented from the analysis of
retrospective data from the Texas Prevention and
Early Intervention project designed to reduce
rates of child maltreatment
• Results indicate the need for a comparison group
included from the beginning of the intervention
and the utility of case-worker identified risk factors
in predicting maltreatment
• Child maltreatment is matter of immediate
national concern and efforts to better understand
and address it have resulted in a variety of
evidence-based prevention programs
• The state of Texas Prevention and Early
Intervention (PEI) funds the implementation for
such programs for at-risk families.
• Data collected from PEI must be analyzed to
assess program effectiveness
0%
1%
2%
3%
4%
5%
6%
7%
18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60
Age
Pro
po
rtio
n o
f P
CG
th
at
Ag
e w
ith
a C
on
firm
ed
Case o
f M
alt
reatm
en
t
Fewer than 3% of PCGs enrolled in a PEI program
(including STAR) were implicated in a confirmed
case of maltreatment during the sample period.
Variables meaningfully related to the presence of a
confirmed case include:
• PCG age
• PCG household income level
• Number of caseworker-identified risk factors
content.
• State of Texas PEI programs are reaching at-risk
families and (when compared to similar state-level
programs across the country) are moderately
effective at preventing maltreatment
• Caseworker-identified risk factors should be
implemented as a primary predictive
measurement for maltreatment, while additional
testing of the PFS Is needed
• Future implementations of prevention programs
should be carried-out with a ‘built-in’ comparison
group for establishing effectiveness
• Independent data from Texas Child Protective
Services (CPS) and Prevention and Early
Intervention (PEI) were merged and analyzed for
patterns of maltreatment and effectiveness of
prevention programs
• Data from over 137,000 primary caregivers
(PCGs) were included
• Examined predictors include PCG demographics
and protective and risk factor scores
Findings from the Retrospective Data Analysis of the
Texas Prevention and Early Intervention Project
Patrick S. Tennant, Ph.D., LMFT-Associate Monica Faulkner, Ph.D., LMSW Beth Gerlach, Ph.D., LCSW
University of Texas School of Social Work
Abstract
References
Methods
Introduction Conclusions
ResultsResults
Click headings to further view content
Click Here to insert full content.
1Counts, J. M., Buffington, E. S., Chang-Rios, K.,
Rasmussen, H. N., & Preacher, K. J. (2010). The
development and validation of the protective factors
survey: A self-report measure of protective factors
against child maltreatment. Child Abuse & Neglect,
34(10), 762-772.
Results also indicated that effective predictors of future maltreatment include
primary caregiver age and household income level.
• Findings presented from the analysis of
retrospective data from the Texas Prevention and
Early Intervention project designed to reduce
rates of child maltreatment
• Results indicate the need for a comparison group
included from the beginning of the intervention
and the utility of case-worker identified risk factors
in predicting maltreatment
• Child maltreatment is matter of immediate
national concern and efforts to better understand
and address it have resulted in a variety of
evidence-based prevention programs
• The state of Texas Prevention and Early
Intervention (PEI) funds the implementation for
such programs for at-risk families.
• Data collected from PEI must be analyzed to
assess program effectiveness
Household Income
Pro
po
rtio
n o
f P
CG
wit
h t
hat
Ho
useh
old
In
co
me
that
have a
Co
nfi
rmed
Case o
f M
alt
rea
tme
nt
0%
1%
2%
3%
4%
5%
6%
Fewer than 3% of PCGs enrolled in a PEI program
(including STAR) were implicated in a confirmed
case of maltreatment during the sample period.
Variables meaningfully related to the presence of a
confirmed case include:
• PCG age
• PCG household income level
• Number of caseworker-identified risk factors
content.
• State of Texas PEI programs are reaching at-risk
families and (when compared to similar state-level
programs across the country) are moderately
effective at preventing maltreatment
• Caseworker-identified risk factors should be
implemented as a primary predictive
measurement for maltreatment, while additional
testing of the PFS Is needed
• Future implementations of prevention programs
should be carried-out with a ‘built-in’ comparison
group for establishing effectiveness
• Independent data from Texas Child Protective
Services (CPS) and Prevention and Early
Intervention (PEI) were merged and analyzed for
patterns of maltreatment and effectiveness of
prevention programs
• Data from over 137,000 primary caregivers
(PCGs) were included
• Examined predictors include PCG demographics
and protective and risk factor scores
Findings from the Retrospective Data Analysis of the
Texas Prevention and Early Intervention Project
Patrick S. Tennant, Ph.D., LMFT-Associate Monica Faulkner, Ph.D., LMSW Beth Gerlach, Ph.D., LCSW
University of Texas School of Social Work
Abstract
References
Methods
Introduction Conclusions
ResultsResults
Click headings to further view content
Fewer than 3% of PCGs enrolled in a PEI program
(including STAR) were implicated in a confirmed
case of maltreatment during the sample period.
Variables meaningfully related to the presence of a
confirmed case include:
• PCG age
• PCG household income level
• Number of caseworker-identified risk factors
content.
Click Here to insert full content.
1Counts, J. M., Buffington, E. S., Chang-Rios, K.,
Rasmussen, H. N., & Preacher, K. J. (2010). The
development and validation of the protective factors
survey: A self-report measure of protective factors
against child maltreatment. Child Abuse & Neglect,
34(10), 762-772.
Results also indicate that the established subscales of the Protective Factors
Survey (PFS1) are not meaningful predictors of a confirmed case of child
maltreatment. The total number of risk factors identified by a caseworker
was a meaningful predictor maltreatment.
Risk Factors: High parental conflict/separation/divorce, Teen parent, Poor
parent/child interaction, Parent/Guardian has negative attitudes/attributions
about the child's behavior, Parent/Guardian has inaccurate knowledge and
expectations about child development, Non-traditional family structure -
especially Single parent with lack of social support and or a high number of
children in the household, Social isolation of family/parent/guardian - lack of
support, High general stress level, Homelessness
• Findings presented from the analysis of
retrospective data from the Texas Prevention and
Early Intervention project designed to reduce
rates of child maltreatment
• Results indicate the need for a comparison group
included from the beginning of the intervention
and the utility of case-worker identified risk factors
in predicting maltreatment
• Child maltreatment is matter of immediate
national concern and efforts to better understand
and address it have resulted in a variety of
evidence-based prevention programs
• The state of Texas Prevention and Early
Intervention (PEI) funds the implementation for
such programs for at-risk families.
• Data collected from PEI must be analyzed to
assess program effectiveness
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
10%
1 2 3 4 5 6 7 8 9
Total Number of Risk Factors
Pro
po
rtio
n o
f P
CG
wit
h t
hat
Man
y R
isk
Facto
rs t
hat
have a
Co
nfi
rmed
Cas
e o
f
Malt
reatm
en
t
• State of Texas PEI programs are reaching at-risk
families and (when compared to similar state-level
programs across the country) are moderately
effective at preventing maltreatment
• Caseworker-identified risk factors should be
implemented as a primary predictive
measurement for maltreatment, while additional
testing of the PFS Is needed
• Future implementations of prevention programs
should be carried-out with a ‘built-in’ comparison
group for establishing effectiveness
• Independent data from Texas Child Protective
Services (CPS) and Prevention and Early
Intervention (PEI) were merged and analyzed for
patterns of maltreatment and effectiveness of
prevention programs
• Data from over 137,000 primary caregivers
(PCGs) were included
• Examined predictors include PCG demographics
and protective and risk factor scores
Findings from the Retrospective Data Analysis of the
Texas Prevention and Early Intervention Project
Patrick S. Tennant, Ph.D., LMFT-Associate Monica Faulkner, Ph.D., LMSW Beth Gerlach, Ph.D., LCSW
University of Texas School of Social Work
Abstract
References
Methods
Introduction
Conclusions
Click headings to further view content
Click Here to insert full content.
Analyses of the retrospective data from the Texas PEI program indicate that
PEI PCGs are at a similar level of risk for a confirmed case of child
maltreatment as families as families in other similar state-level programs,
indicating that PEI is reaching at-risk families and being
moderately successful at prevention efforts.
Findings also indicate that, compared to the subscales of the self-report
PFS, case-worker indicated risk factors (and specifically the total number of
indicated risk factors for a given family) are a superior predictor of child
maltreatment.
Conclusions
Results
• State of Texas PEI programs are reaching at-risk
families and (when compared to similar state-level
programs across the country) are moderately
effective at preventing maltreatment
• Caseworker-identified risk factors should be
implemented as a primary predictive
measurement for maltreatment, while additional
testing of the PFS Is needed
• Future implementations of prevention programs
should be carried-out with a ‘built-in’ comparison
group for establishing effectiveness
• Findings presented from the analysis of
retrospective data from the Texas Prevention and
Early Intervention project designed to reduce
rates of child maltreatment
• Results indicate the need for a comparison group
included from the beginning of the intervention
and the utility of case-worker identified risk factors
in predicting maltreatment
1Counts, J. M., Buffington, E. S., Chang-Rios, K.,
Rasmussen, H. N., & Preacher, K. J. (2010). The
development and validation of the protective factors
survey: A self-report measure of protective factors
against child maltreatment. Child Abuse & Neglect,
34(10), 762-772.
• Child maltreatment is matter of immediate
national concern and efforts to better understand
and address it have resulted in a variety of
evidence-based prevention programs
• The state of Texas Prevention and Early
Intervention (PEI) funds the implementation for
such programs for at-risk families.
• Data collected from PEI must be analyzed to
assess program effectiveness
- Match families from present data to families from Medicaid
or TANF for comparison of rates of confirmed cases
- Design evaluation studies with a randomly-assigned no-
treatment control group to validly establish project
effectiveness Goin
g F
orw
ard
-Validate and standardize the use of case-worker indicated
risk factors for predicting future cases of maltreatment
-Develop a self-report measure designed to be a valid
indicator of families at risk for maltreatment Goin
g F
orw
ard
Fewer than 3% of PCGs enrolled in a PEI program
(including STAR) were implicated in a confirmed
case of maltreatment during the sample period.
Variables meaningfully related to the presence of a
confirmed case include:
• PCG age
• PCG household income level
• Number of caseworker-identified risk factors
content.
• Independent data from Texas Child Protective
Services (CPS) and Prevention and Early
Intervention (PEI) were merged and analyzed for
patterns of maltreatment and effectiveness of
prevention programs
• Data from over 137,000 primary caregivers
(PCGs) were included
• Examined predictors include PCG demographics
and protective and risk factor scores
Findings from the Retrospective Data Analysis of the
Texas Prevention and Early Intervention Project
Patrick S. Tennant, Ph.D., LMFT-Associate Monica Faulkner, Ph.D., LMSW Beth Gerlach, Ph.D., LCSW
University of Texas School of Social Work