abstract - texas institute for child & family wellbeing...• data collected from pei must be...

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











Conclusions

Results














34(10), 762-772.






• PCG age



content.
















prevention programs









Abstract

References

Methods

Introduction

Methods



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























34(10), 762-772.






• PCG age



content.
















prevention programs









Abstract

References

Methods

Introduction Conclusions

ResultsResults








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.


















FIGURE 1. SUBSTANTIATED CHILD MALTREATMENT CASES IN FAMILIES RECEIVING

PREVENTION SERVICES 2008-2015

Of those families with a

confirmed case:






• PCG age



content.
















prevention programs









Abstract

References

Methods


ResultsResults








34(10), 762-772.

Results also indicated that effective predictors of future maltreatment include

primary caregiver age and household income level.


















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






• PCG age



content.
















prevention programs









Abstract

References

Methods


ResultsResults








34(10), 762-772.

Results also indicated that effective predictors of future maltreatment include

primary caregiver age and household income level.


















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%






• PCG age



content.
















prevention programs









Abstract

References

Methods


ResultsResults







• PCG age



content.







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


















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
















prevention programs









Abstract

References

Methods

Introduction

Conclusions



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

























34(10), 762-772.










- 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






• PCG age



content.





prevention programs









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