Program

Aug 27, 2014

OVERVIEW

Family Connections (FC) is a multi-component intervention for families at-risk for child neglect. Family Connections is designed to improve children’s safety and behavior by reducing the risk factors, and increasing the protective factors that are associated with child neglect. Results from an experimental evaluation indicate that children who participated in Family Connections had significant reductions in internalizing and externalizing behavior over time. Additionally, results indicate that children whose families were randomly assigned to participate in Family Connections for nine months had a greater reduction in internalizing behavior over time than children whose families participated in Family Connections for three months. Finally, findings for Family Connections’ impact on protective and risk factors were mixed, with families who participated in Family Connections generally demonstrating significant increases in family protective factors, and significant reductions in family risk factors over time.

DESCRIPTION OF PROGRAM

Target population: Families at-risk for child neglect

Family Connections (FC) was created to prevent the occurrence of child neglect in at-risk families by  increasing the number of protective factors (i.e., parenting attitudes, parenting sense of competence, family functioning, and social support), and reducing the number of risk factors (i.e., caregiver depressive symptoms, parenting stress, and everyday stress) associated with the onset of child neglect. There are four core components of Family Connections: (1) emergency assistance for concrete needs (e.g., food, utilities, and homelessness) and safety issues (e.g., suicide, child abuse, and domestic violence), (2) home-based family intervention (e.g., family assessment, outcome driven service plan development, counseling), (3) service coordination and referrals (e.g., matching services to family needs), and (4) multifamily recreational activities (e.g., dinner gatherings, trips to museums). Direct services are provided for at least one hour per week and families typically receive services for three months, however, families can receive services for extended periods of time as needed.

EVALUATION(S) OF PROGRAM

DePanfilis, D. & Dubowitz, H. (2005). Family connections: A program for preventing child neglect. Child Maltreatment, 10(2), 108-123.

Evaluated population: Families were referred to participate in Family Connections (FC) by schools (30 percent), community based agencies (22 percent), self-referred (16 percent) or public social services (12 percent). To be eligible to participate in the evaluation, families had to (1) have at least one child aged 5-11 years, (2) have at least one subtype of neglect (e.g., unsafe housing conditions, inadequate supervision, inadequate healthcare) occurring at a low level (not yet reportable to Child Protective Services), and (3) at least two family risk factors (e.g., child behavior problems, child disabilities, parental mental health problems, parental substance use, domestic violence)

A total of 154 families that met the eligibility requirements and resided in a high poverty neighborhood in Baltimore were randomly assigned to participate in FC for either nine months (N=84) or for three months (N=70). There were initially four conditions (FC for three months; FC for three months plus an enhanced group intervention; FC for nine months, FC for nine months plus an enhanced group intervention), however, due to an extremely low uptake of the enhanced group intervention (only 32 percent of caregivers attended any session) the four conditions were collapsed into two conditions (FC for three months and FC for nine months).

The majority of caregivers who participated in the evaluation were unemployed (57.8 percent), female (98.1 percent), and never married (65 percent). The average education level for caregivers was 10.8 years, and the average annual income was $9,571 in 2001. On average, families had three children, and 473 children participated in the evaluation. On average, children were 8.3 years of age at baseline, and the vast majority was Black/African American (84.6 percent).

Approach: Data were collected prior to the start of the intervention (pretest), immediately following completion of the intervention (posttest), and six months following the intervention (follow-up).  The outcome variables for children collected in this study included children’s safety (assessed by CPS referrals) and children’s externalizing and internalizing behavior (assessed by parent survey). In addition to child outcomes data were also collected on family protective factors (parenting attitudes, parenting competence, family functioning, and social support), and family risk factors (caregiver depressive symptoms, parenting stress and everyday stress). A total of three of the 62 families assigned to the three month condition (5 percent), and 16 of the 63 families assigned to the nine month condition (25 percent) dropped out of the study.  All analyses are based on intent-to-treat analyses.

Results: Results of the experimental evaluation indicate that across both groups (three months of FC participants, and nine months of FC) there were significant decreases in children’s internalizing, and externalizing behavior at both the end of the intervention, and the six month follow-up. Although there were no significant differences in internalizing or externalizing behavior between children in the three month and nine month groups, there was a significant interaction between intervention group and time. Specifically, children who participated in Family Connections for nine months demonstrated greater improvements in internalizing behavior over time than children who participated in Family Connections for three months.

In relation to family risk factors, there were significant decreases in caregiver depressive symptoms, parents’ perceived difficulty of their child, parental distress, and everyday stress from pretest to posttest. Additionally, the significant improvements in caregivers’ perceived difficulty of their child, parental distress, and everyday stress persisted at the six month follow-up. There was a significant interaction between intervention group and time, where parents assigned to participate in FC for nine months demonstrated greater reductions in depressive symptoms from baseline to posttest than parents assigned to participate in FC for three months, however, this difference was no longer significant at the six month follow-up. No significant impacts on parent-child dysfunctional interactions were identified.

In relation to family protective factors, there were significant improvements in caregivers’ parenting satisfaction, and social support (guidance, and attachment) from pretest to posttest. Additionally, there were significant improvements caregivers’ empathy, parent-child role reversals, parenting satisfaction, and social support (guidance, and attachment) from posttest to follow-up. In contrast there were no significant improvements in caregivers’ developmental expectations, value of corporal punishment, parenting efficacy, opportunities for nurturance, family health, family conflict, family cohesion, family leadership, or family effectiveness. With the exception of opportunities for nurturance, there were no significant interactions between time and group for any of the family protective factors. Compared with caregivers assigned to participate in FC for nine months, caregivers assigned to participate in FC for three months reported significantly fewer opportunities for nurturance at baseline, yet significantly more opportunities at posttest, and follow-up.

SOURCES FOR MORE INFORMATION

References

DePanfilis, D. & Dubowitz, H. (2005). Family connections: A program for preventing child neglect. Child Maltreatment, 10(2), 108-123.

Website

http://www.family.umaryland.edu/fc-replication

Contact Information

Diane DePanfilis

Associate Professor, Director
Ruth H. Young Center for Families & Children
ddepanfilis@ssw.umaryland.edu
phone: (410) 706-3609
525 West Redwood Street
Baltimore, MD 21201

 

KEYWORDS: Children, Males and Females (Co-ed), Black/African American, Urban, Home-based, Community-based, Cost, Manual, Parent or Family Component, Home Visitation, Case management, Child-maltreatment, Other Mental Health, Other Behavioral problems.

Program information last updated 08/27/14

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