Researchers at the University of Oklahoma Health Sciences Center have found a home-based intervention program targeting child abuse and neglect works as effectively in American Indian communities as in other groups.
With 39 federally recognized tribes as well as individuals from more than 100 other tribes found in the state, Oklahoma was uniquely situated to be the focus of a first-of-its-kind study examining the effectiveness of an evidence-based home-visiting, parent training curriculum among American Indian parents involved with child welfare.
"Oklahoma has such a diverse population of American Indians that one of the critical considerations was what works and what doesn't work from one community to the next," said Dolores Subia BigFoot, Ph.D., Assistant Professor in the Department of Pediatrics at the OU College of Medicine.
The SafeCare model is designed to directly address parent-child interactions, home safety, and child health. Previous research has shown SafeCare to be successful in the general population in reducing child neglect, the most common form of maltreatment involving children from infancy to five years of age.
However, SafeCare was not designed specifically for American Indians, and researchers wondered if differences in cultural beliefs and practices between American Indian families and the general population might impact its effectiveness. "The concern was that the model would be less effective and less culturally competent," said lead researcher Mark Chaffin, Ph.D., of the OU Center on Child Abuse and Neglect. Chaffin is also a professor of pediatrics with the OU College of Medicine.
The study represents the largest American Indian sample in an experimental evaluation examining child welfare outcomes to date. It involved 354 American Indian families in Oklahoma, comparing those receiving SafeCare to those receiving standard child welfare services.
The long-term effectiveness of SafeCare among the American Indian families in reducing maltreatment was measured using state administrative records over a period of six years. Short-term effectiveness was measured by levels of engagement, satisfaction with services, and cultural competency as reported by the parents who went through the intervention.
"What we found was that it was equivalently effective and actually more culturally competent then services as usual," Chaffin said.
Researchers found a 27 percent reduction in re-occurrence of maltreatment for those families who received SafeCare instead of services as usual. In addition to reducing child welfare recidivism in American Indian parents, the parents receiving SafeCare reported reductions in depression. The cultural competence of the model, the quality of service, and its benefit was rated higher than services as usual.
"I absolutely see the impact of providing learning opportunities to parents in the environment of their own homes. Individualized attention in an atmosphere of friendly concern succeeds in creating fertile ground for positive change in parents who are motivated to participate in a home-based program. I highly recommend SafeCare to anyone who wishes to become a better parent and begin a journey to a more fulfilling life," said Leslie Brown, Crisis Intervention Specialist, Iowa Tribe of Oklahoma Social Services Department. Given the disproportionate representation of American Indian children in out-of-home placement, OU researchers say effective prevention models with this population are needed. They believe this research helps address that need, decreasing concerns that SafeCare, and similar structured models, might not work as well as other approaches with American Indians families.
The research was recently published in a leading child welfare journal, Child Maltreatment. It involved collaboration between the OU Health Sciences Center and Casey Family Programs, the nation's largest operating foundation whose work is focused on safely reducing the need for foster care and building communities of hope for all of America's children and families.
Additional support for the research came from the National Institute for Mental Health and the Violence Prevention Branch of the U.S. Centers for Disease Control and Prevention.
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