SafeCare - Detailed Report

Planned Activities assessment and training:

• Teach parent time management
• Explain rules to child
• Reinforcement/rewards
• Incidental teaching
• Activity preparation
• Outcome discussions with child
• Explain expectations to child

Home Safety assessment and training:

• Assess accessible home hazards with the Home Accident Prevention Inventory-Revised to assess accessible home hazards
• Provide parents with door and cabinet latches
• Use graduated plan to have parents remove identified hazards and to child proof doors and cabinets
• Perform healthy home assessment and training

Infant and child health care assessment and training:

• Use HEALTH checklists to assess parent skills
• Teach any skill deficits (i.e., how to take a temperature)
• Teach use of health checklists and how to determine when to self-treat illness and when to seek medical care
• Include problem solving training as needed

Parent and staff training:

• Modeling
• Role rehearsal
• Performance criteria in simulation and actual interactions.
• Monitoring of staff for model fidelity.
• Booster training if performance falls below criteria

Gershater-Molko, R.M., Lutzker, J.R., & Wesch, D. (2002). Using recidivism data to evaluate Project Safecare: Teaching bonding, safety and healthcare skills to parents. Child Maltreatment, 7(3), 277-285.
Type of Study: Matched comparison group design
Number of participants: 41 SafeCare participants, 41 Family Preservation participants
Population:

Age Range: Families with children aged 0 to 5.
Race/Ethnicity: Not available
Status (e.g., foster care, CW): All families had a substantiated child abuse claim with the DCFS.

Location/Institution: Information not provided in journal article.
Summary: (To include comparison groups, outcomes, measures, notable limitations). This study examined recidivism [habitual relapse] in a sample of families referred to the study by the local child welfare system due to recent substantiated reports of child abuse and/or neglect. The control group was matched based on child's birth date and geographical location from a sample of families participating in a Family Preservation program. Families in the SafeCare group had significantly lower rates of re-abuse reporting during the 24-month follow-up period than the control group. At 36 months after the intervention 85% of the SafeCare families had no further reports of child abuse, compared with 54% of the Family Preservation families. One limitation noted was that only those families who had completed all components of SafeCare, including post-training data collection using the Beck Depression Inventory, Child Abuse Potential Inventory and Parenting Stress Index were included in the treatment group, while there was no comparable assurance of level of service provided for the Family Preservation group, which makes the comparison less generalizable.
Length of post-intervention follow-up: A minimum of 24 months.

Gershater-Molko, R., Lutzker, J.R., & Wesch, D. (2003). Project SafeCare: Improving Health, safety and parenting skills in families reported for and at-risk for child maltreatment. Journal of Family Violence, 18(6), 377-386.
Type of Study: Pre/post test
Number of participants: 41 families completed all three training components.
Population:

Age Range: Families with children 0 -5.
Race/Ethnicity: Unknown
Status (e.g., foster care, CW): Participants were families with recent reports of child maltreatment and those referred by social workers due to the risk factors of parents' age, low level of education, and lack of social support.

Location/Institution: Information not provided in journal article.
Summary: (To include comparison groups, outcomes, measures, notable limitations):
Parents were trained in treating children's illnesses and maximizing their own healthcare skills (Health), positive and effective parent-child interaction skills (Parenting), and maintaining low-hazard homes (Safety) during a 24-week program. The effectiveness of these training components was evaluated as the change in the parents' scores on role-play situations for child health problems, hazards present in the home, and the frequency and quality of parent-child interactions during activities of daily living. Statistically significant improvements were seen in Health, Safety, and Parenting over baseline measures. However, the authors note that there was a high level of attrition from the program [decrease in using program components] among those who were referred, with only 10% completing all of the training components. This is cited as typical for maltreating and at-risk families referred to interventions with possible contributing factors including family stressors, involuntary referrals, and lack of resources or motivation.
Length of post-intervention follow-up: N/A

Bigelow, K.M., & Lutzker, J.R. (1998). Using video to teach planned activities to parents reported for child abuse. Child & Family Behavior Therapy, 20, 1-14.

Bigelow, K.M., & Lutzker, J.R. (2000). Training parents reported for or at risk for child abuse and neglect to identify and treat their children's illnesses. Journal of Family Violence, 15, 311-330.

Cordon, I.M., Lutzker, J.R., Bigelow, K.M., & Doctor, R.M. (1998). Evaluating Spanish protocols for teaching bonding, home safety, and health care skills. Journal of Behavior Therapy and Experimental Psychiatry, 29, 41-54.

Lutzker, J.R., Bigelow, K.M., Doctor, R.M., & Kessler, M.L. (1998). Safety, health care, and bonding within an ecobehavioral approach to treating and preventing child abuse and neglect. Journal of Family Violence, 13, 163-185.

Mandel, U., Bigelow, K.M., & Lutzker, J.R. (1998). Using video to reduce home safety hazards with parents reported for child abuse or neglect. Journal of Family Violence, 13, 147-162.

Metchikian, K.L., Mink, J.M., Bigelow, K.M., Lutzker, J.R., Doctor, R.M. (1999). Reducing home safety hazards in the homes of parents reported for neglect. Child and Family Behavior Therapy, 3, 23-34.

Taban, N., & Lutzker, J.R. (2001). Consumer evaluation of an ecobehavioral program for prevention and intervention of child maltreatment. Journal of Family Violence, 16, 323-330.