@article{ref1,
title="A mixed methods evaluation of early childhood abuse prevention within evidence-based home visiting programs",
journal="Maternal and child health journal",
year="2018",
author="Matone, M. and Kellom, K. and Griffis, H. and Quarshie, W. and Faerber, J. and Gierlach, P. and Whittaker, J. and Rubin, D. M. and Cronholm, P. F.",
volume="22",
number="Suppl 1",
pages="79-91",
abstract="OBJECTIVEs In this large scale, mixed methods evaluation, we determined the impact and context of early childhood home visiting on rates of child abuse-related injury. <br><br>METHODS Entropy-balanced and propensity score matched retrospective cohort analysis comparing children of Pennsylvania Nurse-Family Partnership (NFP), Parents As Teachers (PAT), and Early Head Start (EHS) enrollees and children of Pennsylvania Medicaid eligible women from 2008 to 2014. Abuse-related injury episodes were identified in medical assistance claims with ICD-9 codes. Weighted frequencies and logistic regression odds of injury within 24 months are presented. In-depth interviews with staff and clients (n = 150) from 11 programs were analyzed using a modified grounded theory approach. <br><br>RESULTS The odds of a healthcare encounter for early childhood abuse among clients were significantly greater than comparison children (NFP: 1.32, 95% CI [1.08, 1.62]; PAT: 4.11, 95% CI [1.60, 10.55]; EHS: 3.15, 95% CI [1.41, 7.06]). Qualitative data illustrated the circumstances of and program response to client issues related to child maltreatment, highlighting the role of non-client caregivers. All stakeholders described curricular content aimed at prevention (e.g. positive parenting) with little time dedicated to addressing current or past abuse. Clients who reported a lack of abuse-related content supposed their home visitor's assumption of an absence of risk in their home, but were supportive of the introduction of abuse-related content. Approach, acceptance, and available resources were mediators of successfully addressing abuse. <br><br>CONCLUSIONS for Practice Home visiting aims to prevent child abuse among high-risk families. Adequate home visitor capacity to proactively assess abuse risk, deliver effective preventive curriculum with fidelity to caregivers, and access appropriate resources is necessary.<p /> <p>Language: en</p>",
language="en",
issn="1092-7875",
doi="10.1007/s10995-018-2530-1",
url="http://dx.doi.org/10.1007/s10995-018-2530-1"
}