Child Abuse Prevention Programmatic Interventions

1
Child Abuse Prevention Programmatic
Interventions

• Charles Oberg, MD, MPH
• Hennepin County Medical Center
• Maternal and Child Health, Epidemiology, School
  of Public Health,
• University of Minnesota

2
Prevention basics

• Using research to inform programs and policy
• Conflict
• desire to protect children BUT
• family is the desirable location for child
  rearing.

3
Programmatic Framework

• Audience of focus
• Universal population to
• Specific family
• Stages of prevention
• Primary Universal population
• Secondary At-risk population
• Tertiary Abusive families

4
Head Start Primary Prevention

• Promote safety of children from a global
  perspective
• 4 components
• Education
• Health and nutrition
• Parental involvement
• Social service intervention

5
Head Start (continued)

• Activity objectives
• Reduce family stress
• Decrease the likelihood of maltreatment
• Promote social capital support networks

6
Home Visitation Secondary Prevention

• Service provision for selected at-risk persons
• Home visiting new parents are visited by a
  professional, paraprofessional and/or trained
  layperson
• Support
• Advice
• Referrals
• General encouragement

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Home Visitation (continued)

• Documented effectiveness 20 years ago
• Home visits reduced rate of child abuse cases for
  poor, unmarried adolescent mothers compared to
  moms without visits
• 1997 15-year study
• Nurse-visited, at-risk families had half the
  child abuse than those at-risk families without
  nurse visits

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Key ingredients in effective home visitation
programs

• Begin visits before or soon after birth
• Extend visits over time
• Form alliance between visitor and parents
• Watch for early signs of abuse
• Teach effective parenting skills
• Focus on child
• Provide specific and practical services
• Involve father when appropriate
• Adjust services to meet family needs

9
Family Centered ServicesTertiary Prevention

• Focus on families with serious parenting problems
• Attempts to keep the family together after abuse
  or neglect
• Combine direct crisis and counseling assistance
  with case management strategy

10
Family Centered ServicesTertiary Prevention

• If the severity of the situation does not allow
  the preservation of the family
• Foster care
• Kinship care
• Less external support
• Fewer services
• Less contact with child protective services
• 
  than foster care

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Summary

• Successful programs
• Are proactive
• Reach across economic distinctions
• Appreciate the complexity of factors
• Future directions
• Incorporate other areas of research (e.g.,
  domestic violence)
• Strength oriented approach (vs. deficit model)