Research Watch

Promising home visitation intervention to reduce recurrent maltreatment for child welfare - involved families

Year of Publication
Reviewed By
Tareq Hardan

Lee, E., et al. (2018). Reducing maltreatment recurrence through home visitation: A promising intervention for child welfare involved families. Child Abuse and Neglect, 86: 55-66.


United States Federal Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) has evidenced positive impact on birth outcomes, child development, maternal health, life course development, and parenting practices. Healthy Family America (HFA) is one of MIECHV models that targets at risk families residing in communities with high rates of teen pregnancy, low birth-weight babies, infant mortality, Medicaid births, and mothers with later or no prenatal care. This study aims to explore whether HFNY (an accredited HFA evidence-based home visiting program) is effective in reducing recurrence of substantiated child maltreatment among mothers with substantiated Child welfare (CW).

Data was collected (March 2000 - August 2001) from a randomized control trial consisting a group of mothers (n = 104; 52 in the control group and 52 in the intervention group) with at least one substantiated CW report before HFNY`s enrollment, who completed baseline and follow-up interviews at the time of the target child’s 1st, 2nd, and 7th birthdays. This subgroup was obtained from 1254 recent or expectant mothers who already had one or more children indicated in CPS report within five years prior to this study.

Results from Generalized Linear Model indicated that CW reported maltrea­­­tment recurrence was consistently reduced for HFNY`s program participating mothers compared to the control group at the year 7 follow-up. The intervention group was twice likely to be early detected for child maltreatment than mothers in the control group, suggesting that HFNY`s program is contributing to better life outcomes for both mother and child, such as reducing long-term risks of child maltreatment, lowering needed CW family support services, and improving maternal life course development through reductions in family size, and birth spacing. This study recommends expanding Home visiting programs beyond current targeted population to include multiparous mothers, and CW-involved parents to reduce maltreatment recidivism. On top of that, cross-linking social services departments and Home visiting programs to forge enduring relationships with families at a time when parents are vulnerable, and their newborn developmental path is malleable.  

Methodological Notes

For this study, Independent, and blinded to group assignment researchers conducted baseline interviews in participating mothers` homes. Concurrently, researchers used these administrative databases (New York Statewide (NYS) Central Register of Child Abuse and Neglect, NYS Child Care Review System, NYS Welfare Management System) to identify respondents and their target children.

To estimate cumulative and annual rates of study dichotomous outcomes, researchers used Generalized Linear Models, with a binomial distribution and Logit link function. Then, Post-Hoc analyses was conducted to examine factors that account for the association between the HFNY`s intervention and reduced rates of subsequent child welfare reports. In this analysis, researchers employed measures, such as parenting attitudes, limit setting, parenting behaviors and subsequent births as mediators. Finally, researchers highlighted small prospective sample size (n = 104) and geographic specificity (New York State) as limitations for this study.