Awarded Cooperative Agreement to Prevent Violence and Violence-Related Injury


Early home visitation programs are among the most widely adopted and studied child maltreatment prevention efforts. Reviews of the efficacy of early home visitation are available, most recently in the form of the CDC’s Task Force on Community Preventive Services, which found strong evidence to support early home visitation for the prevention of child maltreatment. However, that evidence is by no means consistent, and significant concerns have been raised with respect to the ability of such programs to: (a) retain participants; (b) implement program models with fidelity; (c) effectively address known risk factors formal treatment; or (d) consistently incorporate available evidence-based approaches with fidelity. Interactive software—when used as a supplemental intervention delivery platform—has the potential to address many of these challenges. For example, it can facilitate identification of risks, can implement a range of evidence-based approaches, and can improve retention through the use of motivational approaches. It can also do these things in a perfectly replicable and highly cost-effective manner. The present study will modify motivational intervention software that has already been developed by the PI specifically for use with high-risk post-partum mothers with histories of drug use. The current motivational software will be expanded to address other maltreatment risks and program adherence/engagement as well as substance abuse; additional modules will provide Cognitive Retraining and elements of the ecobehavioral SafeCare approach. The present study will randomly assign a total of 350 mother-infant dyads from three Healthy Families America (HFA) sites to either traditional or software-supplemented services. An additional non-equivalent no-treatment comparison group (N = 175) will consist of parents who were eligible for and accepted HFA services, but who were unable to receive services due to insufficient program resources. All parents will be followed-up at 6, 12, and 18 months and evaluated for maltreatment and maltreatment risks as measured by self-report, home visitor report, blinded independent observers, and statewide CPS data. If validated, the proposed intervention can provide augmentation of home visiting services with unprecedented ease of dissemination, at negligible additional cost, and with limitless potential for further development.