Abstract
The prevention of child abuse and neglect is a global public health priority due to its serious, long-lasting effects on personal, social, and economic outcomes. The Children At Risk Model (ChARM) is a wraparound-inspired intervention that coordinates evidence-based parenting- and home-visiting programmes, along with community-based supports, in order to address the multiple and complex needs of families at risk of child abuse or neglect. The study comprises a multi-centre, randomised controlled trial, with embedded economic and process evaluations. The study is being conducted in two child-welfare agencies within socially disadvantaged settings in Ireland. Families with children aged 3-11 years who are at risk of maltreatment (n = 50) will be randomised to either the 20-week ChARM programme (n = 25) or to standard care (n = 25) using a 1:1 allocation ratio. The primary outcomes are incidences of child maltreatment and child behaviour and wellbeing. Secondary outcomes include quality of parent-child relationships, parental stress, mental health, substance use, recorded incidences of substantiated abuse, and out-of-home placements. Assessments will take place at pre-intervention, and at 6- and 12-month follow-up periods. The study is the first evaluation of a wraparound-inspired intervention, incorporating evidence-based programmes, designed to prevent child abuse and neglect within intact families. The findings offer a unique contribution to the development, implementation and evaluation of effective interventions in the prevention of child abuse and neglect. The trial is registered with the International Standard Randomised Controlled Trial Number Register (DOI 10.1186/ISRCTN13644600, Date of registration: 3 rd June 2015).
Highlights
It is widely acknowledged that child abuse and neglect has serious and far-reaching effects on child health outcomes, educational and employment prospects, criminality, life expectancy, intergenerational transmission of maltreatment, and expenditure on health, judicial and social welfare services (Sethi et al, 2013)
The findings offer a unique contribution to the development, implementation and evaluation of effective interventions in the prevention of child abuse and neglect
It is widely acknowledged that child abuse and neglect has serious and far-reaching effects on child health outcomes, educational and employment prospects, criminality, life expectancy, intergenerational transmission of maltreatment, and expenditure on health, judicial and social welfare services (Sethi et al, 2013)
Summary
It is widely acknowledged that child abuse and neglect ( called child maltreatment [CM]) has serious and far-reaching effects on child health outcomes (including mental health), educational and employment prospects, criminality, life expectancy, intergenerational transmission of maltreatment, and expenditure on health, judicial and social welfare services (Sethi et al, 2013). In Ireland, over 40, 000 referrals of child welfare and abuse cases were made to social work annually during 2012-2014, which represents a rate of 35 per 1000 children; this was almost double the number referred in 2007 (Tusla Quarterly National Performance Activity Report, 2015) These figures ( unlikely to be all confirmed cases) are a source of considerable concern and may be related, at least in part, to the impact of the economic recession in Ireland, including unemployment, financial difficulties and homelessness, all of which have been a feature of life in Ireland in recent years (Williams et al, 2016). The authors demonstrate that empirically supported programs are useful, but none can prevent child maltreatment on its own since vulnerable families are so hard to reach. Another argument for such a program could be that child maltreatment is explained by multi-systemic factors
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