Editorial: The helping alliance in work with families where children have been abused or neglected

Abstract

Home visiting programs are a promising early prevention model for improving parenting and reducing children's risk for child maltreatment. However, randomized studies of widely implemented (scalable) home visiting models targeting infants and toddlers remain relatively scarce. Moreover, few studies provide much-needed information about whether home visiting services may be differentially effective for families with different social, demographic, and other characteristics. As part of a larger randomized study of the Healthy Families America home visiting program being conducted in Oregon (Healthy Families Oregon, HFO), we conducted a telephone survey with a randomly selected group of mothers to assess early outcomes at children's 1-year birthday. Eight hundred three first-time mothers (n = 803, 402 randomly assigned to receive the HFO program and 401 control) were interviewed by telephone to assess the effects of the program on service utilization and on early parenting and child risk and protective factors associated with abuse and neglect. Results found that mothers assigned to the Healthy Families program group read more frequently to their young children, provided more developmentally supportive activities, and had less parenting stress. Children of these mothers were more likely to have received developmental screenings, and were somewhat less likely to have been identified as having a developmental challenge. Families with more baseline risk had better outcomes in some areas; however, generally there were not large differences in outcomes across a variety of subgroups of families. Implications of these results for understanding which short-term program impacts are most feasible for early prevention programs, as well as for understanding how these services might be better targeted are discussed.