Testing the Relief Nursery Program, a Multimodal Preventive Intervention for Families with Infants and Toddlers At Risk for Child Welfare Involvement

Purpose

Recent reviews of the child abuse intervention literature suggest that a variety of interventions hold promise for child abuse prevention and treatment. Consistent with research findings on resiliency, these interventions tend to focus on fostering and building strength within families, and to assist children and parents in coping better with life stressors. Building on these findings, the Relief Nursery child abuse prevention program is an integrated array of individually responsive prevention services designed for families at high risk for child abuse and neglect. The multi-modal program, which includes therapeutic early childhood education, home visits, parent education classes and support groups, respite care, case management, and assistance to families in accessing basic resources and other community services, was developed by community-based practitioners in a moderate sized urban area in Oregon and through public and private efforts has been disseminated throughout the state and elsewhere. Here, we describe the development of the program, the work towards conducting a randomized controlled trial, and then the initial 6 month follow-up outcomes of participants in that trial.

Method

Successive first time callers to the Relief Nursery were randomized to the program or to a respite care and referral condition, and then invited to participate in the study. Participants include 180 children and families. The average child in the study is 2.5 years of age.  About half of participating children are male. In terms of race, 76% are white, 21% multiracial, and 1% African American. In terms of ethnicity, 34% of children are Latino.  Twenty percent of caregivers report Spanish as their primary language. Once enrolled, participating families are assigned a caseworker who engages them in their respective treatment conditions. Baseline assessment occurs before the intervention begins, and then participants are assessed every 6 months for 2 years. Assessments focus on parent and child outcomes as well as services received.

Results

Pre-study work for this trial took place over a period of 7 years. Recruitment into the trial occurred over the past two years, and data collection is ongoing for the 6 month follow-up assessment (currently n = 150), and will be completed in February 2013. Using regression analyses, and controlling for participant clustering and missing data, outcomes for children and families in the Relief Nursery and the respite care conditions will be compared, and the relations between service contacts and outcomes in each group will be examined.  

Implications

While adapting evidence-based interventions for children and families at risk for or involved with the child welfare system is important, so is investigating outcomes for research-based but unstudied programs that are already being used in the field. Work in this regard presents new complications to prevention scientists, but the conduct of a new generation of studies in the field is needed to find the best ways to provide this set of at risk families the best preventive interventions possible.