Methods: Utilizing a Group Model Building (GMB) approach to engage eight stakeholders, we developed a systems-informed framework for child maltreatment and a quantitative system dynamics simulation model. The model simulated effects of the three evidence-based interventions on the number of families at low or high risk, the number of parents or caregivers receiving trauma treatment services, and the predicted number of child neglect incidents based on the proportion of families at high or low risk. We explored how outcomes varied by the adult caregivers’ trauma history and trauma treatment status. We parameterized the model using data from the National Survey of Child and Adolescent Welfare waves I and II (NSCAW). Tests of structural validity, behavior reproduction, and robustness were also performed.
Results: Simulation experiments suggested key risk and protective factors such as maternal stress, housing insecurity, trauma provider availability, and parent peer support should be targeted for intervention. Stakeholders lamented the lack of peer support specialists that were utilized in the interventions.
Conclusion: We find that the reach and effectiveness of parenting interventions to prevent child neglect are influenced by factors across the socio-ecological levels. Stakeholders were crucial in identifying the intervention factors that should be presented to decision makers in order to select which interventions should be implemented. As communities respond to legislation such as the Family First Prevention Services Act that require only evidence-based programs be eligible for reimbursement, simulation models could be helpful for making evidence-informed decisions with respect to a given community context.