National SafeCare® Training and Research Center
Ongoing SafeCare Research
Current Grants
NSTRC Primary Grants
National SafeCare Training and Research Center
Doris Duke Charitable Foundation (PI: John R. Lutzker)
This grant establishes the National SafeCare Training and Research Center. Funds are provided to develop a train-the-trainer model for SafeCare, training, and generation of research proposals.
Implementing SafeCare to prevent Child Maltreatment in Underserved Populations,
Centers for Disease Control and Prevention (PI: Daniel J. Whitaker)
This study will be conducted in coordination with a statewide implementation of SafeCare in Georgia. NSTRC will train Georgia Department of Human Resource (DHR) staff to become SafeCare trainers and coaches. DHR staff will then train providers to implement the SafeCare model. With CDC funding, we will randomly assign DHR trainers to receive either the standard or an enhanced Train the Trainer protocol and will examine the impact on coach and home visitor implementation of the SafeCare model and the downstream impact on family engagement.
Implementation of SafeCare in Fulton County NPU-V: A Pilot Project.
Annie E Casey Foundation/Atlanta Civic Site (PI: Shannon Self-Brown)
With this funding, NSTRC will work with the Annie E. Casey-Atlanta Civic Site to increase the reach of SafeCare to at-risk families in neighborhood Planning unit V, a once-thriving African-American community that has experienced a great deal of decline in the past 30 years. Specifically, NSTRC will help coordinate a home visiting program coalition, which will bring together various organizations that conduct home visiting in this community. Additionally, NSTRC will train staff at Project Healthy Grandparents at GSU in the SafeCare model. PHG will deliver SafeCare to families in NPU-V. A single case research study will be conducted to examine how well the SafeCare curriculum can be implemented in NPU-V in an existing home visiting organization that targets grandparents raising grandchildren.
Intervening Early to Prevent Juvenile Delinquency And Other Adverse Outcomes
Office of Juvenile Justice and Delinquency Prevention (PI: Daniel J. Whitaker)
The overall goal of this project is to provide services, information, and other supports for children and their families and organizations that work with them in order to prevent delinquency and interactions with the justice system. Target populations are (1) children in families who have a history of, or are at high risk for, child maltreatment, and (2) children with challenging behaviors. Specific efforts in this project include:
● Increase the use of SafeCare®, an evidence-based parent training program for families with a history of, or who are at risk for, child maltreatment by home visitation organizations in Georgia and throughout the United States.
● Work with Georgia schools to develop programs in positive behavioral interventions and supports for students with challenging behaviors, so that these children develop the skills they need to participate successfully in school, home, and community settings.
● Develop information resources for families and professionals that address gaps in information, to help support and encourage trajectories for children that decrease risk for future delinquency.
Effectiveness and Cost Effectiveness of Coaching Models for the SafeCare Program (PI: Daniel J. Whitaker)
The proposed study will compare three methods of SafeCare coaching to test the impact on home visitor fidelity, family engagement and skill-acquistion, and related costs. Specifically, we will compare purveyor (expert) coaching (conducted by NSTRC) to local coaching that is supported by the purveyor (NSTRC), and to local coaching that is supported by a second generation of SafeCare trainers that are not part of the purveyor group. The study will include 90 SafeCare providers at approximately 30 different agencies. Thirty agencies will be randomly assigned to implement SafeCare with direct purveyor coaching, local coaching with purveyor support (Local-P), or local coaching with support from a second generation SafeCare trainers (local-2G). The findings will provide data on the most effective and efficient manner of conducting SafeCare coaching, and help other evidence-based practices in public health and child welfare bring research to practice. Data collection will begin in January 2010.
Collaborating Grants
Center for Leadership in Disability at Georgia State University, Administration on Developmental Disabilities (PI: Daniel Crimmins)
This grant establishes the Center for Leadership in Disability as a University Center for Excellence in Developmental Disabilities, which works in a collaborative partnership with the National SafeCare Training and Research Center.
Cascading Diffusion of an Evidence-based Child Maltreatment Intervention
Centers for Disease Control and Prevention (PIs: Mark Chaffin, Greg Aarons, John R. Lutzker)
This study implements and evaluates a novel method of SafeCare implementation in which local organizational structures, contracting, and policy are maximized to support the development of local expertise in SafeCare. This maximized support model aims to promote effective implementation and sustainability of the SafeCare intervention.
E-Parenting Project, Centers for Disease Control and Prevention (PI: Steve Ondersma)
Investigators from Wayne State University and Indiana University will examine a computer delivered intervention, EPP, which includes components of Project SafeCare, along with two other evidence supported treatments (MI, Cognitive Attribution training), incorporated into the Healthy Families America home visiting program. Specifically, participating families will be randomly assigned to Healthy Families America as usual, Healthy Families America+EPP, or a control group. Outcomes will include parent and child behavior, parent engagement, and child maltreatment reports.
Use of Cellular Phone Technology to Enhance a Child Maltreatment Prevention Parenting Program, Centers for Disease Control and Prevention (PI: Judy Carta)
Dr. Carta and colleagues are randomly assigning at-risk families to one of three interventions groups: Planned Activities Training as usual (a component of Project SafeCare), Planned Activities Training + cellular phone technology (including voice to voice calls and texts), or a wait-list control. Outcomes will include family engagement, family retention, parent and child behaviors, and child maltreatment reports.
Oklahoma Statewide Study, NIMH, Oklahoma Child Welfare (PI: Mark Chaffin)
Chaffin, Lutzker, and colleagues are conducting a statewide trial of the SafeCare model, in which half of the six service regions in Oklahoma were randomly assigned to implement SafeCare, while the other half delivered services as usual (SAU). The study also is evaluating the impact of ongoing coaching (or fidelity monitoring) by randomly assigning half of the SafeCare providers and half of the SAU providers to receive regular live supervision sessions by a designated coach. Outcome measures focused on CPS reports of maltreatment as well as indirect self-reported measures of parent and child outcomes. Initial results presented by Chaffin and colleagues indicate that the coached-SafeCare is performing significantly better than the other three conditions (uncoached SafeCare, plus both coached and uncoached SAU) with regard to recidivism rates for neglect and out-of-home placements.
Oklahoma High Risk Study, CDC, OJJDP, State of Oklahoma (PI: Jane F. Silovski (HSC))
Chaffin, Silovsky, Hecht and colleagues are conducting a single-site prevention study of SafeCare with a population at high-risk for child maltreatment. In this study, families (N = 293) must have multiple risk factors (e.g., substance use, partner violence, mental illness) to enter the study, but are not currently involved with the child welfare system and have no history of involvement. Families are randomly assigned to receive either the SafeCare model (delivered by bachelor’s level providers) or unstructured in-home services delivered by licensed mental health professionals (typically Master’s level individuals). The emerging results favor the SafeCare model for a variety of outcomes. Families receiving SafeCare have lower parental depression, lower child abuse potential scores, fewer financial problems, and higher social support. They also report greater satisfaction with services and that the services received were more culturally sensitive compared to the unstructured services.
Mixed-methods study of a statewide EBP implementation, NIMH (PI: Greg Aarons)
This project is an adjunct to Oklahoma’s statewide implementation of SafeCare. The investigators are collecting organizational data from all 21 case management teams implementing SafeCare to understand individual and organization factors that influence the implementation of the SafeCare model. Agency directors and managers report that a number of factors can improve implementation (e.g., tangible agency leadership, support for SafeCare, high motivation/low resistance in staff) (Palinkas & Aarons, in press). For home visitors SafeCare implementation is facilitated by factors such as the suitability of the EBP to the needs of the families, positive training experiences, the extent of organizational support for SafeCare, etc. (Aarons & Palinkas, 2007). Finally, and most importantly, SafeCare implementation with ongoing coaching resulted in an almost 45% reduction in staff turnover in Oklahoma (Aarons, Sommerfeld, Hecht, Silovsky, & Chaffin, In Review).
Developing Multi-Component Evidence Based Practice in Child Abuse Service Systems (PI: Debra Hecht)
The overarching goal of this proposal is to use develop and pilot a more complex, modular, child welfare family preservation/reunification Evidence Based Practice(EBP) system, based on SafeCare. The proposed project will involve two main sequential activities: a) to develop an EBP system comprised of a set of feasible, theoretically coherent and technically consistent practice elements that are aimed at reducing future incidents of physical abuse, and a simple set of decision rules that match elements with key client or context factors and b) to conduct a feasibility and pilot trial of the modular model. This will involve both a small-sample comparison of complex EBP vs. simple EBT cases and within-subjects multiple baseline testing of the concordance of targeted changes with their matched practice elements. The laboratory for this pilot and feasibility test will be two provider teams from among the 20 teams currently delivering SafeCare services in Oklahoma.
Dynamic Adaptation to Implement an Evidence-Based Child Maltreatment Intervention (PI: Greg Aarons)
This project will address two related critical implementation issues for the dissemination and implementation of SafeCare. First, a “Dynamic Adaptation Process” (DAP) will be studied, which uses an assessment to guide and prepare systems, organizations, and service staff to make appropriate decisions about SafeCare adaptation prior to and during implementation and service delivery, and provides a process to maintain fidelity. Second, an innovative approach to fidelity assessment, namely, automated telephone technology to assess client fidelity and satisfaction data, will be examined and compared to the in-vivo observation method to test fidelity. 12 new SafeCare teams in multiple California counties will be randomly assigned to either the DAP approach or implementation as usual. The specific aims of the study are to 1) Use the DAP to modify SC training and ongoing consultation to support adaptation of SC in practice, 2) Use qualitative methods to examine the process, feasibility, acceptability, and utility of the DAP, 3) Test whether DAP implementation results in fidelity to SC core elements equal to implementation as usual as well as greater provider engagement with the implementation, and client satisfaction. 4) Examine organizational and provider factors likely to impact adaptation and implementation outcomes. 5) Test the utility of automated telephone technology for client fidelity assessment and satisfaction data. Data collection will begin in fall 2009.
Evidence-Based Child Maltreatment Prevention for High Risk Families (PI: Jane F. Silovsky (HSC))
The goal of this project is to implement SafeCare with a population at high risk for child maltreatment, and to develop and test important adaptations of SafeCare. SafeCare will be implemented with a group of Latino parents at high risk for child maltreatment. The adaptations that will be developed will focus on providing culturally competent services for Latino families, and the development and testing of an intervention to prevent violence, with a focus on intimate partner violence. Adapted SafeCare will be delivered to a group of Latino families, and will be compared to services as usual for those families.