title: Family preservation and family support programs: child maltreatment outcomes across client risk levels and program types.
abstract: OBJECTIVE
  This study evaluated client-level outcomes among an entire statewide group of Family Preservation and Family Support (FPFS) programs funded under PL 103-66.
  
  
  METHODS
  A total of 1,601 clients (primarily low income, moderate to high risk with no current involvement in the child protection system) were assessed and followed over time for future child maltreatment events reported to Child Protective Services. The study compared program completers with program dropouts, compared recipients of more lengthy full-service programs with recipients of one-time services, and examined the effects of program duration, intensity, service site (center-based vs. home based) and service model/content. Effects were modeled using survival analysis and variable-exposure Poisson hierarchical models, controlling for initial client risk levels and removing failure events because of surveillance bias. Changes in lifestyle, economic and risk factors were also examined.
  
  
  RESULTS
  A total of 198 (12.2%) participants had at least one defined failure event over a median follow-up period of 1.6 years. Controlling for risk and receipt of outside services, program completers did not differ from program dropouts or from recipients of one-time services, and there was no relationship between program intensity or duration and outcomes. Program types designed to help families meet basic concrete needs and programs using mentoring approaches were found to be more effective than parenting and child development oriented programming, and center-based services were found to be more effective than home-based services, especially among higher risk parents.
  
  
  CONCLUSIONS
  The findings did not support the effectiveness of these services in preventing future maltreatment cases, and raised questions about a number of common family support assumptions regarding the superiority of home-visiting based and parent training services. A number of possible reasons for this are explored.
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City 73190, USA.
authors.forename: M
authors.initials: M
authors.lastname: Chaffin
authors.forename: B L
authors.initials: BL
authors.lastname: Bonner
authors.forename: R F
authors.initials: RF
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000517:prevention & control / Q000706:statistics & numerical data*; D002669:Child Welfare; D003153:Community Health Services; D005006:Ethnicity; D005190:Family / Q000208:ethnology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D009825:Oklahoma / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D016012:Poisson Distribution; D011368:Professional-Family Relations; D015397:Program Evaluation; D012944:Social Support; D012959:Socioeconomic Factors; D016019:Survival Analysis