title: Understanding change among multi-problem families: Learnings from a formative program assessment.
abstract: This paper describes the implementation of a long-term voluntary intervention to prevent chronic maltreatment among multi-problem families with histories of child welfare involvement. A small formative evaluation included a limited number of interviews with program participants during the first year of program implementation (n=10), a retrospective case file review (n=17) of closed cases following the first three years of implementation, and notes from ongoing meetings and discussion with program staff. Findings regarding client engagement, long-term interaction between risk and services, and program refinement are discussed. Despite the program's voluntary nature, positive comments from families, and extensive engagement strategies, only about 22% of families remained engaged for the full two-year program. Material hardship was one of the most persistent risk factors from baseline to termination. In many cases, unforeseen negative events occurred that, at least partly, derailed progress. In all cases, progress made was not reflective of a consistent linear process used in the design of most child welfare programs. Implications for program theory and design are discussed.
authors.affiliation: College of Nursing, University of Missouri, One University Blvd, St. Louis, MO, United States. Electronic address: millettl@umsl.edu.
authors.forename: Lina Sapokaite
authors.initials: LS
authors.lastname: Millett
authors.affiliation: Brown School Work, Washington University in St. Louis, United States. Electronic address: vdavid@brownschool.wustl.edu.
authors.forename: Vered
authors.initials: V
authors.lastname: Ben-David
authors.affiliation: Brown School Work, Washington University in St. Louis, United States. Electronic address: jonsonrd@wustl.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Jonson-Reid
authors.affiliation: Family Resource Center, St. Louis, MO, United States. Electronic address: gechele@frcmo.org.
authors.forename: Greg
authors.initials: G
authors.lastname: Echele
authors.affiliation: Family Resource Center, St. Louis, MO, United States. Electronic address: pmoussette@frcmo.org.
authors.forename: Pam
authors.initials: P
authors.lastname: Moussette
authors.affiliation: Family Resource Center, St. Louis, MO, United States. Electronic address: vatkins@frcmo.org.
authors.forename: Valerie
authors.initials: V
authors.lastname: Atkins
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D002653:Child Behavior Disorders / Q000453:epidemiology; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D016487:Parenting; D011203:Poverty / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Child maltreatment; Chronic; High-risk families; Long-term intervention; Poverty; Prevention