Link to Dr. Lutzker's press release following his slideshow presentation at Qatar University: http://publichealth.gsu.edu/1928.html

1. SafeCare®: An Evidence-based
Widely Disseminated Parent
Training Program to Prevent
Child Maltreatment
John R. Lutzker, Ph.D.
Director, Center for Healthy Development
Associate Dean for Faculty Development
and Professor of Public Health
Georgia State University

2. NCANDS, 2011
Data from Exhibit 4-F
681,000 substantiated cases of child maltreatment

3. Source: Finkelhor, Jones, Shattuck
(2010)

4. Violence
Against
Women
Youth
Violence
Suicide
Child
Maltreatment
Child Maltreatment Pathways

5. SafeCare Protocols
• Parent-Child Interactions
+ Parent-Infant Interactions
+ Planned Activities Training (another evolution)
• Home Safety
+ Removal of hazards
+ Removal of filth and clutter
• Child Health Care
+ When to call a doctor
+ When to self-treat
+ When to visit emergency room
* Counseling and problem solving skills
* Round 3 Content Validations

6. Project 12-Ways
• 1979 - present
• Over $20 million funding
• Over 3000 families served
• Hundreds of staff trained
• Referrals: DCFS-homogenous
• Service area: 10-12 counties, rural
southern Illinois

7. Original Project 12-Ways Services
 Alcohol abuse referral
 Job finding
 Money management
 Health and safety
training
 Multiple setting
behavior management
 Prevention
 Parent-child training
 Stress reduction
 Self-management for
parents
 Basic skill training for
children
 Activities planning
 Relationship
counseling

8. Project 12-Ways
Outcomes
Three studies showed that Project
12-Ways families
•Had significantly less child
maltreatment
•Were more difficult than
comparison families

9. SafeCare
• Urban: San Fernando Valley in Los Angeles, CA
• Hispanic/Latino participants
• Diverse
• Succinct
(5 sessions per
module)
• Staff not
“behavioral”

10. Evaluation
• Outcome evaluations
• Social validation
• Goals
• Process
• Outcome
Gershater-Molko, R., Lutzker, J.R., &
Wesch, D. (2002) Using Recidivism data to
evaluate Project SafeCare: Teaching
“bonding”, safety and healthcare skills to
parents. Child Maltreatment,1, 277-285.

11. Oklahoma Statewide Trial
(PI: Mark Chaffin)
• 6 service regions in OK assigned to SafeCare or SAU
 Providers receive SC training or do SAU
 Regions 1,2, & 3 = SafeCare; 4,5 & 6 = SAU
• Half of each got “fidelity monitoring” or coaching
• Outcomes: CPS referrals + intermediate variables
• Economic evaluation to test cost effectiveness of
coaching

12. OK Statewide Trial: Sample
• N = 2175
• 91% women
• 67% white, 16% American Indian, 9%
African American
• Mean of 2.8 children
• 82% below poverty line
• 4.7 prior CPS reports

13. OK Statewide SC trial: Results
s}SafeCare
Survival
• SafeCare decreased re-reports by 26% for families with children 0-5
• With a re-report rate of 45% annually, SC prevented 64-104 reports
• ROI analyses, suggest $14 return for every $1 invested in SC
• Other research: much lower attrition for SafeCare providers
}SAU

15. The National SafeCare® Training and
Research Center
Born: October 2007
Delivered by: The Doris Duke Charitable
Foundation

16. Home Safety Data
Jabaley, et al (2011). Journal of Family Violence.

17. SafeCare Service Completion
• RCT comparing SC to usual
service in-home behavioral
health services (N=398)
• SafeCare families assigned
more likely to enroll (80%
vs. 49%) and complete
services (49% vs. 21%).
• Service satisfaction higher
among SC families as well
Damashek, A., Doughty, D., Ware, L., & Silovsky, J. (2011). Predictors of Client Engagement
and Attrition in Home-Based Child Maltreatment Prevention Services. Child Maltreatment,
16(1), 9-20.

18. SafeCare Training

19. SafeCare Implementation
By doing this…

20. SafeCare Sites

21. Research Question & Hypotheses
Does
combining PAT
+ SafeCare
result in better
outcomes for
families?
Compared to those receiving
PAT, those receiving PAT +
SafeCare, will:
1. Produce even better
parenting outcomes
2. Produce children with
better developmental
outcomes and school
readiness
3. Show lower risk of child
maltreatment
PATSCH = Parents as Teachers and SafeCare at Home

22. RESEARCH PRACTICE
Why Focus on Implementation?
IMPLEMENTATION
“Children and families cannot benefit from
interventions they do not experience.”

23. © Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Organizational Change
"All organizations [and systems] are
designed, intentionally or unwittingly, to
achieve precisely the results they get."
R. Spencer Darling
Business Expert

25. Lessons learned in related efforts
Critical considerations in bringing implementing EBP:
•Initial and ongoing training
•Quality control
•Organizational context and commitment
•Ongoing monitoring of fidelity
•Reliance on special people
•Staff training, selection, qualifications
•Blending Research and Service
•Certification/National Centers

26. Organizational readiness for EBP
• Leadership and staff support and endorsement
• Time for planning and implementation (i.e., regular and ongoing meetings)
• Good communication from the beginning
• Staff buy-in and concerns
• Fit with mission and community need
• Commitment to ongoing evaluation
• Financial support
• Political support
• Community support
• Technology
• Economic Issues
• Implementation Issues
• Balance between structure and fidelity
• Clear role definitions for HVs, Coaches, and Trainers

27. Training costs: includes training, NSTRC travel
to site, materials and 1 year support
Implementation costs:
•Estimated $1900 - $2300 per family.
•Very few unique costs to SafeCare.

28. Technology
• iPhones
• Tablets
• Webcams
• Digital Frames
• Cell Phones
• ?????

29. What does the future hold?

30. John R. Lutzker, PhD
Center for Healthy
Development
Georgia State University
Box 3995
Atlanta, GA 30302-3995
jlutzker@gsu.edu
404-413-1284
http://publichealth.gsu.edu
www.safecarecenter.org