An in-home training program for parents of children aged 0 to 5, that are at-risk of or have been reported for child neglect or physical abuse.
The Evidence Summaries presented on this site were drawn from the best available evidence of the program’s effectiveness. It does not necessarily reflect all the evidence about the program. The research was selected and assessed for inclusion on the Menu and towards the evidence rating because it met selection criteria related to the specific topic area, study design, quality assessment and the outcomes of interest.
Overview
Evidence Rating
Pathway
- Early help
- Targeted and specialist
- Continuing care
Australian Study
Risk of Bias
Cost
Target Age Group
About
An evidence summary for SafeCare® under the topic area Preventing maltreatment is also available.
SafeCare® is a home-visiting parent training program that targets risk factors for child neglect and physical abuse. SafeCare® providers work with families improve parents’ skills through a structured behavioural skills training program that focuses on caregiving, household management and parenting skills.
Aims
- Improve engagement in services
- Improve the quality of parent-child relationships
- Improve parenting skills
- Increase parents’ competence in managing behaviours problems
- Reduce out-of-home placement
- Reduce parents’ use of coercive and punitive methods of discipline
- Improve parents’ personal coping skills and reduce stress
- Improve parents’ problem-solving skills.
Impact
Evidence shows that SafeCare® was effective in long-term recidivism 5 years post-enrolment into the program, the only outcome measured in the study. The data was accessed from child protection administrative data for families with children from preschool age to age 12, who interacted with child protection services.
| Outcome domain | Outcome measured | Positive effect | No effect | Negative effect |
|---|---|---|---|---|
| System | Child protection system contact | Yes | Not found | Not found |
How to read the table:
When ‘Yes’ is indicated for one of the three directions of effect, this means there is evidence of ‘positive’, ‘no effect’ or ‘negative effect’. Evidence is mixed and inconclusive when ‘Yes’ is indicated for two or more directions of effect. Further information about direction of effect can be found on the Using the Menu page.
SafeCare® has an evidence rating of Supported+.
This means that SafeCare® has evidence from one randomised controlled trial (RCT) or quasi-experiment (QE) demonstrating positive, long-term impact on at least one child and family outcome.
This assessment is based on one research output of RCT design. Another RCT (Chaffin et al., 2012) and QE (Gershater-Molko et al., 2002) were identified but did not count towards the evidence due to concerns with study quality. SafeCare® has not received a Well-supported rating as it has not yet replicated its results in another rigorous RCT or QE with a different population or setting.
| Study design | Number of research outputs included |
|---|---|
| Systematic review with meta-analysis | Not identified or included |
| Randomised controlled trial | 1 |
| Quasi-experiment | Not identified or included |
The evidence has low concerns with risk of bias.
We can be confident about the results and quality of evidence from the included study.
The study was conducted in the United States and does not include Aboriginal children and families.
Aboriginal knowledge and evidence is critical to recognise, document and share practices that lead to improved outcomes for Aboriginal children and families. The department is consulting with the Aboriginal community and stakeholders on how Aboriginal knowledge and evidence is defined and included on the Menu.
Location
- The trial was conducted in Oklahoma, United States.
Sample
- Participants in this study were a subpopulation of 354 parents or caregivers who identified as American-Indian from a larger SafeCare® trial.
- The majority of participants identified as female, are living in households which fall below the federal poverty line, are involved in maltreatment and were referred by child welfare.
Implementation
Delivery model, mode and setting
- SafeCare® is delivered in-person, to the parent only.
- SafeCare® is delivered as a home-visiting program in the adoptive home, birth family home or in foster/kinship care.
Target cohort
- Families at risk of neglect and abuse.
- Children up to age 5.
Program delivery
- SafeCare® can be delivered as a free-standing program or as a component of a broader home-visiting service.
- Staff work with families in their home visits. A series of typically 4 training sessions follows, and Home visitors work with parents until they show mastery of module skills. A final observational assessment is used to assess parents’ uptake of skills.
- Parent-Child/Infant Interaction: Focuses on parent-infant interactions from birth to walking and parent-child interactions from walking up to 5 years of age, and targets risk factors associated with neglect and physical abuse.
- Health: Teaches parents to identify childhood illnesses and injuries and follow a structured process to determine when and how to care for the child to target risk factors for medical neglect. Parents are also taught to use health reference materials, including a validated SafeCare® health manual.
- Home Safety: Helps parents identify and eliminate common household hazards to target risk factors for environmental neglect and unintentional injury. Parents learn how to eliminate home hazards and are taught the importance of supervision.
- Family Engagement Skills: Teaches parents using a structured problem-solving process to solve many difficulties not addressed by SafeCare®. Good communication skills are emphasised to engage parents and build rapport.
- SafeCare® providers work with families in their homes to improve parents’ skills by:
- Explaining the skills and why they are important
- Demonstrating how to do each skill
- Having parents practice the skills
- Providing positive and corrective feedback to parents on their use of skills.
Duration and intensity
- In the standard SafeCare® model, weekly home visits last from 60 to 90 minutes each. The program typically lasts 18 to 20 weeks for each family.
- Each module is taught over the course of approximately 6 sessions. Each module begins with an observational assessment to determine parents’ current skills and areas needing improvement.
Guides and manuals
- There is an implementation manual to deliver SafeCare®.
- Agencies are assessed for their readiness before implementation. They are also provided with formal support to implement SafeCare® through several mechanisms, including coaching and feedback, technical assistance on first year of implementation, fidelity monitoring and trainee certification via a web portal that collects data on provider demographics and certification progress.
Additional information
- The SafeCare® website provides more information about the program.
Staffing
- At a minimum, staff are required to have a bachelor's degree in human services.
- There appears to be no minimum stipulations regarding the number of trained staff to deliver SafeCare®. However, for agencies to deliver SafeCare®, they do require a SafeCare® coach position to be available.
Training
- Provider agencies are required to participate in 32 hours of workshop training and undertake post-workshop coaching to promote fidelity and proficiency in delivering SafeCare® to receive their certification.
- Ongoing coaching is required to keep provider certifications active.
To our knowledge, SafeCare® is available in Victoria, New South Wales and Queensland.
In Victoria, OzChild and Anglicare are funded by the Department of Families, Fairness and Housing to deliver the program.
In New South Wales, the Parenting Research Centre is working with the New South Wales Department of Communities and Justice to trial SafeCare® in 8 agencies at 17 sites that are part of the Brighter Futures initiative.
In Queensland, SafeCare® was introduced in 2018 as a pilot on the Gold Coast.
Cost
The cost of SafeCare® training varies according to the number of individuals trained and the level of training desired (provider, coach or trainer). Because SafeCare® training can be delivered with a very small trainer to trainee ratio, it is generally more efficient to train large numbers of staff at once.
References
Studies identified and included in the review
- Chaffin M, Bard D, Bigfoot DS and Maher EJ (2012a). Is a structured, manualized, evidence-based treatment protocol culturally competent and equivalently effective among American Indian parents in child welfare? Child Maltreatment 17(3): 242-252.
Studies identified but not counted towards the evidence rating due to study quality
- Chaffin M, Hecht D, Bard D, Silovsky JF and Beasley WH (2012b). A statewide trial of the SafeCare home-based services model with parents in Child Protective Services. Pediatrics 129(3): 509-515.
- Gershater-Molko, R.M., Lutzker, J.R. and Wesch, D., 2002. Using recidivism data to evaluate project safecare: Teaching bonding, safety, and health care skills to parents. Child Maltreatment, 7(3), pp.277-285.