A home-visiting, child abuse preventing program for pregnant woman aimed at enhancing mother-child relationship and support.
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
Australian Study
Risk of Bias
Cost
Target Age Group
About
Child Parent Enrichment Project (CPEP) is a child abuse prevention program for pregnant women based on the theory that enhancing mother-child relationships, social and material support, goal setting, and problem solving can reduce the risk of child abuse. The program uses a task-centred approach in which parents identify and complete tasks to achieve their goals. During home visits, Parenting Consultants and parents discuss tasks associated with the parent’s goals for caring for herself and the child and record tasks that had been performed.
Aims
- Reduce stressors that contribute to child abuse
- Promote good parenting
- Reduce child abuse.
Impact
The evidence suggests that CPEP improves child's birth weight but results for other outcomes measured were mixed and inconclusive.
| Outcome domain | Outcome measured | Positive effect | No effect | Negative effect |
|---|---|---|---|---|
| System | Child protection system contact | Not found | Yes | Not found |
| System | Health service use | Yes | Yes | Not found |
| System | Out-of-hone care | Yes | Yes | Not found |
| Child | Mental health/behaviour | Yes | Not found | Not found |
| Child | Reproductive outcomes | Yes | Not found | Not found |
| Child | Wellbeing | Yes | Yes | Not found |
| Parent/caregiver | Mental health/functioning | Yes | Yes | Yes |
| Parent/caregiver | Reproductive outcomes | Yes | Yes | Yes |
| Parent/caregiver | Social support | Yes | Yes | Yes |
| Cost | Wellbeing | Yes | Yes | 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.
CPEP has an evidence rating of Supported+.
This means that CPEP 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 2 research outputs from one primary study. CPEP has not received a Well-supported rating as it has not yet replicated its results in another 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 | 2 |
| Quasi-experiment | Not identified or included |
The evidence has some concerns with risk of bias.
We can be reasonably confident about the results and the quality of evidence from the included studies.
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 study was conducted in California, United States.
Sample characteristics
- The studies’ sample sizes ranged from 65 (29 intervention, 36 control) to 240 mothers (118 intervention, 122 control) mothers.
- The mothers were pregnant women with 2 or more risk factors.
- Across both studies, participants identified as White, Latino, Black, Asian and Native American.
Implementation
Delivery model, mode and setting
- CPEP is delivered in-person, to parents in their home by paraprofessional Parenting Consultants.
Target cohort
- Pregnant women at risk for child abuse.
Program delivery
- CPEP services consisted of home visits with paraprofessional parenting consultants.
- Assignment of a Parenting Consultant to parents is based on ethnic or geographic considerations.
- During home visits, consultants and parents discussed tasks associated with the parent’s goals for caring for herself and the child and recorded tasks that had been performed. Tasks could be completed during or between home visits, and in the parent’s home or within the community.
- There are 3 types of tasks:
- Parent-focused: Completed by the parents alone and could include preparing one clean room for the baby to come home to, visiting a thrift shop to obtain a crib and using a respite care program one-half day per week after the child is born.
- Consultant-focused: Tasks led by Parenting Consultants, either during or between visits, including modeling positive parenting and home care skills, advocating on a client’s behalf and discussing the care of a colicky baby.
- Shared: Typical joint tasks were driving together to a church to pick up food and repairing an appliance together.
Duration and intensity
- The number of home visits range from 5 to 20.
- Home visits occur approximately twice per month over a 6-month period.
Manuals and guides
- We were unable to locate any manuals of guides to implement CPEP.
Staffing
- We were unable to locate any information on the minimum education requirements for staff delivering CPEP.
- Parenting Consultants each carry a caseload of about 10 families and work 20 hours per week.
Training
- Parenting Consultants undergo more than 100 hours of training that cover the perinatal period, community resources, child abuse and child abuse reporting and team building. Training also includes the basics of implementing a task-centred service approach, in which consultants focused on identifying goals to improve parental self-care and child care and enhancing parents’ ability to identify and complete tasks to meet their goals. Certification is not required.
To our knowledge, CPEP is not available and has not been implemented in Australia.
Cost
We were unable to locate any information on the cost of CPEP.
References
Studies identified and included in the review
- Barth RP, Hacking S & Ash JR (1988). Preventing child abuse: An experimental evaluation of the child parent enrichment project. Journal of Primary Prevention, 8(4):201-217.
- Barth RP (1991). An experimental evaluation of in-home child abuse prevention services. Child Abuse & Neglect, 15(4):363-375.
Studies identified but not counted towards the evidence rating due to study quality
- Euser S, Alink LR, Stoltenborgh M, Bakermans-Kranenburg MJ & van IJzendoorn MH (2015). A gloomy picture: A meta-analysis of randomized controlled trials reveals disappointing effectiveness of programs aiming at preventing child maltreatment. BMC Public Health, 15:1068.
- Geeraert L, Van den Noortgate W, Grietens H & Onghena P (2004). The effects of early prevention programs for families with young children at risk for physical child abuse and neglect: a meta-analysis. Child Maltreatment, 9(3):277-291.
- van der Put CE, Assink M, Gubbels J & Boekhout van Solinge NF (2018). Identifying effective components of child maltreatment interventions: A meta analysis. Clinical Child and Family Psychology Review, 21(2):171-202