全球智库信息集成服务系统

Almost All of the Sites Succeeded in Launching Interventions Relevant to Children Exposed to Violence

• Almost 1,500 families received Safe Start services (and about 1,250 received comparison group services) across the ten sites.
• However, families did not take up the services fully, receiving fewer services than planned. Nonetheless, satisfaction with services was high.
• Program staff were trained in specific intervention models and brought those skills to families who might not otherwise have had access to these types of family-focused programs.

Families Who Participated in Safe Start Improved over Time

• Analyses found positive change in many of the outcomes, with families in six of the studies showing statistically significant improvement in their primary outcomes over time (in the intervention or comparison group).
• Among the powered studies, there was no strong evidence that the intervention groups improved more than the comparison groups on the outcomes examined.

There Was a Range of Effect Size Changes Across the Outcomes Examined

• For those who received Safe Start services, only one site had large significant effect size changes on outcomes (child posttraumatic stress disorder), and one site had medium significant effect size changes on multiple outcomes (child self-control, posttraumatic stress disorder, and behavior; caregiver depression; and family conflict). Otherwise, the changes in outcomes within the intervention group were generally small.

Children's exposure to violence is common and can lead to mental health problems and delinquent behaviors. Because many interventions have focused on specific violence types or symptoms and been difficult to implement in real-world settings, the evidence base is still emerging. The Office of Juvenile Justice and Delinquency Prevention's Safe Start Promising Approaches (SSPA) initiative focused on preventing and reducing the impact of children's exposure to violence through interventions in ten diverse communities. The evaluation examined the effectiveness of the SSPA interventions to address issues for children and families exposed to violence. The ten sites were diverse in their intervention approaches, types of violence exposure targeted, and implementation settings. To evaluate each approach's effectiveness in reducing violence's harmful effects, RAND researchers partnered with the community-based sites to develop a rigorous controlled evaluation design for each intervention, with either a randomized control group or a comparison group selected on similar characteristics. The longitudinal analyses found that families in both the intervention and comparison groups had positive gains on many outcomes, but there was no evidence that the intervention groups improved more. Among those who received Safe Start services, one site produced large, significant improvements in posttraumatic stress disorder symptoms, and another site produced medium, significant effects on several outcomes (child self-control, posttraumatic stress disorder, and behavior; caregiver depression; and family conflict). Although the initiative added to knowledge about how to address the problem, there was no clear case for using a particular intervention to help these children and their families.

• Chapter One

  Introduction

• Chapter Two

  Evaluation Methods

• Chapter Three

  Overview of the Outcome Evaluation Across Studies

• Chapter Four

  Study Findings

• Chapter Five

  Discussion and Next Steps

• Appendix A

  Measures