Public policy has been shifting from child abuse and neglect (CAN) intervention toward prevention, using public health style frameworks, which emphasize shared community and legislative responsibilities to support families (Browne, 2014; CDC, 2014). Analysis of qualitative data from statewide focus groups held in 2019 in Alabama with 99 community-based CAN prevention workers shows strengths in community collaboration, but also, struggles to help families meet basic needs because of lack of community resources, such as transportation and quality child care, and other barriers, including stigma. The results demonstrate confusion between prevention, which is intended to build family resilience to avert crisis, and intervention, meant to reunite families after child protection services involvement. We recommend researchers consistently link CAN research to prevention frameworks so as to build meaningful understanding how to create better prevention programs. Future practitioners should understand prevention, and be prepared to document their work so as to demonstrate need

Burks, Brianna

Flowers, Synithia W.

Jackson, Terra

McDaniel, Beth S.

Merritt, Allie

Sherman, Haley

Vilches, Silvia L

English

East Tennessee State University

Engaging With a Prevention Approach: System Supports Needed in Child Abuse and Neglect PreventionVilches, S.L., McDaniel, S.E., Sherman, H., Burks, B., Merritt, A. & Flowers, S.W. (2020, April, refereed). Engaging With a Prevention Approach: System Supports Needed In Child Abuse And Neglect Prevention. Paper presentation for the annual meeting of the Southeastern Council on Family Relations. Birmingham, AL. (conference cancelled). https://southeastern.ncfr.org/upcoming-conference-secfr20/Findings of the Phase 2 Discussion Groups of the Social Indicators Project on Child Abuse and Neglect Prevention in AlabamaVilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC The Challenge: Maltreatment Prevention • Child maltreatment has significant lifetime consequences1• Economic and human costs• Increased risk of injury, future violence, substance use• Lower educational attainment, poor employment outcomes  • Impaired brain development • Recent policy shifts are focusing on prevention vs. intervention• Prevention focuses our attention on community conditions, resilience, and social conditions • At the same time: between 2014-2018, after changes to mandatory reporting requirements, there was a 40% increase in documented first-time child maltreatment victims in Alabama21. Center for Disease Control, 2019.2. U.S. Department of Health and Human Services, 2020.Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Social Indicators StudyThe Social Indicators Research Program explored community-based child abuse and neglect prevention across the state of Alabama, from the perspective of community leaders and service providers engaged in prevention work, to: 1. Better understand how existing programs successfully prevent child abuse and neglect2. Identify how to support existing programs to further strengthen this work.Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Three Phases (2018 – 2020)Phase 3 Community Asset MappingPhase 2 Key Stakeholder Discussion GroupsPhase 1 Scoping Review (Literature)Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Phase I Scoping Review: Key Findings• Lack of common prevention frameworks • Terms prevention and intervention often mixed• Emerging use of public health style prevention frameworks• Strengthening Families Framework 31. Social connections2. Resilience3. Concrete supports in times of need4. Social and emotional competence of children5. Knowledge of parenting and child development• CDC Essential Steps framework1Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Key Stakeholder Discussion GroupsRecruitment and CharacteristicsPhase II Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Recruitment Target Sample• Service providers and community leaders involved in prevention work in AlabamaInclusion Criteria• Service provider, community leader• Age 19 or older• Work in state of AlabamaExclusion Criteria• Work with families involved in child protective servicesDemographic and Service Questions• Funding source• Service region • Characteristics of target service population • Homelessness• Poverty• Incarceration• Immigrated to US• Veteran or active duty military • Child with special needs• Non-two-parent headed household (family form)• Title IX School Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Characteristics of ParticipantsCharacteristics of Participants Percent and Total Number in Each Category Percent of Total Number of Participants (N = 99)Total Respondents Answering Each QuestionRoleService provider 69% 68Community leader 21% 21Funding ADCANP-funded 28% 28Not ADCANP-funded 62% 61Service RegionRural 54% 53Urban 35% 35Participant MinorityStatusIdentify as member of minority 39% 39Does not identify as member of minority 58% 57Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Regional Representation of Discussion GroupsRegion In-Person ZOOMNorth Central (Morgan)July 18 July 30North East (Madison)North West (Jasper) July 11Central West (Pickens) July 26 June 18Central (Shelby and Lowndes)May 23 May 3 June 25Central East (Chambers)June 20 July 23South East (Montgomery)May 13 June 13South West (Mobile) June 27 July 24Spillover July 304. Adapted from Cartographic Research Laboratory. (2020, Jan. 17).Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Discussion Group Questions 1. In your experience, how do the services and supports that you provide or advocate for help support families and prevent child abuse and neglect in each of the 5 protective areas?2. What other supports do families access that help support the 5 protective factors?3. If you had a million dollars tomorrow, what else would you make available to support families in each of the 5 protective factors?*4. How do you see parent leadership helping to support the 5 protective factors?5. What key points would you like people to know about the needs of the families you serve?6. Are the families you serve the parents that are most at-risk in your community?7. Is there anything else we need to know about what services and agencies need to help strengthen prevention work?* Question is modelled on participatory budgeting research, which pushes participants to prioritize. Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Findings of Discussion GroupsKey Points Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Theme One – Meeting Basic Needs• Protective Factor: • “Providing Concrete Support in Times of Need”• Participants confirmed extensive work in meeting needs• Most basic needs cannot be met through funding prevention• Concrete needs are met by and through networking with others• Outcomes• Supporting families in need• Building trust by meeting basic needs• Developing a collaborative network that supports familiesVilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Building TrustD: Sometimes with building relationships, if you can find some concrete needs to help with, we notice that the families will bond with us through that meeting of those needs….Then [they become] more open to the services that we can provide. That not only alleviates that stress for them, but it also helps them with trusting you and saying, ‘Okay, this person is actually here to help me, so I appreciate that, and I’m actually gonna do some of the things they are trying to teach me.’ It gets that relationship going a little bit better I think. (FG F) Networking with Others J: We partner with different agencies in the community that we can send them to for like food and clothing referrals and also if they need assistance with like utility bills. We partner with different community agencies to send referrals to them so they can receive their assistance. (FG D)Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Mental Health and Transportation SL: We have kids that come in on a regular basis that have mental health issues. Most of them have we have directed through DHR to get any type of support that they can get. When they get placement, the only two places that I know that they normally send the kids is a place in [town a little ways  away], and there’s a place in  [town], which is a great distance … from [here]...The parents, a lot of them, don’t have transportation [so] they’ll defer that and decide not to, because they [are] so far away from the children, and they can't come and go and see them. And as a result of that, a lot of kids in [here], not just here in [our] County, are not receiving the mental health counseling that they really need. (FG A) Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Theme 2 – Gaps in Lateral Systems SL: We have kids that come in on a regular basis that have mental health issues. Most of them have we have directed through DHR to get any type of support that they can get. When they get placement, the only two places that I know that they normally send the kids is a place in [town a little ways  away], and there’s a place in  [town], which is a great distance … from [here]...The parents, a lot of them, don’t have transportation [so] they’ll defer that and decide not to, because they [are] so far away from the children, and they can't come and go and see them. And as a result of that, a lot of kids in [here], not just here in [our] County, are not receiving the mental health counseling that they really need. (FG A) Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Transitional AssistanceS: We work in the jail. We do parenting in the county jail [and] fatherhood. We also do GED in the county jail with the males and females, but it’s when they get out of there; Where do they have to go if their only place to go is to right back to where they came from? (Mhmm). I mean, what do we expect them to do differently if they’re going right back to that? Transitional housing is such a need in our communities, to transition people and give them job skills. (FG A)Outcome AssessmentP: Trying to measure that is really difficult, and even if you use, like I understand the evidence-based programs, and those are great. Obviously, they are evidence based, but when you serve real rural counties where transportation is a barrier, it is hard to get sixteen classes, to get somebody to come for that many classes. (FG A)Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Theme 3 – Systems ChallengesWe asked: What do you want the public to know? Responses: • Public stigma generates more work by…. [sv fill in]• We need to move from reactive interactive to prevention • Providers wear multiple hats to “work the system” to prevent child abuse and neglect Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Public Perception vs. Reality • Prejudice and judgement about service recipients creates additional barriers • Stigma and lack of understanding extends to clients and to reporting of child abuse and neglect (confirmed in research studies).Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Providing Second ChancesS: Sometimes, the outside people that really don’t know, they call them ‘lazy,’ (affirmation from other participants) ‘good for nothing,’ [and that they] ‘don’t deserve a second chance.’ We all deserve a chance, because we all did something wrong in our life time that should be forgiven. (FG D)…. But, sometimes people just don’t want to forgive people that are less fortunate than them. Especially in [the] rural area that we’re living in, this is what we see all the time. People just don’t want to give a person a second chance and that person could be trying all he or she can, but we don’t want to give them a second chance. (FG D)Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Prevention vs. Intervention • Often challenging to implement programs in real-world conditions in which communities exist.• Prevention and intervention get mixed up in “reacting to problems”• Concerns that nature of prevention services makes it difficult to assess program impactsVilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Defining Prevention and Intervention T: I think this is in most things, even in healthcare, we don’t do prevention. (Mhmm, right.) We’re using that word, but we’re not preventing. We don’t have a department that’s focused on preventing [or] prevention: We don't. The Department of Human Resources is an intervention – if something has already happened. (Right.) They’re intervening. What I’m gathering from all of these other services: We are interventions. So I really think that if we’re going to use that term, then that’s what we are going to need to get to, we really need to get to prevention. (FG W)Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Providers: Many Hats, Many Roles• Participants provide a range of services and tasks vary on daily basis, in response to specific family needs • Providers must document client progress, especially if they are mandated • Many (or most) use personal time, resources to meet needsM: “Every day is different, and every case is different.” (FG W) Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Conclusion One: Prevention Work is ComplexDiversity and Complexity of Prevention Work• Prevention work is diverse; providers perform multiple roles, in variety of capacities• Collaborations are numerous and essential, particularly in context of limited funding Connecting to Meet Basic Needs • Prevention workers and community leaders work together to connect to resources and community supports to address barriers  • Many Alabama families who are served are experiencing economic challenges; struggle to meet basic needs that they have difficulty overcoming• Builds relationships, trust with familiesVilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC Conclusion Two: Structural Changes are NeededStructural Conditions Support Family Well-Being• Emerging CAN Prevention approaches recommend society level advocacy approaches with public health style messaging• In this study: • Stakeholders wish for increased public awareness of structural conditions that promote well-being, prevent maltreatment• Advocacy is needed for supportive policies and services (public transportation, childcare, living wage, etc.) as child abuse and neglect prevention measures Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC RecommendationsTheory: Meso-level Research Needed• Need for greater attention to how community conditions & provider relationships impact (1) maltreatment prevention efforts, and (2) child and family well-being• (meso-level research)Renewed Family and Community Research Connections• Renewing efforts to ensure that research reflects community realities• Understanding how real world conditions impact prevention implementation, e.g. conditions that impact prevention program fidelity Practitioner Recommendations• Document “hidden” work, such as community networking to meet basic needsVilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC THANK YOU FOR YOUR TIME AND SUPPORTAll participants and the families you serve and representUndergraduate Research Team:  Allie Merritt, Parker Levins, Haylee Singleton, Gabriela Diaz, Haley Gaar, Kierra Goldsborough, and Brantley ShieldsRegional Extension Agents, Alabama Cooperative Extension: Synithia Flowers, Debra Ward, Melanie Allen, Sallie Hooker, Wanda Carpenter, Leigh Akins, Tera GlennCore Research Team: Terra Jackson, Brianna Burks, Beth McDaniel, Haley Sherman, Dr. Silvia Vilches Vilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC References 1. Centers for Disease Control and Prevention. (2014). Essentials for Childhood: Steps to Create Safe, Stable, Nurturing Relationships and Environments. Atlanta, GA: Author.2. U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau. (2019). Child maltreatment 2017. Retrieved from https://www.acf.hhs.gov/sites/default/files/cb/cm2017.pdf3. Browne, C. H. (2014, September). The Strengthening Families Approach and Protective Factors Framework: Branching out and reaching deeper. Washington, DC: Center for the Study of Social Policy4. Cartographic Research Laboratory (2020, Jan. 17). Alabama Counties Alabama Maps.http://alabamamaps.ua.edu/contemporarymaps/alabama/counties/index.htmlVilches McDaniel Sherman Burks Merritt Flowers  (2020) Engaging with Prevention (Auburn University) for SEFRC 

Engaging with a Prevention Approach: System Supports Needed in Child Abuse and Neglect Prevention

https://dc.etsu.edu/cgi/viewcontent.cgi?article=1136&context=secfr-conf

Engaging with a Prevention Approach: System Supports Needed in Child Abuse and Neglect Prevention

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East Tennessee State University