Document text
Principal Investigator: MONICA L OXFORD
Organization: UNIVERSITY OF WASHINGTON
Fiscal Year: 2024
Award: $661,957
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
ABSTRACT
The severe acute respiratory syndrome coronavirus 2 (denoted COVID-19) pandemic has shaken the
foundation of services delivered to vulnerable families involved with or monitored by the child
protective/welfare system. COVID-19 has changed the landscape of how children and families interact with the
vital services provided by the child welfare system. Home visitation, which includes a bedrock of essential and
transformative parenting support services for families involved with child welfare, was no longer safe or viable
in the presence of COVID-19. The pandemic shredded safety nets. It made evident to providers, administrators,
and policymakers how fragile our child protective system is. Under this strained state, child welfare agencies
and mental health providers innovated service delivery systems. In Washington State, the Department of
Children, Youth, and Families (DCYF) worked with local service agencies providing evidence-based programs
to revise program protocols. Provider teams and program developers worked together to transition in-person
services to remote platforms by developing and delivering telehealth services to families. The pandemic created
the conditions for a natural experiment in service delivery in Washington State. The natural experiment proved
that telehealth services are a viable service delivery system; thousands of child welfare involved families were
served via telehealth. We do not know, however, if these services were effective, or which families had the
technological capacity to engage, or for those who did engage were they able to complete the program. Did
online home visiting produce the expected outcomes? While online delivery was an innovation driven by the
necessity in response to COVID-19, many questions remain. The potential is high, but little is known about
telehealth in child welfare. This proposal is a three-arm effectiveness trail of an evidence-based home visiting
program: 1) delivered online, 2) delivered in-person, and 3) usual care. We will assess the effectiveness of
Promoting First Relationships (PFR: a 10-week model) to improve observed parent-child interaction and
caregivers’ knowledge of social and emotional development in a sample of 358 caregivers with children under
age 18 months at enrollment. We will also assess if PFR reduces child externalizing behavior and reduces out of
home placements of the child into foster care. We will assess the cost-effectiveness of providing PFR via
telehealth. We will address the degree to which families in Child Protective Services (CPS) have the technology
needed to engage with telehealth services, as well as family satisfaction and compliance. Finally, we will
measure service providers’ fidelity to the PFR model and their adherence to delivering PFR via telehealth. The
proposed study leverages a longstanding partnership between the University of Washington and Washington
State DCYF, overseeing services in child welfare to answer these questions.
Terms: <0-11 years old><2019 novel corona virus><2019 novel coronavirus><2019-nCoV><Access to Care><Address><Adherence><Administrator><Age><Attention><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 virus><COVID-19 years><COVID19 virus><CV-19><Care Givers><Caregivers><Caring><Child><Child Care><Child Rearing><Child Welfare><Child Youth><Children (0-21)><CoV-2><CoV2><Communities><Control Groups><Coronavirus Infectious Disease 2019><Cost Analyses><Cost Analysis><Cost-Benefit Analysis><Data><Development><Drops><Economics><Effectiveness><Eligibility><Eligibility Determination><Emotional><Enrollment><Evidence based program><Failure><Family><Foundations><Funding><Health Care Providers><Health Personnel><Health Services><Health Services Accessibility><Healthcare Providers><Healthcare worker><Home><Home visitation><House Call><Household><Interruption><Investigation><Jobs><Knowledge><Learning><Measures><Mental Health><Mental Hygiene><Methodology><Modeling><Monitor><Natural experiment><Noise><Occupations><Outcome><Parent-Child Relations><Parent-Child Relationship><Parenting><Parenting behavior><Parents><Persons><Policy Maker><Procedures><Professional Positions><Protocol><Protocol Screening><Protocols documentation><Provider><Psychological Health><Puericulture><Randomized, Controlled Trials><Reporting><Risk><SARS corona virus 2><SARS-CO-V2><SARS-COVID-2><SARS-CoV-2><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-CoV2><SARS-associated corona virus 2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><SARS-related corona virus 2><SARS-related coronavirus 2><SARSCoV2><Sampling><Schools><Service delivery model><Service model><Services><Severe Acute Respiratory Coronavirus 2><Severe Acute Respiratory Distress Syndrome CoV 2><Severe Acute Respiratory Distress Syndrome Corona Virus 2><Severe Acute Respiratory Distress Syndrome Coronavirus 2><Severe Acute Respiratory Syndrome CoV 2><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe Acute Respiratory Syndrome-associated coronavirus 2><Severe Acute Respiratory Syndrome-related coronavirus 2><Severe acute respiratory syndrome associated corona virus 2><Severe acute respiratory syndrome coronavirus 2><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Severe acute respiratory syndrome related corona virus 2><Social Change><Social modification><Social transformation><Source><System><Technology><Time><United States><Universities><Washington><WiFi><Work><Wuhan coronavirus><Youth><Youth 10-21><access to health services><access to services><access to treatment><accessibility to health services><adherence by clinicians><adherence by providers><adolescent welfare><ages><arm><assess cost><assess effectiveness><availability of services><care access><care as usual><care delivery model><care services><care systems><child protection services><child protective service><child well being><child wellbeing><childrearing><clinician adherence><clinician compliance><coronavirus disease 2019><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease 2019 virus><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><coronavirus disease-19 virus><coronavirus infectious disease-19><cost assessment><cost benefit economics><cost benefit effectiveness><cost effective><cost effectiveness><cost evaluation><delivered on-line><delivered online><design><designing><determine effectiveness><developmental><distraction><dosage><economic><effectiveness assessment><effectiveness evaluation><effectiveness testing><enroll><evaluate cost><evaluate effectiveness><evidence base><examine cost><examine effectiveness><externalizing behavior><family support><foster care><hCoV19><health care delivery model><health care personnel><health care worker><health provider><health service access><health services availability><health workforce><healthcare delivery model><healthcare personnel><home visit><homes><improved><innovate><innovation><innovative><kids><maltreatment><medical personnel><member><mistreatment><nCoV2><on-line delivery><online delivery><pandemic><pandemic disease><parent><parent child interaction><parent offspring interaction><physician adherence><physician compliance><prevention service><programs><provider adherence><provider compliance><randomized control trial><randomized controlled design><response><safety net><satisfaction><school closing><school closure><service availability><service delivery><service providers><service utilization><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><social><social service provider><telehealth><treatment access><treatment as usual><treatment provider><usual care><web based delivery><welfare><wi-fi><wireless fidelity><youngster>