Band-aid solutions

She has been a faculty member at Carnegie Mellon University; Director of the Division of Economic and Quantitative Analysis, Office of the Deputy Assistant Secretary for Planning and Evaluation, Department of Health and Human Services; and Director of the Office of Research in the Health Care Financing Administration. She is president of the Foundation for Health Services Research.     

Classroom training in sexual victimization awareness and prevention skills: An extension of the Red Flag/Green Flag people program

This study is an extension of a previous evaluation of a program (Red Flag/Green Flag) in which children, parents, and teachers were exposed to a workbook and film designed to teach personal safety strategies for preventing sexual victimization or encouraging adult assistance through disclosure of such incidents. In the current investigation, only children and their teachers received this didactic training program. Children and teachers from neighboring schools were assigned to a Training or Control group. Self-reports from children, teachers, and parents, as well as guidance counselor incident reports, were obtained to evaluate outcome. Results indicated greater gains in general knowledge and prevention skills at post-training and 6-month follow-up for trained than control children. Some improvements were made by trained teachers and parents of trained children. Child reports of personal experiences and guidance counselor incident reports were in accord with the assistance component of the program. However, the pattern of reports across sources is difficult to interpret. The findings are discussed in light of salient issues regarding the content of training, child disclosure, and methodology.     

Predictors of Early Engagement in Home Visitation

Predictors of engagement in mothers receiving home visitation in the first year of service was examined. Early engagement was studied in three ways: (1) length of time active in the program during the first year of service (duration), (2) number of visits received (quantity), and (3) gaps in service between visits (consistency). Examined visits received in 515 first-time mothers in a Healthy Families America (HFA) program. Parameters of engagement were investigated, and predictors of engagement were identified using demographics and the Kempe Family Stress Inventory. Inclusive of the Assessment Visit, 31.8% of mothers disengaged prior to the first month of service. Remaining active in the program was associated with being Caucasian, and increased parenting risk (mental health/substance abuse history, low social support, increased stress). Most mothers had fewer home visits than prescribed. Gaps in prescribed service were common, with 89.4% of mothers experiencing gaps between visits of 1 month, and dropping to 16.4% having gaps of 2 months. In contrast to findings from clinic-based interventions, early engagement in home visitation is associated with lower levels of functioning and acute needs. These findings add to a growing body of literature suggesting that increased adversity promotes engagement in prevention programs in general, and home visitation programs in particular. To the extent that mothers who are actively engaged in home visitation are likely to have increased psychosocial needs, curricula may require modification and augmentation to address these needs and optimize program effectiveness.