FRIDAY, June 25, 2004 (HealthDayNews) -- A popular program that uses home visits by paraprofessionals to encourage effective parenting in families at risk of child abuse does not prevent abuse or reduce known risk factors.
That's the conclusion of a Johns Hopkins Children's Center study in the June issue of the journal Child Abuse and Neglect.
The study recommended that the Healthy Start Program provide better training for its paraprofessionals and establish more coordination with community resources.
In 1991, the U.S. Advisory Board on Child Abuse and Neglect cited the Healthy Start Program as the most promising strategy for child-abuse prevention. It inspired hundreds of similar programs in 39 states.
For the new study, the researchers studied families -- mostly poor -- in Hawaii's Healthy Start Program.
The study identified maternal depression and domestic violence as factors most likely to predict physical abuse of a child by a mother. However, paraprofessionals visiting homes often failed both to identify these and other risk factors for child abuse and to direct families to appropriate community resources that could help them.
"Program leaders and staff were very passionate about their work and really believed they were preventing child abuse," principal investigator Anne Duggan, associate professor of pediatrics and of health policy and management, said in a prepared statement.
"But even the home visitors gave themselves better marks for promoting a positive outlook and building on strengths than on developing mothers' ability to solve problems, set and work toward goals, and establish support networks," Duggan said.
"We know from these results that addressing the physical difficulties related to living in poverty is not enough. Parental behavioral and mental health problems also must be addressed in order to make lasting improvements in child health and development," she said.
The American Academy of Pediatrics has more about child abuse and neglect.