Department of Health and Human Services (SAMHSA)

Fostering Hope Initiative

The FHI initiative is a collaborative project to study the effects of concentrating services and increasing engagement in high-poverty communities on reducing family risk factors, increasing protective factors, and decreasing child maltreatment rates. The FHI was one of four Research and Demonstration projects selected by the Quality Improvement Center on Early Childhood (QIC-EC), a service of the Children’s Bureau, Administration for Children and Families, and the United States Department of Health and Human Services, for the purpose of generating and disseminating new knowledge and robust evidence about programs and strategies that contribute to child maltreatment prevention and optimal development for infants and young children, especially those at risk for child maltreatment.

Key to this ongoing initiative is collaboration among multiple agencies including health, mental health, social services, faith-based, and Latino community organizations, as well as the Oregon Department of Human Services (DHS). The evaluation includes a contractual agreement with DHS to obtain maltreatment and foster care data on an annual basis. The study funded by the QIC-EC employed a repeated measures, quasi-experimental design comparing selected outcomes between participants who received FHI services and families recruited from similar communities who did not receive coordinated FHI services. Participants were required to meet inclusion criteria defined by the Healthy Start/Healthy Families America home visiting model, in addition to meeting additional criteria set forth by the QIC-EC. Data collection included the administration of a comprehensive battery of assessments at intake and six-month intervals including the Adult-Adolescent Parenting Inventory-2 and the Parenting Stress Index which both assess parenting attitudes and behaviors, the Ages and Stages Questionnaires which addresses child development, and the Caregivers Assessment of Protective Factors, which is based on the Strengthening Families™ framework. Bilingual interviewers were trained to collect data in both English and Spanish across the multi-county service area, and this data collection effort has extended almost two years beyond QIC-EC funding. Extensive scheduling coordination and data management is required to meet the evaluation demands of this project.

A unique component of this study, collaborative partner members, parents/caregivers, and additional stakeholders engage in a developmental evaluation approach called Participatory Evaluation and Planning (PEP). PEP is a real-time, issue-focused data sharing partnership that supports implementation and facilitates outcome achievement. PEP combines participatory, utilization-focused evaluation methods with the Shewhart Cycle, a process for continuous quality improvement, to monitor implementation and progress toward program outcomes.

The child maltreatment prevention work being done through the FHI has received national attention. The project was recently selected to partner with The Center on the Developing Child at Harvard University, a leader in the design and implementation of innovative, research-based program and practice models that reduce preventable disparities in child well-being. Results from the QIC-EC funded evaluation conducted by PRE were published in the journal Zero to Three.


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