Skip Navigation

SafeCare®

Yes (SafeCare Augmented only)

In Brief

Last Updated

August 2013

Top

Evidence of Program Model Effectiveness

An adaptation of SafeCare, called SafeCare Augmented, meets the criteria established by the Department of Health and Human Services (DHHS) for an “evidence-based early childhood home visiting service delivery model” for the general population, but does not meet the criteria for tribal populations.

SafeCare does not meet the DHHS criteria for the general population or for tribal populations.

Top

Program Model Description

SafeCare aims to prevent and address factors associated with child abuse and neglect among the clients served. Eligible clients include families with a history of child maltreatment or families at risk for child maltreatment. SafeCare was developed to offer a more streamlined and easy-to-disseminate program based on key components of its precursor, Project 12-Ways.

SafeCare typically provides 18 to 22 weeks of training to parents with children from birth to age 5. Trained SafeCare providers conduct 60- to 90-minute weekly or biweekly home visits focusing on three modules: (1) parent-child/parent-infant interactions, (2) infant and child health, and (3) home safety. Each SafeCare module typically includes a baseline assessment and observations of parental knowledge and skills, four parent training sessions, and a follow-up assessment to monitor change. During the parent trainings, SafeCare providers explain the rationale for a particular concept, model the concept, have the parent practice the steps, and then provide feedback. SafeCare providers are not required to meet specific education requirements.

Project 12-Ways, the precursor to SafeCare, provides twelve key services: (1) parent-child interaction support, (2) stress reduction for parents, (3) basic skills training for children, (4) money management training, (5) social support, (6) home safety training, (7) multisetting behavior management, (8) information on infant and child health and nutrition, (9) problem solving, (10) marital discord counseling, (11) alcohol abuse referral, and (12) a variety of pre- and post-natal prevention services for young and unwed mothers. Direct services are delivered to families in their homes by highly-trained counselors, most of whom are advanced graduate students with specialized training.

This report also includes reviews of four adaptations or enhancements to SafeCare: (1) SafeCare Augmented, (2) Project 12-Ways/SafeCare Plus a Home Safety Enhancement, (3) an Australian adaptation of University of California, Los Angeles (UCLA) Parent-Child Health and Wellness Project, and (4) Cellular Phone Enhanced Planned Activities Training.

SafeCare Augmented adds Motivational Interviewing—a technique that explores and builds on an individual’s motivation to change—and additional training of providers on the identification and response to imminent child maltreatment and risk factors, such as substance use and depression. SafeCare Augmented was adapted for high-risk, rural communities.

Project 12-Ways/SafeCare Plus a Home Safety Enhancement includes Project 12-Ways services and a Home Safety Education Package, with an audio slide-show containing information on hazards such as poisoning, suffocation, and firearms. Parents are also offered safety accessories, a review manual and stickers they could place on storage areas that were accessible to their children.

The Australian adaptation of the UCLA Parent-Child Health and Wellness Project adapted the UCLA Health and Safety interventions (based on SafeCare) for the Australian context (e.g., language was changed to reflect Australian usage). The goal of the intervention is to equip parents of young children with the knowledge and skills necessary for managing home dangers, accidents, and childhood illnesses. The intervention consists of 10 lessons over a 10- to 12-week period.

The core of Cellular Phone Enhanced Planned Activities Training (CPAT) is the parent training component of the SafeCare model. Mothers receive services during five home visiting sessions, focusing on skills such as engaging in positive interactions and establishing rules and limits. The cellular phone component of CPAT provides encouragement and skill reinforcement via text messages and phone calls.

For more information, please read the Program Model Overview.

Top

Extent of Evidence

Results of Search and ReviewNumber of Studies for SafeCare/Project 12-WaysNumber of Studies for SafeCare AugmentedNumber of Studies for Project 12-Ways/SafeCare Plus a Home Safety EnhancementNumber of Studies for Australian Adaptation of UCLA Parent-Child Health and Wellness ProjectNumber of Studies for Cellular Phone Enhanced Planned Activities Training
Released from 1979 to 2012 441112
Eligible for review 162111
     Rated high 11001
     Rated moderate 00110
     Rated low 150000
     Additional sourcesa 01000

aAdditional sources overlap with another study and are not rated.

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.

Top

Summary of Findings



SafeCare/Project 12-Ways
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 1
No effect: 3
Unfavorable or ambiguous: 0

Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 5
Unfavorable or ambiguous: 0

Positive Parenting Practices

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 4
No effect: 0
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

SafeCare Augmented
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness Not measured Not measured
Child Health Not measured Not measured
Family Economic Self-Sufficiency

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 4
Unfavorable or ambiguous: 0

Linkages and Referrals

Favorable: 1
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Maternal Health

Favorable: 0
No effect: 2
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 4
Unfavorable or ambiguous: 0

Positive Parenting Practices Not measured Not measured
Reductions in Child Maltreatment

Favorable: 1
No effect: 5
Unfavorable or ambiguous: 0

Favorable: 1
No effect: 5
Unfavorable or ambiguous: 0

Reductions in Juvenile Delinquency, Family Violence, and Crime

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 3
Unfavorable or ambiguous: 1


Project 12-Ways/SafeCare Plus a Home Safety Enhancement
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness Not measured Not measured
Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices

Favorable: 1
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

Australian Adaptation of UCLA Parent-Child Health and Wellness Project
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness Not measured Not measured
Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 24
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

Cellular Phone Enhanced Planned Activities Training
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 2
No effect: 6
Unfavorable or ambiguous: 0

Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 5
No effect: 5
Unfavorable or ambiguous: 0

Positive Parenting Practices

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 5
No effect: 3
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

Top

Criteria Established by the Department of Health and Human Services

 SafeCare/Project 12-WaysSafeCare AugmentedProject 12-Ways/SafeCare Plus a Home Safety EnhancementAustralian Adaptation of UCLA Parent-Child Health and Wellness ProjectCellular Phone Enhanced Planned Activities Training
Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study? YesYesYesYesYes
Across high- or moderate-quality studies, favorable impacts in…
 
   at least two outcome domains within one sample
 
   OR
 
   the same domain for at least two non-overlapping samples?
YesYesNoNoYes
Favorable impacts on full sample? YesYesYesNoYes
Any favorable impacts on outcome measures sustained at least 12 months after program enrollment?a NoYesNoNoNo
One or more favorable, statistically significant impact reported in a peer-reviewed journal?a NoYesYesYesNo

aThis information is reported for all program models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the DHHS Criteria for Evidence-Based Program Models for more information.

Top