Implementing SafeCare®

Entries in this row combine information across all versions of SafeCare except for SafeCare Augmented. The main version of SafeCare has no high- or moderate-quality impact studies. Some other versions of SafeCare have at least one such study, but no version of the model other than SafeCare Augmented meets HHS criteria for an evidence-based home visiting model. Planned Activities Training (a SafeCare module) and Cellular Phone Enhanced Planned Activities Training (a SafeCare module with an add-on) show evidence of effectiveness.

Last updated: May 2018

Model Overview

Implementation Support

The National SafeCare Training and Research Center (NSTRC), as part of the Mark Chaffin Center for Healthy Development at Georgia State University, provides training, technical assistance, implementation support, and quality assurance to all agencies and systems that deliver the SafeCare model.

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Theoretical Model

SafeCare is a structured parenting intervention that is designed to address the behaviors that can lead to child neglect and abuse. SafeCare is an adaptation of Project 12-Ways. SafeCare was developed to offer a more easily disseminated and streamlined intervention to parents at risk for child abuse and neglect, based on three key modules from Project 12-Ways.

The SafeCare parent training includes three modules: (1) Planned Activities Training, which focuses on parent-child/parent-infant interactions, (2) infant and child health, and (3) home safety. The model emphasizes learning in a social context and uses behavioral principles for parent training across the three modules. SafeCare Augmented, an enhanced version of SafeCare, adheres to the SafeCare model with additional training on Motivational Interviewing and domestic violence.

Project 12-Ways, the model on which SafeCare was based*, employs an ecobehavioral approach to the treatment and prevention of child abuse and neglect. Ecobehavioral refers to the multifaceted in-home services provided to families. As the name implies, Project 12-Ways offers training in twelve key topic areas: (1) parent-child interaction, (2) stress reduction for parents, (3) basic skills training for children, (4) money management training, (5) social support, (6) home safety training, (7) multi-setting behavior management, (8) 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.

*Project 12-Ways is described because studies of Project 12-Ways are included in the evidence base for SafeCare.

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Target Population

SafeCare, like its precursor Project 12 Ways, is designed for families with a history of child maltreatment or risk factors for child maltreatment, including young parents; parents with multiple children; parents with a history of depression or other mental health problems, substance use, or intellectual disabilities; foster parents; parents being reunified with their children; parents recently released from incarceration; and parents with a history of domestic violence or intimate partner violence. The model also serves parents of children with developmental or physical disabilities, or mental health, emotional, or behavioral issues. SafeCare is intended to complement the more specialized intervention services these families might be receiving from other agencies.

SafeCare is available to parents with children ages birth to 5 and has been used with culturally diverse populations.

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Targeted Outcomes

SafeCare aims to prevent and address factors associated with child abuse and neglect by offering services targeting improved health care skills, including identifying symptoms of illness or injury and seeking appropriate treatment; safety of the home environment; and parenting skills, including providing stimulating activities and positive parent-child interactions.

Project 12-Ways aims to reduce first-time, repeated, and recidivistic child abuse and neglect among clients by offering training in 12 distinct service areas (see the Theoretical Model section).

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Model Components

SafeCare, like its precursor Project 12-Ways, includes one-on-one home visits between providers and families. SafeCare includes three modules: (1) Planned Activities Training, (2) infant and child health, and (3) home safety. The Planned Activities Training module aims to teach parents to provide engaging and stimulating activities, increase positive interactions, and prevent troublesome child behaviors. The infant and child health module trains parents to use health reference materials, record health information, use basic health supplies (such as a thermometer), prevent illness, identify symptoms of childhood illnesses or injuries, and provide or seek appropriate treatment. The home safety module helps parents identify and eliminate safety and health hazards to children.

The three SafeCare modules typically involve a baseline assessment and observation of parental knowledge and skills, followed by four parent training sessions, and conclude with a follow-up assessment to monitor change. Providers use a four-step approach during the parent training sessions to address target behaviors: (1) describe and explain the rationale for each behavior, (2) model each behavior, (3) ask the parent to practice the behavior, and (4) provide positive and constructive feedback. This approach is designed to promote generalization of skills across time, behaviors, and settings.

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Model Intensity and Length

NSTRC recommends that SafeCare providers conduct weekly or biweekly home visits for approximately 50 to 90 minutes each.

SafeCare is typically delivered between 18 and 22 weeks, depending on parents’ progress and whether other services are integrated into SafeCare delivery. Providers work with parents until they meet a set of skill-based criteria established for each of three modules (infant and child health, home safety, Planned Activities Training).

Project 12-Ways addresses up to 12 topic areas over one year.

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NSTRC is part of the Mark Chaffin Center for Healthy Development in the School of Public Health at Georgia State University in Atlanta, Georgia. NSTRC has trained SafeCare providers in 25 states. Internationally, NSTRC has trained SafeCare providers in Australia, Belarus, Canada, Israel, Japan, Spain, Taiwan, and the United Kingdom.

Project 12-Ways has been implemented in southern Illinois for more than 30 years.

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Adaptations and Enhancements

SafeCare Augmented is an enhanced version of SafeCare that incorporates additional training for providers on Motivational Interviewing, and ongoing consultation for providers from local experts in substance use, mental health, and intimate partner violence. SafeCare Augmented has also been adapted for use with high-risk, rural families who do not have a long history of involvement with child welfare services.

Cellular Phone Enhanced Planned Activities Training is an add-on to SafeCare’s Planned Activities Training module that incorporates cellular telephones to promote family engagement between home visits. Specifically, providers send families daily text messages and occasional voice messages to encourage and remind them about newly learned parenting strategies.

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Implementation Notes

The information contained on this page was last updated in May 2018. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the National SafeCare Training and Research Center on April 13, 2018. HomVEE reserves the right to edit the profile for clarity and consistency.

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