Assignment Content1. Top of FormProfessional dispositions ha.docx

Assignment Content
1.
Top of Form
Professional dispositions have been defined as the “values,
commitments, and professional ethics that influence behavior
toward candidates, families, colleagues and communities and
affect candidate learning, motivation and development as well
as the educator’s own professional growth” (NCATE, 2000).
Dispositions can also be described as attitudes and beliefs about
counseling, as well as professional conduct and behavior. Not
all dispositions can be directly assessed, but aspects of
professional behavior are assessed during classes and field
experiences in counseling settings.
Review the Master of Science in Counseling Professional
Dispositions.
To prepare for professional dispositions assessments in this
program, write a 700 word paper in which you:
· Reflect on your personal strengths in connection to the
dispositions. Support your ideas with examples.
· Identify areas for personal growth in connection to the
dispositions. Support your ideas with examples.
· Outline an action plan for developing the identified areas for
personal growth.
· Describe why it is important to adhere to the dispositions.
How do they support professionalism in counseling? How do
they make a counselor effective?
Format your assignment according to course-level APA
guidelines.
Bottom of Form

The title for this Special Section is Developmental Research and
Translational
Science: Evidence-Based Interventions for At-Risk Youth and
Families, edited by
Suniya S. Luthar and Nancy Eisenberg
Processes of Early Childhood Interventions to Adult Well-Being
Arthur J. Reynolds, Suh-Ruu Ou, Christina F. Mondi, and
Momoko Hayakawa
University of Minnesota
This article describes the contributions of cognitive–scholastic
advantage, family support behavior, and school
quality and support as processes through which early childhood
interventions promote well-being. Evidence
in support of these processes is from longitudinal cohort studies
of the Child–Parent Centers and other pre-
ventive interventions beginning by age 4. Relatively large
effects of participation have been documented for
school readiness skills at age 5, parent involvement, K-12
achievement, remedial education, educational attain-
ment, and crime prevention. The three processes account for up
to half of the program impacts on well-being.
They also help to explain the positive economic returns of many
effective programs. The generalizability of
these processes is supported by a sizable knowledge base,
including a scale up of the Child–Parent Centers.
Growing evidence that early childhood experiences
can improve adult well-being and reduce educa-
tional disparities has increased attention to preven-

tion (Braveman & Gottlieb, 2014; Power, Kuh, &
Morton, 2013). Early disparities between high- and
low-income groups are evident in school readiness
skills, which increase substantially over time in
rates of achievement proficiency, delinquency, and
educational attainment (Braveman & Gottlieb, 2014;
O’Connell, Boat, & Warner, 2009). In this article, we
review evidence for three major processes by which
early childhood interventions (ECIs) promote well-
being and reduce problem behaviors. These are (a)
cognitive advantage, (b) family support behavior
(FS), and (c) school quality and support (SS).
The accumulated research widely supports these
processes as critical targets of preventive interven-
tions for children growing up in economically dis-
advantaged contexts. Our perspective on promoting
well-being is informed by three decades of studying
the Child–Parent Centers (CPC), a large-scale pro-
gram providing comprehensive education and fam-
ily services to low-income children from preschool
to third grade. CPC’s success in promoting well-
being and high economic returns is documented in
the Chicago Longitudinal Study (CLS), which has
tracked 1,500 families into adulthood. We also draw
on the accumulated life course research on the ben-
efits of primarily center-based ECIs, as well as con-
temporary programs and practices.
Consistent with prevention research, well-being
is used to describe the multidimensional outcomes
of ECI, including school achievement and attain-
ment, socioemotional development and mental
health, and health behavior. We regard well-being
as not just the absence of negative outcomes but

the presence of positive ones. Strengthening pro-
cesses can promote lifelong good health and reduce
the risk of social, emotional, and behavioral prob-
lems (O’Connell et al., 2009). We use the term pro-
cess to describe how ECI affects later well-being.
Documenting processes or mechanisms can
improve program design. Paths that are identified
can contribute to improvement efforts. Understand-
ing processes also can increase generalizability. If
Preparation of this article was supported in part by the
National Institute of Child Health and Human Development
Grant HD034294-21, the Office of Innovation, U.S. Department
of
Education (Grant U411B110098), matching grants to the U.S.
Department of Education, and the National Science Foundation
Graduate Student Fellowship Program. The views expressed are
those of the authors and not necessarily the funding agencies
Correspondence concerning this article should be addressed to
Arthur J. Reynolds, Institute of Child Development, University
of
Minnesota, 51 East River Road, Minneapolis, MN 55455. Elec-
tronic mail may be sent to [email protected]
© 2017 The Authors
Child Development © 2017 Society for Research in Child
Development, Inc.
All rights reserved. 0009-3920/2017/8802-0005
DOI: 10.1111/cdev.12733
Child Development, March/April 2017, Volume 88, Number 2,
Pages 378–387
results across studies share a common process,

expansion would be more likely to be successful.
Three Processes of ECI Impacts
In recognition of the complex array of factors dur-
ing and after program participation that account for
long-term effects, research has increasingly empha-
sized examination of a comprehensive set of child,
family, and school-related processes. This led to the
development of the 5-hypothesis model of interven-
tion (5HM; Reynolds, 2012). Derived from the accu-
mulated research on ECI over four decades, 5HM
posits that effects are explained by indicators of five
general paths of influence: cognitive–scholastic
advantage (CA), FS, SS, motivational advantage
(MA), and social adjustment (SA).
Because the major purpose of ECI is to promote
enduring effects into adulthood, the extent to which
this pattern is observed will depend on the magni-
tude of effects on one or more of the processes. As
shown in Figure 1, we emphasize the contributions
of CA, FS, and SS due to their strong evidence as
processes. The contributions of MA and SA are usu-
ally initiated by the other three. Space limitations
also necessitate this focus (see Ou & Reynolds,
2010; Reynolds, 2012). To be valid explanations,
paths must be independently associated with both
program and outcome measures. The hypotheses
could work in combination. For example, participa-
tion may affect parent involvement through early
CA, just as parent involvement and CA may link
directly to SS. Although substantial support exists
for the independent and combined influence of the
processes, the pattern is expected to vary depend-

ing on goals, program content (e.g., family vs. cen-
ter-based), and implementation fidelity. The
summary of evidence for the three processes, which
are not rank ordered, is followed by a review of
findings from a variety of interventions.
Cognitive–Scholastic Advantage
Effective ECIs provide systematic, activity-based
educational experiences that stimulate children’s
emerging cognitive, language, numeracy, and social
skills. All of these skills are necessary for optimal
school readiness. Decades of research have linked
participation in effective ECIs to CA and reductions
in the achievement gap among high-risk popula-
tions (Camilli, Vargas, Ryan, & Barnett, 2010; Rey-
nolds, 2012, p. 19). CA promotes effective and
smooth school transitions that provide cumulative
advantages in adjustment and performance by
enhancing later learning, increasing teacher expecta-
tions of performance, promoting school commit-
ment and stability in learning environments, and
SS
FS
CA
SS
FS
CA
Early Childhood

Age 3-9
Adult
Age 18-30
Program
Participation
Timing
Duration
Intensity
Adult Well Being
Target Child
-Educational Attainment
-Employment
-Avoidance of Crime
-Avoidance of Social
Welfare Services
-Psychological Well-
Being
-Health Status/Behavior
Parent
-Educational Attainment
-Employment
-Avoidance of Social
Welfare Services
-Mental HealthCA = Cognitive Advantage
FS = Family Support Behavior
SS = School Quality & Support
Exogenous

Conditions
Gender
Socio-Environmental
Risk
Neighborhood
Attributes
Developed Abilities
Cognitive Development
Language & Literacy
Math & Numeracy Skills
Family Support Behavior
Involvement in School
Parent Expectations
Home Support for Learning
Parenting Skills
School Quality and Support
Classroom & School Climate
School-Level Performance
Continuity in Learning
Early Childhood to Adolescence
Age 5-17
Figure 1. Three processes from early childhood intervention to
adult well-being. Adapted from 5-hypothesis model of
intervention
(5HM, Reynolds, 2012); motivational advantage (MA) and

social adjustment (SA) also contribute to impacts (see
Appendix).
Processes in Early Childhood 379
avoiding the need for remediation. The cumulative
benefits of CA was a key finding of the landmark
multisite Cornell Consortium for Longitudinal Stud-
ies (1983), in which participants in 11 ECI programs
experienced increases in cognitive and school readi-
ness skills by half a standard deviation (half a year
gain over controls). This culminated in reduced
remedial education and higher rates of school com-
pletion. Findings from the Abecedarian Project,
HighScope/Perry Preschool, and CPC consistently
show that participation is associated with CA and
achievement (Campbell et al., 2002; Reynolds, 2012;
Schweinhart et al., 2005). CA is also supported by
ECI meta-analyses documenting mid- to long-term
effects on achievement, socioemotional learning,
and delinquency (Camilli et al., 2010; Washington
State Institute for Public Policy [WSIPP], 2014).
In sum, graduates of high-quality ECIs tend to
exhibit CA relative to nonparticipating peers. Upon
school entry, they are more cognitively prepared,
motivated, and confident in their ability to succeed.
CA thus initiates a process of scholastic achievement
and commitment, which has in turn been linked to
well-being in other domains across the life span. For
example, children with greater CA upon school
entry have been found to exhibit higher levels of
social competence and lower rates of problem
behaviors, and are more likely to obtain high school

diplomas, college degrees, and steady employment
as adults (Power et al., 2013). Thus, the research in
this area has increasingly affirmed that “doing well”
in school is strongly predictive of “being well”—
psychologically, physically, and financially—in both
childhood and adulthood (Figure 1).
Family Support Behavior
The FS process indicates that longer term effects
of ECI will occur to the extent that participation
enhances parenting skills, attitudes, and expecta-
tions, and involvement in children’s education (Ou
& Reynolds, 2010; Reynolds, Ou, & Topitzes, 2004).
The main factors examined are parent involvement
in school, parent expectations for achievement, and
support for learning at home. Parenting behaviors
lead to improved well-being (e.g., achievement) by
increasing children’s learning time directly (reading
with parents, higher school attendance) or indi-
rectly (parental monitoring), enhancing children’s
motivation and school commitment, and increasing
expectations for attainment and success. They also
improve social support and parenting skills, which
reduce social isolation and the risk of child mal-
treatment. Meta-analyses of family interventions
and parenting behaviors (Farrington & Welsh, 2007;
Jeynes, 2007) show that involvement and monitor-
ing link to higher achievement and delinquency
prevention.
Previous CPC research supports the critical role
of FS—and especially parent involvement—in pro-
moting children’s academic success and long-term
well-being. Using longitudinal CPC data, Haya-

kawa, Englund, Warner-Richter, and Reynolds
(2013) reported that parent involvement influenced
continued achievement via two major pathways.
First, early parent involvement predicted later par-
ent involvement, such that parents who were
highly involved in kindergarten were likely to con-
tinue their high levels of involvement throughout
the elementary grades. Second, parent involvement
in school influenced children’s school motivation,
which in turn impacted achievement. These results
suggest that parents’ sustained involvement across
the elementary years initiates a cumulative process
that continues to foster children’s motivation and
subsequent parent involvement, which both influ-
ence school achievement.
Further evidence on the importance of FS in fos-
tering well-being comes from home visiting and
parenting interventions, including Nurse–Family
Partnership, Family Check-Up, and Parents as
Teachers (Avellar & Supplee, 2013). In a large-scale
Parents as Teachers study, Zigler, Pfannenstiel, and
Seitz (2008) found that significant improvements in
third-grade achievement for a state sample were
initiated by parental home literacy and school
readiness skills, both of which were further
impacted by preschool participation. This suggests
the reinforcing influences of FS and CA. Other par-
enting and home visiting programs generally sup-
port these findings (Avellar & Supplee, 2013; Sweet
& Appelbaum, 2004), though mixed effects are also
reported. The strongest impacts occur for high-need
families at relatively high levels of dosage.
In another CPC study, FS, as measured by par-
ent involvement in school and avoidance of later

child maltreatment, was found to mediate the
effects of preschool on educational attainment,
crime, and health behaviors (Reynolds & Ou, 2011).
Increased parent involvement in school led to
greater school commitment and student achieve-
ment, which in turn reduced the incidence of child
maltreatment. The generalizability of these results is
supported by research from three different ECIs,
each of which identified parent involvement as a
contributing path from ECI to educational attain-
ment (Abecedarian, Perry, CPC; Englund, White,
Reynolds, Schweinhart, & Campbell, 2014).
380 Reynolds, Ou, Mondi, and Hayakawa
School Quality and Support
In this process, intervention effects are expected
to persist as a function of attending schools of suf-
ficient quality and enrichment. Key indicators of
SS include aggregate achievement, student school
stability, and school climate (Bogard & Takanishi,
2005; Kyriakides et al., 2013; Reynolds et al., 2004).
SS provides the developmental continuity neces-
sary to sustain preschool gains by increasing the
duration, predictability, and stability of enriching
postprogram learning environments. Families are
likely to value and seek out schools that match the
quality and climate of children’s preschool pro-
gram (Reynolds, 2012). ECI gains are more sus-
tained in the presence of this learning environment
(Campbell et al., 2002; Englund et al., 2014; Rey-
nolds, Magnuson, & Ou, 2010). Evidence indicates
that attendance in schools with relatively high per-

centages of proficient achievers positively affects
school climate, performance expectations, and peer
norms (Jennings & Greenberg, 2009; Kyriakides
et al., 2013; Pianta, 2005). School mobility, espe-
cially if frequent, creates learning discontinuities
that hinders the maintenance of a positive and pre-
dictable environment (Takanishi & Kauerz, 2008).
These discontinuities can be reduced and counter-
acted by ECI (Bogard & Takanishi, 2005; Reynolds,
2012).
Previous studies have indicated that the benefits
of Head Start participation are more strongly sus-
tained if participants attend more supportive and
higher quality elementary schools (Currie & Tho-
mas, 2000; Lee & Loeb, 1995; Redden et al., 2001).
These results parallel studies showing that
enhanced elementary-grade services (e.g., smaller
classes and greater instructional time) add to and
sustain the benefits of earlier intervention (Finn,
Suriani, & Achilles, 2010; Mashburn, 2015; Rey-
nolds, Magnuson, et al., 2010). These links have
also been corroborated in the findings for children
attending CPCs. For example, continued enrollment
in higher quality schools mediates the relation
between participation and school achievement and
attainment (Reynolds, Englund, et al., 2010; Rey-
nolds & Ou, 2011).
School mobility is a negative indicator of the
continuity in learning environments that has been
frequently associated with lower school perfor-
mance and higher levels of school dropout and
behavioral problems (Han, 2014; Reynolds, Chen, &
Herbers, 2009). Recent studies have found that
school mobility is associated with adjustment and

mental health difficulties (Gruman, Harachi,
Abbott, Catalano, & Fleming, 2008), because it may
break social ties that increases the risk of later prob-
lem behaviors.
Most prior studies indicate that frequent mobility
is associated with lower school achievement and
problem behaviors, and this impact holds after
many individual and family differences are taken
into account. Participation in high-quality preschool
promotes school stability and support (Bogard &
Takanishi, 2005; Englund et al., 2014; Schweinhart
et al., 2005), which helps maintain learning gains.
Mobility has also been found to mediate preschool
effects on early adult well-being (Englund et al.,
2014; Reynolds et al., 2009; Reynolds, Englund,
et al., 2010), as school-stable children are more
likely to remain in better schools, as well as avoid
remediation and delinquency.
In the next section, we describe the background
and impacts of the CPC program and other ECIs
that promote the three processes of influences. This
is followed by a breakdown of the magnitude of
the influence of the processes in accounting for
effects on long-term well-being.
Effects of CPC Intervention
The CPC program opened in 1967 with funding
from Title I of the Elementary and Secondary Edu-
cation Act to counteract the negative effects of pov-
erty on school success. The 25 CPCs were located
in the highest poverty neighborhoods in Chicago,
in which 7 in 10 families are low income. Common

problems were high rates of absenteeism and low
achievement.
As the second oldest federally funded preschool
program, CPC provides comprehensive educational
and family support services to children within a
developmentally appropriate ecological framework
(Reynolds, 2012; Sullivan, 1971). The program is
implemented in centers that are directed by a head
teacher; a parent-resource teacher, who manages the
parent-resource room; and a school-community repre-
sentative to connect families with health and social
services. Core program principles include a school-
based structure, a strong emphasis on literacy, the
use of child-focused instructional approaches, and
strengthening the family–school relationship. To
maximize individual learning opportunities, pre-
school class sizes are small (average teacher to child
ratio is 2 to 17). Comprehensive parent involvement
included a variety of home- and school-based
approaches. Services are provided from preschool
to third grade.
Research on CPC effectiveness is based on many
cohorts of graduates and a diverse set of studies,
including the Chicago Longitudinal Study (2005).
The CLS is an ongoing prospective study of a com-
plete cohort of 989 children who attended 20 CPCs,
as well as a matched comparison group of 550
same-age children who attended publicly funded
full-day kindergarten in five randomly selected
schools. The groups were equivalent on child and

family characteristics, and many analyses assessing
robustness (e.g., propensity score and latent vari-
able approaches) support internal validity (Rey-
nolds & Ou, 2011; Reynolds, Temple, Ou, Arteaga,
& White, 2011). Over 90% of the groups have been
followed successfully from kindergarten to adult-
hood. Evidence from CPC studies meet the rigorous
standards of the What Works Clearinghouse and
many other registries of effectiveness (Reynolds &
Temple, 2008; Reynolds, Temple, Ou, et al., 2011).
The performance of CPC preschool participants
consistently exceeded that of the comparison group
on many indicators of well-being, from the begin-
ning of kindergarten through early adulthood.
Although effect sizes (ES) varied by outcome, most
exceeded .20 SD, which translate to substantial
social benefits (see Appendix S1). For example, the
program’s initial effect on cognitive skills
(ES = .63 SD) at age 5 contributed to a cumulative
advantage on later well-being. Program-related
reductions in special education placement
(ES = �.45 SD) and grade retention (ES = �.37 SD)
as well as lower rates of delinquency and crime are
indicative of significant economic benefits. For
example, by age 24 the preschool group had a 22%
lower rate of felony arrest than the comparison
group (16.5% vs. 21.1%, respectively). The educa-
tional and crime prevention benefits also carry over
to mental health, as CPC graduates had lower rates
of depressive symptoms in early adulthood (12.8%
vs. 17.4%; ES = .20 SD or a 26% reduction). Benefi-
cial effects were not detected for classroom adjust-
ment, perceived competence, or overall college
attendance (Ou & Reynolds, 2010; Reynolds, 2012).

Effects of Other ECIs
Although there is a large literature on the effects of
ECIs, only a few studies have tracked participants
into adulthood. We highlight studies examining the
effects of five programs on school achievement,
educational attainment, and crime prevention. They
illustrate the three processes of long-term effects.
Findings from the Abecedarian Project, Perry
Preschool, and the Cornell Consortium show ES on
school achievement ranging from one third to three
fourths of a standard deviation. These are consis-
tent with the ES of CPC and state prekindergarten
programs (Camilli et al., 2010). A similar pattern of
findings was found for high school completion and
years of education (Reynolds & Temple, 2008).
Perry Preschool, a panel study of Head Start
(Garces, Currie, & Thomas, 2002), and Nurse–Fam-
ily Partnership (Eckenrode et al., 2010) also found
reductions in criminal behavior of 30%–40%, which
also match those from CPC. This latter effect is lar-
gely attributable to reductions in child maltreat-
ment. Reductions in health compromising behavior
and mental health problems have also been
observed (Englund et al., 2014; O’Connell et al.,
2009; Ou & Reynolds, 2010). Overall, these findings
show that high-quality ECIs enhance participants’
well-being across a range of contexts and over time.
Some shorter term studies (e.g., Early Head Start,
Head Start) have found few gains (O’Connell et al.,
2009), which may be a function of dosage, fidelity,
attrition, and levels of family and school support
(Reynolds, Temple, Ou, et al., 2011).
Summary of Processes of Influence

We summarize the contributions of the three pro-
cesses of CPC and related programs for four youth
and adult outcomes using the percentage contribu-
tion of each process to the total indirect (mediated)
effect (see Appendices S2–S4; Reynolds & Ou,
2011). The findings are based on structural equa-
tion modeling of longitudinal associations in which
measurement error, multiple indicators of each pro-
cess, and alternative specifications are taken into
account. After adjusting for gender, family risk, and
the influence of other processes, CA-initiated path-
ways involving early achievement and need for
remedial education accounted for 19%–40% of the
indirect effect. These are sizable contributions, both
direct and indirect, in good-fitting models. FS-
initiated pathways, which included parent involve-
ment in school and avoidance of child maltreat-
ment, independently accounted for 18%–26% of the
indirect effects. SS paths, measured by school qual-
ity and frequent mobility, accounted for 27%–50%
of the indirect effect of preschool (see Appendices
S5 and S6). Domain crossover was evident as FS
and SS accounted for sizable shares of impacts on
arrests. Impacts on felony arrest were mediated by
the number of school moves alone (bs = �.13 [pro-
gram to moves] and .09 [moves to arrest]) and by
paths involving parent involvement, school mobil-
ity, and high school completion (Appendices S3
and S6). CA and SS accounted for substantial
shares of impacts to adult depressive symptoms.

With regard to depressive symptoms, the major-
ity of the indirect effect of CPC was attributable to
paths initiated and contributed by CA, FS, and SS.
CA showed the largest contribution. Similar to the
other outcomes, one process was that the early CA
advantage (b = .36) carried over to promote greater
parent involvement (b = .19) and attendance in
higher quality schools (b = .24), which lowered
rates of delinquency (b = �.12) and improved the
likelihood of school completion (b = .18), leading to
lower rates of depressive symptoms (Appendix S6).
SS was the largest contributor to juvenile arrest,
whereas the three processes made equal contribu-
tions to high school completion and felony arrest.
A similar pattern of findings has been found for
school achievement and occupational attainment.
Studies have also used structural equation modeling
to strengthen validity. Reanalyses of the Perry, Abe-
cedarian, and CPC programs (Englund et al., 2014;
Reynolds, Englund, et al., 2010), which included
matched measures and sequences of each process,
revealed that the processes accounted for a majority
of the observed impacts on educational attainment
and health behaviors at age 21 (see also
Appendix S7). The studies also showed that class-
room SA helped transmit the effects of CA. CA con-
tributed more to long-term effects for Perry and
Abecedarian, whereas FS and SS influences were
larger for CPC. In both Perry and CPC, the number
of school moves was predicted by program partici-
pation (bs = �.11 and �.17) and directly linked to
juvenile arrest (bs = .20 and .12, respectively). Many
studies also show that the sustainability of effects
in ECI and prevention programs is strengthened by

SS (Jennings & Greenberg, 2009; Mashburn, 2015;
Redden et al., 2001).
Feasibility and Cost Effectiveness at a Larger
Scale
Our review of the three processes shows their posi-
tive direct and indirect contributions to many indi-
cators of well-being. These provide a strong
foundation for expanding effective ECIs that target
these processes. For example, because FS is an
established influence on children’s outcomes, a vari-
ety of interventions (e.g., center-based, family-
based) are being expanded as two-generational
approaches (Avellar & Supplee, 2013). The No
Child Left Behind Act also mandates that schools
develop parent involvement and engagement plans.
Parallel efforts to improve school quality through
curricular reforms, increased alignment of instruc-
tion, and small classes also are feasible and scalable.
Expanding access to effective programs can provide
cumulative advantages, which lead to enhanced
well-being in multiple domains.
ECIs that operate by promoting CA, FS, and SS
also show high economic returns (O’Connell et al.,
2009). Table 1 shows the results of cost–benefit
analyses for three programs: Abecedarian, Perry,
and CPC. Although studies vary dramatically in
cost per child and in age of measurement, each pro-
gram demonstrates a positive economic return with
regard to cost savings in remediation and increases
in economic well-being due to higher levels of edu-
cation. Abecedarian showed a return of roughly 3
dollars per dollar invested, CPC 7–11 dollars, and

Perry 9–16 dollars (Barnett & Masse, 2007; Reynolds
& Temple, 2008; Reynolds, Temple, White, Ou, &
Robertson, 2011; Schweinhart et al., 2005). The
Table 1
Benefit–Cost Findings of Selected Early Childhood
Interventions (2012 Dollars)
Program Program scale Age at follow-up
Program cost
per child ($)
Total benefits to
society per child ($) Benefit–cost ratio
Abecedarian project Model 21 53,495 172,988 3.23
Chicago CPC Preschool-1 Large 21 9,426 67,271 7.14
Chicago CPC Preschool-2 26 9,426 102,117 10.83
Perry Preschool-1 Model 27 20,221 176,740 8.74
Perry Preschool-2 40 20,221 326,407 16.14
WSIPP (2014) meta-analysis Large 4–17 6,974 29,210 4.20
Values were converted for the original studies to 2012 dollars
using the Consumer Price Index for Urban Workers (CPI-U).
Studies were
as follows: Abecedarian (Barnett & Masse, 2007), Child–Parent
Center (CPC; Reynolds et al., 2002; Reynolds, Temple, White,
et al.,
2011), and Perry (Schweinhart et al., 2005). Washington State
Institute for Public Policy (WSIPP) meta-analysis included 49
studies of
state and school district programs.

benefits were also spread among many outcome
domains.
A meta-analysis of 49 state and school districts
programs (WSIPP, 2014), primarily for children
from economically disadvantaged contexts, shows a
projected return of roughly four dollars per dollar
invested, in large part because of early enrichments
in cognitive and scholastic development, parent
involvement, and socioemotional learning. This
indicates that implementation at larger scales can
provide sizable economic benefits provided that
program quality is relatively high. As shown in
Table 1, the cost per child to achieve positive
returns is lower than that of model programs.
Generalizability Across Child, Family, and
Community Contexts
The CPC program has been recently expanded to
serve children from diverse ethnic backgrounds
(e.g., Latinos, Hmong refugees) and other under-
studied groups. With funding from the U.S. Depart-
ment of Education’s Office of Innovation, the
Midwest CPC Expansion preschool to third-grade
intervention is presently located at more than 30
urban and metropolitan schools in Illinois and Min-
nesota. A cohort of over 2,500 program and 1,300
comparison-group students in four districts is being
followed to third grade. The comparison group par-
ticipated in the usual preschool programs for 3-
and 4-year-olds, and attended 25 schools that were
matched to program schools on propensity scores
of economic disadvantage. School achievement and
adjustment, and parent involvement are the pri-

mary outcomes of investigation. The six core ele-
ments of the program are collaborative leadership,
effective learning experiences, aligned curriculum,
parent involvement and engagement, professional
development, and continuity and stability. They are
tailored to the needs of each school and commu-
nity. The program manual (Reynolds, Hayakawa,
Englund, Candee, 2016) describes the CPC imple-
mentation system and the larger evidence base (see
also Hayakawa et al., 2015; Temple Reynolds,
2015).
Initial findings show that Chicago and Saint Paul
implementation in 2012–2013 have effects on school
readiness and parent involvement in school that are
similar to CPC implemented in the 1980s (Reynolds
et al., 2014). This pattern was observed in the pres-
ence of a significantly enhanced program in which
baseline performance was equivalent and compar-
ison groups received existing school-based
preschool (i.e., state preschool or Head Start). For
example, full-day compared to part-day preschool
in the same schools was linked to higher rates of
meeting school readiness norms (81% vs. 59%) at
the end of preschool and lower rates of chronic
absence (21% vs. 38%; Reynolds et al., 2014). Rela-
tive to participants in the usual preschool program,
a substantially greater percentage of Chicago CPC
participants met school readiness norms at the end
of the year (70% vs. 52%; Reynolds et al., 2016).
These effects indicate the continued feasibility and
effectiveness of the program across contexts. Other
high-quality state and local programs show similar
patterns of effectiveness (e.g., Camilli et al., 2010;
WSIPP, 2014).

It will be important to assess effects on ethnic
and geographic subgroups. The original CLS sam-
ple was nearly all African American. Although this
sample was representative of urban poverty, it does
not reflect other types of contexts. The CPC pro-
gram generally exerts its strongest effects on boys
and children affected by the highest levels of
sociodemographic risk (Ou & Reynolds, 2010; Rey-
nolds, Temple, White et al., 2011). Girls benefit
more from school-age intervention (Reynolds, Tem-
ple, Ou, et al., 2011; Reynolds, Temple, White,
et al., 2011). Impacts of extended intervention are
similar for most groups.
Limitations of Knowledge
Although the processes substantially explained
impacts on well-being, three limitations should be
noted. First, studies primarily examined educational
outcomes. Only a few have examined mental
health, crime, and health behaviors. Individual pro-
cesses may play different roles depending on the
outcome and age of measurement. Further research
is warranted.
Second, few studies have examined several pro-
cesses together within a comprehensive model.
The contributions of each process may vary by
individual indicators and across programs and
social contexts. Social and motivational factors, for
example, may play significant yet complex roles.
More extensive longitudinal studies into adulthood
are needed. Although distinct, the processes are
correlated and should be interpreted within the
full model specification and program theory. Find-

ings from life course studies show the relative
strength of the three processes. Alternative pro-
cesses across a wide range of studies also warrant
greater attention.
Finally, the three processes reviewed in our arti-
cle have not been fully assessed for particular child
and family subgroups, such as family economic sta-
tus, different racial and ethnic groups, and for dif-
ferent levels of risk. The magnitude of influence for
each will depend on the level of variation observed,
which will be affected by child and family risk fac-
tors. However, the accumulated research in human
development and health sciences (Braveman & Got-
tlieb, 2014; O’Connell et al., 2009) is consistent with
the findings of our review.
Conclusion
Strengthening programs and sustaining their effects
are key contributions of processes. Given the impor-
tance of entering kindergarten and the early grades
proficient in multiple domains, it is expected that
improving the quality of programs and increasing
their length and intensity will strengthen the paths
to well-being. Program features such as well-trained
teachers and small classes are key sources of
impacts and economic benefits (Table 1). The provi-
sion of comprehensive services can broaden the
paths of influence necessary for sustained effects.
Our review supports the generalizability of the pro-
cesses in promoting well-being. A range of inter-

ventions that impact these processes would be
expected to positively contribute. These could be
independent or complementary of ECI. For exam-
ple, interventions that prevent child maltreatment
may exert longer term effects on health and well-
being by impacting juvenile delinquency, school
achievement, and need for remedial education. The
processes reviewed can promote sustained effects of
intervention. Their reproducibility in a variety of
contexts will help ensure that the demonstrated
benefits of ECI can be effectively scaled.
References
Avellar, S. A., & Supplee, L. H. (2013). Effectiveness of
home visiting in improving child health and reducing
child maltreatment. Pediatrics, 132(Suppl. 2), S90–S97.
doi:10.1542/peds.2013-1021G
Barnett, W. S., & Masse, L. N. (2007). Comparative bene-
fit-cost analysis of the Abecedarian program and its
policy implications. Economics of Education Review, 26,
113–125. doi:10.1016/j.econedurev.2005.10.007
Bogard, K., & Takanishi, R. (2005). PK-3: An aligned and coor-
dinated approach to education for children 3 to 8 years old.
Social Policy Report, XIX, No. III. Washington, DC: SRCD.
Braveman, P., & Gottlieb, L. (2014). The social determi-
nants of health: It’s time to consider the causes of the
causes. Public Health Reports, 129(Suppl. 2), 19–31.
Camilli, G., Vargas, S., Ryan, S., & Barnett, W. S. (2010).
Meta-analysis of the effects of early education interven-
tions on cognitive and social development. Teachers Col-
lege Record, 112, 579–620.

Campbell, F., Ramey, C. T., Pungello, E. P., Sparling, J. J.
& Miller-Johnson, S. (2002). Early childhood education:
Young adult outcomes from the Abecedarian project.
Applied Developmental Science, 6, 42–57. doi:10.1207/
S1532480XADS0601_05
Chicago Longitudinal Study. (2005). User’s guide (ver. 7).
Minneapolis, MN: University of Minnesota.
Consortium for Longitudinal Studies. (1983). As the twig
is bent. . .lasting effects of preschool programs. Hillsdale,
NJ: Erlbaum.
Currie, J., & Thomas, D. (2000). School quality and the
longer-term effects of Head Start. The Journal of Human
Resources, 35, 755–774. Retrieved from http://www.
jstor.org/stable/pdfplus/146372
Eckenrode, J., Campa, M., et al. (2010). Long-term effects
of prenatal and infancy nurse home visitation on the
life course of youths: 19-year follow-up of a random-
ized trial. Archives of Pediatrics and Adolescent Medicine,
164, 9–16. doi:10.1001/archpediatrics.2009.240
Englund, M. M., White, B., Reynolds, A. J., Schweinhart,
L. J., & Campbell, F. A. (2014). Health outcomes of
early childhood interventions: A 3-study analysis. In A.
J. Reynolds, A. J. Rolnick, J.A. Temple. Health and educa-
tion in early childhood (pp. 257–292). New York, NY:
Cambridge.
Farrington, D. P., & Welsh, B. C. (2007). Saving children
from a life of crime. New York, NY: Oxford University
Press.

Finn, J. D., Suriani, A., & Achilles, C. (2010). Small classes
in the early grades: One policy, multiple outcomes. In
A. J. Reynolds, A. J. Rolnick, M. M. Englund & J. A.
Temple et al. (Eds.), Childhood programs and practices in
the first decade of life (pp. 287–308). New York, NY:
Cambridge University Press.
Garces, E., Currie, J., & Thomas, D. (2002). Longer-term
effects of Head Start. American Economic Review, 92,
999–1013. doi:10.1257/00028280260344560
Gruman, D. H., Harachi, T. W., Abbott, R. D., Catalano,
R. F., & Fleming, C. B. (2008). Longitudinal effects of
student mobility on three dimensions of elementary
school engagement. Child Development, 79, 1833–1852.
doi: 10.1111/j.1467-8624.2008.01229.x
Han, S. (2014). School mobility and students’ academic
and behavioural outcomes. International Journal of Edu-
cation Policy & Leadership, 9, 1–14. Retrieved from
www.ijepl.org
Hayakawa, C. M., Englund, M. M., Candee, A., Lease, E.,
Sullivan, M., Warner-Richter, M., & Reynolds, A. J.
(2015). Effective partnerships in school reform: Lessons
learned from the Midwest Child-Parent Center
http://dx.doi.org/10.1542/peds.2013-1021G
http://dx.doi.org/10.1016/j.econedurev.2005.10.007
http://dx.doi.org/10.1207/S1532480XADS0601_05
http://dx.doi.org/10.1207/S1532480XADS0601_05
http://www.jstor.org/stable/pdfplus/146372
http://www.jstor.org/stable/pdfplus/146372
http://dx.doi.org/10.1001/archpediatrics.2009.240

http://dx.doi.org/10.1257/00028280260344560
http://dx.doi.org/10.1111/j.1467-8624.2008.01229.x
http://www.ijepl.org
Expansion. Journal of Education of Children Placed at Risk,
20, 263–280.
Hayakawa, M., Englund, M. M., Warner-Richter, M. N.,
& Reynolds, A. J. (2013). The longitudinal process of
early parent involvement on student achievement: A
path analysis. National Head Start Association Dialog, 16,
103–126.
Jennings, P. A., & Greenberg, M. T. (2009). The prosocial
classroom: Teacher social and emotional competence in
relation to student and classroom outcomes. Review of
Educational Research, 79, 491–525. doi:10.3102/0034654
308325693
Jeynes, W. H. (2007). The relationship between parental
involvement and urban secondary school student aca-
demic achievement. Urban Education, 41, 82–110. doi:10.
1177/0042085906293818
Kyriakides, L., et al. (2013). What matters for student
learning outcomes: A meta-analysis of studies exploring
factors of effective teaching. Teaching & Teacher Educa-
tion, 36, 143–152. doi:10.1016/j.tate.2013.07.010
Lee, V. E., & Loeb, S. (1995). Where do Head Start atten-
dees end up? One reason why preschool effects fade
out. Educational Evaluation and Policy Analysis, 17, 62–
82. doi:10.2307/1164270
Mashburn, A. (2015). Maintaining the impact of Head Start

on children’ long-term development. Paper presented at
the National Invitational Conference on Sustaining
Early Childhood Gains, Federal Reserve Bank of Min-
neapolis, Minneapolis, MN.
O’Connell, M. E., Boat, T., & Warner, K. E. (Eds.). (2009).
Preventing mental, emotional, and behavioral disorders
among young people: Progress and possibilities. Washing-
ton, DC: NAP.
Ou, S., & Reynolds, A. J. (2010). Mechanisms of effects of
an early intervention program on educational attain-
ment: A gender subgroup analysis. Children & Youth
Services Review, 32, 1064–1076. doi:10.1016/j.childyouth.
2009.10.020
Pianta, R. C. (2005). A new elementary school for Ameri-
can children. SRCD Social Policy Report, 19, 4–5.
Power, C., Kuh, D., & Morton, S. (2013). From develop-
mental origins of adult disease to life course research
on adult disease and aging: Insights from birth cohort
studies. Annual Review of Public Health, 34, 7–28. doi:10.
1146/annurev-publhealth-031912-114423
Redden, S. C., Forness, S. R., Ramey, S. L., Ramey, C. T.,
et al. (2001). Children at risk: Effects of a four-year
Head Start Transition program on special education
identification. Journal of Child and Family Studies, 10,
255–270. doi:10.1023/A:1016659710619
Reynolds, A. J. (2012). Success in early intervention: The Chi-
cago Child-Parent Centers program and youth through age 15
(2nd ed.). Lincoln, CA: University of Nebraska Press.
Reynolds, A. J., Chen, C., & Herbers, J. (2009). School

mobility and educational success: A research synthesis and
evidence on prevention. Washington, DC: National
Research Council.
Reynolds, A. J., Englund, M., Ou, S., et al. (2010). Paths
of effects of preschool participation to educational
attainment at age 21: A 3-study analysis. In A. J. Rey-
nolds, A. J. Rolnick, M. M. Englund & , J. A. Temple,
Childhood programs & practices in the first decade of life
(pp. 415–452). New York, NY: Cambridge.
Reynolds, A. J., Hayakawa, M, Candee, A. J., & Englund,
M. M. (2016). CPC P-3 Program Manual: Child-Parent
Center Preschool-3rd Grade Program. Minneapolis: Human
Capital Research Collaborative, University of Min-
nesota.
Reynolds, A. J., Magnuson, K., & Ou, S. (2010). PK-3 pro-
grams and practices: A review of research. Children and
Youth Services Review, 32, 1121–1131. doi:10.1016/j.child
youth.2009.10.017
Reynolds, A. J., Hayakawa, M., Candee, A. J., & Englund,
M. M. (2016). CPC P-3 Program Manual: Child-Parent
Center Preschool-3rd Grade Program. Minneapolis: Human
Capital Research Collaborative, University of Minne-
sota.
Reynolds, A. J., & Ou, S. (2011). Paths of effects from pre-
school to adult well-being: A confirmatory analysis of
the Child-Parent Center program. Child Development,
82, 555–582. doi:10.1111/j.1467-8624.2010.01562.x
Reynolds, A. J., Ou, S., & Topitzes, J. (2004). Paths of
effects of early childhood intervention on educational
attainment and juvenile arrest: A confirmatory analysis

of the Chicago Child-Parent centers. Child Development,
75, 1299–1328. doi:10.1111/j.1467-8624.2004.00742.x
Reynolds, A. J., & Temple, J. A. (2008). Cost-effective
early childhood development programs from preschool
to third grade. Annual Review of Clinical Psychology, 4,
109–139. doi:10.1146/annurev.clinpsy.3.022806.091411
Reynolds, A. J., Temple, J. A., Robertson, D. L., & Mann,
E. A. (2002). Age 21 cost-benefit analysis of the Title I
Chicago Child-Parent Centers. Educational Evaluation
and policy Analysis, 24, 267–303. doi:10.3102/
01623737024004267
Reynolds, A. J., Temple, J. A., Ou, S., Arteaga, I. A., &
White, B. A. B. (2011). School-based early childhood
education and age 28 well-being: Effects by timing,
dosage, and subgroups. Science, 333, 360–364. doi: 10.
1126/science.1203618
Reynolds, A. J., Temple, J. A., White, B. A., Ou, S., &
Robertson, D. L. (2011). Age-26 cost-benefit analysis of
the Child-Parent Center program. Child Development,
82, 782–804. doi:10.1111/j.1467-8624.2010.01563.x
Reynolds, A. J., Richardson, B. A., Hayakawa, M., Lease,
E. M., Warner-Richter, M., Englund, M. M., . . .
Sullivan, M. (2014). Association of a full-day versus
part-day preschool intervention with school readiness,
attendance, and parent involvement. JAMA, 312, 2126–
2134. doi:10.1001/jama.2014.15376
Reynolds, A. J., Richardson, B. A., Hayakawa, M., Eng-
lund, M. M., & Ou, S. (2016). Multi-site expansion of an
early childhood intervention and school readiness.
Pediatrics, 138. e20154587. doi:10.1542/peds.2015-4587

http://dx.doi.org/10.3102/0034654308325693
http://dx.doi.org/10.3102/0034654308325693
http://dx.doi.org/10.1177/0042085906293818
http://dx.doi.org/10.1177/0042085906293818
http://dx.doi.org/10.1016/j.tate.2013.07.010
http://dx.doi.org/10.2307/1164270
http://dx.doi.org/10.1016/j.childyouth.2009.10.020
http://dx.doi.org/10.1146/annurev-publhealth-031912-114423
http://dx.doi.org/10.1146/annurev-publhealth-031912-114423
http://dx.doi.org/10.1023/A:1016659710619
http://dx.doi.org/10.1111/j.1467-8624.2010.01562.x
http://dx.doi.org/10.1111/j.1467-8624.2004.00742.x
http://dx.doi.org/10.1146/annurev.clinpsy.3.022806.091411
http://dx.doi.org/10.3102/01623737024004267
http://dx.doi.org/10.3102/01623737024004267
http://dx.doi.org/10.1126/science.1203618
http://dx.doi.org/10.1126/science.1203618
http://dx.doi.org/10.1111/j.1467-8624.2010.01563.x
http://dx.doi.org/10.1001/jama.2014.15376
http://dx.doi.org/10.1542/peds.2015-4587
Schweinhart, L. J., Montie, J., Xiang, Z., Barnett, W. S.,
Belfield, C. R. & Nores, M. (2005). Lifetime effects: The
High/Scope Perry Preschool study through age 40. Ypsi-
lanti, MI: High/Scope.
Sullivan, L. M. (1971). Let us not underestimate the children.
Glenview, IL: Scott, Foreman.

Sweet, M. A., & Appelbaum, M. I. (2004). Is home visit-
ing an effective strategy: A meta-analytic review of
home visiting programs for families with young chil-
dren. Child Development, 75, 1435–1456. doi:10.1111/j.
1467-8624.2004.00750.x
Takanishi, R., & Kauerz, K. (2008). PK inclusion:
Getting serious about a P-16 education system. Phi
Delta Kappan, 89, 480–487. doi:10.1177/00317217080
8900706
Temple, J. A., & Reynolds, A. J. (2015). Using social
impact borrowing to expand preschool through third-
grade programs in urban public schools. Journal of Edu-
cation for Students Placed at Risk., 20, 281–292. doi:10.
1080/10824669.2015.1076341
Washington State Institute for Public Policy. (2014). Early
childhood education for low-income students: A review of
the evidence and benefit-cost analysis. Olympia, WA:
Author.
Zigler, E., Pfannenstiel, J. C., & Seitz, V. (2008). The Par-
ents as Teachers program and school success: A replica-
tion and extension. Journal of Primary Prevention, 29,
103–120. doi:10.1007/s10935-008-0132-1
Supporting Information
Additional supporting information may be found in
the online version of this article at the publisher’s
website:
Appendix S1. Effects of Preschool Participation
in the Child–Parent Centers (CPC)

Appendix S2. Percentage Contributions of Three
Processes to Total Indirect Effects of CPC Preschool
Participation
Appendix S3. Percentage Contributions of Paths
of Influence to Standardized Total Indirect Effects
of CPC Preschool
Appendix S4. Percentage Contributions of Medi-
ators to Standardized Direct (Main) Effects of Pre-
school
Appendix S5. LISREL Mediation Model for High
School Completion Coefficients Are Standardized
and Adjusted for Measurement Errors
Appendix S6. LISREL Mediation Model for (a)
Felony Arrest and (b) Depressive Symptoms By
Age 24. Coefficients Are Standardized and
Adjusted for Measurement Errors
Appendix S7. Summary Paths of Effects From
Preschool to Years of Education at Age 21 in Three
Studies.
http://dx.doi.org/10.1111/j.1467-8624.2004.00750.x
http://dx.doi.org/10.1111/j.1467-8624.2004.00750.x
http://dx.doi.org/10.1177/003172170808900706
http://dx.doi.org/10.1177/003172170808900706
http://dx.doi.org/10.1080/10824669.2015.1076341
http://dx.doi.org/10.1080/10824669.2015.1076341
http://dx.doi.org/10.1007/s10935-008-0132-1

This document is a scanned copy of a printed document. No
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accuracy of the copy. Users should refer to the original
published version of the material.
Creating Community Responsibility for Child Protection:
Possibilities and Challenges
V O L . 1 9 / N O . 2 / FA L L 2 0 0 9 6 7
Creating Community Responsibility for Child
Protection: Possibilities and Challenges
Deborah Daro and Kenneth A. Dodge
Summary
Deborah Daro and Kenneth Dodge observe that efforts to
prevent child abuse have historically
focused on directly improving the skills of parents who are at
risk for or engaged in maltreat-
ment. But, as experts increasingly recognize that negative
forces within a community can over-
whelm even well-intentioned parents, attention is shifting
toward creating environments that
facilitate a parent’s ability to do the right thing. The most
sophisticated and widely used com-
munity prevention programs, say Daro and Dodge, emphasize
the reciprocal interplay between
individual-family behavior and broader neighborhood,
community, and cultural contexts.
The authors examine five different community prevention
efforts, summarizing for each both

the theory of change and the empirical evidence concerning its
efficacy. Each program aims to
enhance community capacity by expanding formal and informal
resources and establishing a
normative cultural context capable of fostering collective
responsibility for positive child
development.
Over the past ten years, researchers have explored how
neighborhoods influence child devel-
opment and support parenting. Scholars are still searching for
agreement on the most salient
contextual factors and on how to manipulate these factors to
increase the likelihood parents will
seek out, find, and effectively use necessary and appropriate
support.
The current evidence base for community child abuse
prevention, observe Daro and Dodge,
offers both encouragement and reason for caution. Although
theory and empirical research sug-
gest that intervention at the neighborhood level is likely to
prevent child maltreatment, design-
ing and implementing a high-quality, multifaceted community
prevention initiative is expensive.
Policy makers must consider the trade-offs in investing in
strategies to alter community context
and those that expand services for known high-risk individuals.
The authors conclude that if
the concept of community prevention is to move beyond the
isolated examples examined in
their article, additional conceptual and empirical work is needed
to garner support from public
institutions, community-based stakeholders, and local residents.
www.futureofchildren.org

Deborah Daro is associate professor and research fellow at
Chapin Hall at the University of Chicago. Kenneth A. Dodge is
director of
the Center for Child and Family Policy at Duke University.
6 8 T H E F U T U R E O F C H I L D R E N
D
epending on their composi-
tion and quality, neighbor-
hoods can either foster
children’s healthy devel-
opment or place them at
significant risk for physical, psychological, or
developmental harm. The National Survey
on Children’s Health estimates that almost 75
percent of the nation’s children live in neigh-
borhoods that their parents describe as highly
or moderately supportive, while the balance
live in neighborhoods judged by their parents
to have either moderately low (20 percent) or
very low support (6 percent).1 Although some
of this variation can be attributed to self-
selection (that is, economic conditions and
available options may direct high-risk families
into neighborhoods that are less supportive),
empirical studies indicate that neighbor-
hoods do have an effect on family and child
behaviors and outcomes, including parenting
behaviors.2

Child abuse prevention efforts have histori-
cally focused on developing and disseminating
interventions that target individual parents.3
Early work in the field placed primary
emphasis on identifying parents at risk for or
engaged in abusive or neglectful behaviors.
Once identified, these parents would be
provided with knowledge, skill-building
opportunities, and assistance to overcome
their personal limitations. Such strategies
were considered the most direct and efficient
path to preventing maltreatment. More
recently, however, attention has shifted from
directly improving the skills of parents to
creating environments that facilitate a parent’s
ability to do the right thing. It is increasingly
recognized that environmental forces can
overwhelm even well-intended parents, that
communities can support parents in their
role, and that public expenditures might be
most cost-beneficial if directed toward
community strategies. Some of these strate-
gies seek to expand public services and
resources available in a community by
instituting new services, streamlining service
delivery processes, or fostering greater
collaboration among local service providers.
Other strategies focus on altering the social
norms that govern personal interactions
among neighbors, parent-child relationships,
and personal and collective responsibility for
child protection. In each case, the goal is to
build communities with a rich array of formal
and informal resources and a normative

cultural context that is capable of fostering
positive child and youth development.
We begin our inquiry into community-based
efforts to prevent child maltreatment by
examining the theoretical frameworks of the
new approach. We then explore five different
community prevention efforts and summa-
rize the empirical evidence evaluating their
efficacy. Although not an exhaustive sample,
these five initiatives are representative of
efforts under way in many states to reduce
maltreatment risk or enhance child develop-
ment. After examining the unique challenges
posed by community-based strategies to
address abuse and neglect, we conclude by
discussing key lessons learned and consider-
ing the likely financial and political benefits
of embracing community-wide change to
achieve measurable reductions in child
maltreatment.
Why Does Community Matter
if You Are Trying to Prevent
Child Abuse?
The most sophisticated and widely used
models in current child maltreatment policy
and program development emphasize the
continuous interaction and reciprocal inter-
play among such diverse domains as environ-
mental forces, caregiver and familial
V O L . 1 9 / N O . 2 / FA L L 2 0 0 9 6 9

characteristics, and child characteristics.4 Uri
Bronfenbrenner’s ecological model frames
individual-family behavior as being embedded
in broader neighborhood, community, and
cultural contexts. Although the most fre-
quently cited risk and protective factors for
maltreatment reflect parents’ individual
functioning and capacity, community factors
can influence parent-child interactions in
myriad ways. Community norms frame what
parents may view as appropriate or essential
ways to interact with their children and set
the standards as to when and how parents
should seek help from others.5 Context can
increase or reduce parental stress by influenc-
ing perceptions of personal safety—that is, by
creating a sense of support or reconfirming
feelings of isolation. Community resources
can offer temporary respite from parental
responsibility. Community professional
services can improve parents’ mental health
and capacity to take on the role of parenting.
Although many scholars agree on the need to
cast a broad net in examining how the vulner-
able infant becomes the responsible adult,
few can agree on the most salient contextual
factors and, most important for our purpose,
how to manipulate these factors to increase
the likelihood parents will seek out, find, and
effectively use necessary and appropriate
support.
A series of reports issued by the U.S. Advisory

Board on Child Abuse and Neglect between
1990 and 1993 explicitly recognized the
continuous interplay between individual and
community environment in addressing the
problem of child maltreatment.6 Frank Barry
explains this interplay using four basic
assertions, based on theory and empirical
findings.7 First, child abuse and neglect result
in part from stress and social isolation.
Second, the quality of neighborhoods can
either encourage or impede parenting and
the social integration of the families who live
in them. Third, both external and internal
forces influence the quality of life in neigh-
borhoods. And, fourth, any strategy for
preventing child maltreatment should
address both internal and external dimen-
sions and focus simultaneously on strength-
ening at-risk families and improving at-risk
neighborhoods.
Over the past ten years, a growing body of
research has attempted to measure and
describe the mechanisms by which neighbor-
hoods influence child development and
support parenting. In summarizing this
research, the Working Group on Communi-
ties, Neighborhoods, Family Process, and
Individual Development concluded that
neighborhood matters both directly, in
providing, for example, schools, parks, and
other primary supports, and indirectly, in
shaping parental attitudes and behaviors and
in affecting a parent’s self-esteem and
motivational processes.8

Context also has long been viewed as impor-
tant in explaining why neighborhoods that
share a common socioeconomic profile can
have different levels of maltreatment. In a
study of contrasting neighborhoods in
Omaha, Nebraska, James Garbarino and
Deborah Sherman found that two communi-
ties with similar demographic characteristics
but different rates of reported child maltreat-
ment differed dramatically in terms of their
human ecology.9 Specifically, the community
with higher rates of maltreatment reports was
less socially integrated. It also experienced
less positive neighboring and more stressful
day-to-day interactions. Robert Sampson and
his colleagues have found that these neigh-
borhood assets, which they summarize as
“collective efficacy,” predict variation in
neighborhood violence in Chicago.10
Building on his earlier work, Garbarino and
Kathleen Kostelny found support for the
hypothesis that neighborhood social capital
affects maltreatment rates in a dynamic
model.11 Examining child abuse reports in
four economically disadvantaged Chicago
communities during 1980, 1983, and 1986,
they found significant differences in the
relative ratings of neighborhoods over time.

To explain this pattern, the authors inter-
viewed a sample of residents about their view
of community morale and their perceptions
of their neighborhood as a social environment
and as a source of “neighboring.” On all
dimensions, residents of the community with
the greatest increase in maltreatment rates
expressed the most negative views of their
community, knew little about existing com-
munity services or agencies, and demon-
strated little evidence of a formal or informal
social support network.
One particularly promising pathway for
understanding the role community can play
in shaping parental capacity and behaviors
is the concept of social capital, defined by
Robert Putnam as “features of organization
such as network, norms, and social trust that
facilitate coordination and cooperation for
mutual benefit.” 12 Jill Korbin and Claudia
Coulton used census and administrative
agency data for 177 urban census tracts in
Cleveland to find that variation in rates of
officially reported child maltreatment is
related to structural determinants of commu-
nity social organization: economic and family
resources, residential instability, household
and age structure, and geographic proximity
of neighborhoods to concentrated poverty.
Children who live in neighborhoods charac-
terized by poverty, a high ratio of children to
adults, high population turnover, and a high
concentration of female-headed families are
at highest risk for maltreatment.13

When the study team interviewed residents
in both high- and low-risk communities,
those living in areas with higher rates of
reported maltreatment and other negative
outcomes perceived their neighborhoods as
settings in which they and their neighbors
had little ability to intervene in or control the
behavior of children. In justifying their lack
of action, they were likely to express concerns
that the youths being corrected would
verbally or physically retaliate. In contrast,
residents in low-maltreatment communities
were more likely to monitor the behavior of
local children because they believed it was
their responsibility to “protect” children from
violent or dangerous neighborhood condi-
tions, such as traffic or broken glass.14
Valuing collective actions to accomplish a
common good also has potency in reducing
violence, particularly in communities whose
profiles would suggest high levels of social
disorganization. Robert Sampson and his
colleagues, for example, found lower crime
rates in neighborhoods whose residents
shared the same values and were willing to
intervene on behalf of the collective good.
Their sample included personal interviews
with 8,782 Chicago residents living in 343
distinct “neighborhood clusters” varying in
race and socioeconomic status. The research-
ers used interviews to construct measures of
“informal social control” (the degree to which
residents thought that they could count on
their neighbors to help in such ways as
correcting adolescent behavior, advocating for

necessary services, or intervening in fights)
and of “social cohesion” (the degree to which
respondents felt they could count on their
neighbors to help each other or be trusted).
Together, three dimensions of neighborhood
stratification—concentrated disadvantage,
immigration concentration, and residential
stability—explained 70 percent of the
V O L . 1 9 / N O . 2 / FA L L 2 0 0 9 7 1
neighborhood variation in collective efficacy.
Collective efficacy, in turn, mediated a
substantial portion of the association between
residential stability and disadvantage and
multiple measures of violence.15 In other
words, although structural issues such as
poverty are critical in establishing a commu-
nity’s social milieu, neighborhoods that are
able to establish a sense of community and
mutual reciprocity develop a unique and
potentially powerful tool to reduce violence
and support parents.
Another community approach, based in the
mental health services sector, is system of
care. Less well supported by empirical find-
ings but theoretically and clinically strong,
system of care involves developing a sound
infrastructure of coordinated individualized
services. The concept emerged partly in

response to Jane Knitzer’s dramatic 1982 call
for help for children, which grew out of stark
findings that too many children were living
in poverty and suffering mental disorders.
System of care also evolved in response to a
legal mandate to provide services to high-risk
violent youth within their local communi-
ties rather than detaining them in far-away
training schools.16 System of care is based
on a four-part foundation that includes a
continuum of services ranging from outpa-
tient therapies to in-home family preservation;
coordination of services so that a family can
move from one to another without disruption;
service individualization whereby services
are “wrapped around” the child and family
rather than having families conform to service
requirements;17 and cultural competence in
services so that professionals understand the
community and culture of families.18
How Can Community Be Used
to Prevent Child Abuse?
A large body of theory and empirical research
suggests that intervention at the neighbor-
hood level is likely to prevent child maltreat-
ment within families. The two components of
intervention that appear to be most promising
are social capital development and commu-
nity coordination of individualized services.
Social disorganization theory suggests that
child abuse can be reduced by building social
capital within communities—by creating an
environment of mutual reciprocity in which
residents are collectively engaged in support-

ing each other and in protecting children.
Research regarding the capacity and quality
of service delivery systems in communities
with high rates of maltreatment underscores
the importance of strengthening a communi-
ty’s service infrastructure by expanding capac-
ity, improving coordination, and streamlining
service delivery.
Addressing social dilemmas through a
combination of grassroots community action
and coordinated professional individualized
services is long-standing practice in both
social work and public health.19 At the turn of
the twentieth century, settlement house
workers engaged immigrant communities to
address collective inequalities such as labor
conditions and educational opportunities as
well as personal challenges such as caring for
Valuing collective actions to
accomplish a common good
also has potency in reducing
violence, particularly in
communities whose profiles
would suggest high levels of
social disorganization.
an infant and ensuring child safety.20 Less
known but equally important were African

American club women’s organizations that
focused on building supportive communities
for migrants from the South relocating to
northern urban areas.21 More recently, urban
renewal and efforts to reduce the adverse
impacts of concentrated poverty have
embraced community change initiatives
designed both to improve context and to
empower residents to use collective action to
achieve common goals.22 Although these
efforts have often had disappointing results,23
the power of community and context to
change within-family behaviors and to
enhance the benefits of individualized
interventions continues to advance in many
areas, including obesity, violence prevention,
child welfare, and youth development.24
Community strategies to prevent child abuse
and promote child protection have focused
on creating supportive residential communi-
ties whose residents share a belief in collec-
tive responsibility to protect children from
harm and on expanding the range of services
and instrumental supports directly avail-
able to parents.25 Both elements—individual
responsibility and a strong formal service
infrastructure—are important. The challenge,
however, is how to develop a community
strategy that strikes the appropriate balance
between individual responsibility and public
investment.
In framing its recommendations for fostering
community efforts to prevent child abuse, the
U.S. Advisory Board noted that these two

capacity-building strategies—a focus on
community norms and a focus on coordi-
nated, individualized service development—
are not mutually exclusive and can evolve in
mutually beneficial ways. For example,
expanding services may begin by establishing
community-based service centers, with
multiple providers sharing a common facility
(for example, neighborhood service hubs
located in schools and community organiza-
tions such as New Jersey’s Family Success
Centers).26 Not only do such centers offer
residents a communal place to get services,
they also draw together a diverse set of
providers. As a result, families have access to
a more comprehensive array of interventions
that can simultaneously address multiple risk
factors.27 Building and sustaining a network
of service providers in a system of care
requires participants to engage in a set of
shared activities that can include establishing
a common service philosophy, developing a
shared assessment tool, or forming interdisci-
plinary teams to assess families and outline
effective service plans.28 This type of joint
casework and system planning creates a more
coordinated and integrated service response
and effectively engages both public and
private agencies. As residents or program
participants become engaged in the service
planning process, they can empower them-
selves to assume ownership of the process
and make personal investments in their
community. Although this chain of events
begins with the goal of enhancing services, it

can also, with careful implementation and
planning, enhance social investments and
neighborliness.
Similarly, community change efforts may
begin by focusing on social networks and
building social capital and, in the process,
expand service availability. For example, local
residents and key stakeholders might be
invited to participate in a community plan-
ning initiative that asks them to identify core
concerns and to make a plan for resolving key
issues. Implementing such plans often
requires substantial residential investment.
Such investment might involve supporting
V O L . 1 9 / N O . 2 / FA L L 2 0 0 9 7 3
the reallocation of existing public resources
or the development of new service options
for all or a subset of local residents. In other
cases, it might involve forming cooperatives
to care for each other through existing
community organizations or establishing new
organizational entities. In such cases, service
expansion both provides a tangible resource
for the community and draws residents
together in collective actions to achieve a
shared common good. These dual functions
are particularly evident when services include
a parent-participation component, as is com-

mon in many early education programs, such
as Head Start, or use a range of community-
based institutions or organizations to create a
context in which families can gather and
build connections.29
Where one starts in this process is less
important than recognizing that efforts
to build social capital and expand service
availability can be mutually reinforcing and
equally important. Focusing too heavily on
community capacity-building and normative
change can leave families without the context
and types of institutional supports essential
for addressing complex social and personal
needs. Focusing too heavily on system reform
and service development may sustain an
unproductive reliance on formal services.
More important, changing only service capac-
ity misses an opportunity to create the sense
of mutual reciprocity needed for sustainable
change and continuous support.
How Are Community Child Abuse
Prevention Efforts Structured, and
How Effective Are They?
Community-based efforts to prevent child
abuse incorporate a range of strategies that
place differential emphasis on the value of
these two approaches. For purposes of this
discussion, we examine five different
community efforts that seek to reduce the
frequency of child abuse and neglect—Triple
P-Positive Parenting Program, Strengthening
Families, the Durham Family Initiative,

Strong Communities, and the Community
Partnerships for Protecting Children (CPPC).
As summarized in table 1, all of the interven-
tions employ various strategies to improve
service capacity. In some instances, primary
emphasis is placed on building service
capacity by focusing on improving quality by
reshaping how direct service providers
interact with their clients (as is the case of
Triple P and CPPC) or how agency managers
supervise their staff, define and engage
participant caseloads, or interact with each
other (as reflected in the Durham Family
Initiative’s system of care work, Strengthen-
ing Families’ work with child care providers,
and CPPC’s efforts with child welfare agen-
cies). In addition to improving program
quality, all of the initiatives have strategies to
increase the odds families will have services
available to them either by improving access
to existing services or by generating new
services. Finally, three of the five initiatives
use specific strategies to alter the way in
which local residents view the notion of
seeking help from others to resolve personal
and parenting issues. These initiatives seek to
change a range of behaviors and attitudes
such as mutual reciprocity among neighbors,
parent-child interactions, and collective
responsibility among residents for child
protection and safety.
Capturing the effects of these complex
community change initiatives is daunting. In
addition to having broadly defined outcomes,
the initiatives seek to change individuals

either through programs targeted directly at
individual families or through institutional
changes that indirectly affect families who
may have only limited contact with any of the
initiative’s core strategies. The key operating
assumption in such efforts is that change
initiated in one sector will have measurable
spillover effects into other sectors and that
the individuals provided with information or
direct assistance will change in ways that
begin to alter normative behavioral assump-
tions across the population. This gradual and
evolutionary view of change is reflected in
many public health initiatives that, over time,
have produced dramatic improvement in
such areas as smoking cessation, reduction in
drunk driving, use of seat belts, and increased
conservation efforts.
Assessing such efforts is complicated by this
evolutionary change process as well as by
the tendency of these initiatives to alter their
initial operating assumptions and strategies in
response to the progress or lack of progress
made in the early stages of implementation.
Thus, traditional evaluation methods that use
random assignment to treatment and control
conditions and assume a “fixed” intervention
that adheres to a standardized protocol over

time are of limited utility in determining an
initiative’s efficacy or in producing useful
implementation lessons. On the other hand,
focusing only on level of implementation and
ignoring effects will prevent these initiatives
Five major community child abuse prevention initiatives
Triple P-Positive
Parenting
Program
Strengthening
Families
Durham Family
Initiative
Strong
Communities
Community
Partnerships
for Protecting
Children
Intervention strategies
Practice reform
For example, training providers to deliver
ser vices in a different manner or alter the
provider-participant relationship
X X

Agency reform
For example, altering institutional culture
or altering how agencies and entities within
a community relate to each other through
partnership development
X X X
Expand ser vice capacity or access, or both
For example, introducing a new ser vice or
improving ser vice access or reach in a
comprehensive manner
Access Access Capacity/
Access
Capacity/
Access
Access
Alter normative standards
For example, developing personal
responsibility for child protection
X X X
Evaluation strategies
Randomization of communities X
Randomizations of participants within
program components
X X

Quasi-experimental designs (trend analysis,
sur veys) with comparison communities or
participants
X X X
Theor y-of-change analysis X X X X X
Implementation research X X X X X
Utilization-focused evaluation X X
Note: Areas of primar y emphasis for each initiative are
indicated in bold.
Table 1. Community Child Abuse Prevention: Common
Strategies and Evidence Base for Five
Major Initiatives
V O L . 1 9 / N O . 2 / FA L L 2 0 0 9 7 5
from reaching status as “evidence-based”
in this era of accountability for outcomes.
Furthermore, knowing the early effects of an
initiative can be extremely useful in making
informed mid-course corrections.
In light of these conceptual challenges,
evaluations of community child abuse
prevention strategies such as those we

discuss in this article have used multiple
methodologies to clarify the most promising
pathways to achieving community change
(theory-of-change analysis and implementa-
tion studies), and to more directly use these
data in altering their selection of specific
strategies and program emphasis (utilization-
focused evaluations). As discussed below, all
of the initiatives have a theoretical frame-
work that guides their assumptions about
parent-child relationships as well as about
what communities can do to better support
parents. They also have established methods
for monitoring their implementation and
using implementation data to refine their
approach. Although such research does not
address the very important question of
impact, these evaluative functions are critical
for understanding the most efficient way to
approach this work.
Where appropriate, randomization proce-
dures and various quasi-experimental strate-
gies have been used to assess outcomes,
although in most cases these procedures have
been applied to specific elements or compo-
nents of the initiative rather than capturing
the initiative’s population-level effects. In
addition to the methodological limitations of
this research base, few of these strategies
have been operational long enough to
provide an accurate profile of their potential
accomplishments. Although incomplete,
these data provide preliminary evidence as to
the validity of a strategy’s theory of change,

implementation potential and challenges, and
potential areas of impact.
Triple P
Theory of change and implementation. Triple
P-Positive Parenting Program, originally
developed in Australia to assist parents of
children with developmental delays or
behavioral problems, is increasingly viewed as
a promising strategy to prevent child abuse. It
is a behavioral family intervention designed to
improve parenting skills and behaviors by
changing how parents view and react to their
children. Triple P consists of a series of
integrated interventions designed to provide a
common set of information and parenting
practices to parents who face varying degrees
of difficulty or challenges in caring for their
children. Based on social learning theory,
research on child and family behavior therapy,
and developmental research on parenting in
everyday contexts, each intervention seeks to
reduce child behavior problems by teaching
healthy parenting practices and how to
recognize negative or destructive practices.
Parents in every component are taught
self-monitoring, self-determination of goals,
self-evaluation of performance, and self-
selection of change strategies.
These parenting practices are introduced to
community residents through two primary
avenues. Universal Triple P is a media-based
and social marketing strategy designed to
educate community residents about the
principles of positive parents and to offer a set

of simple techniques for addressing common
child care issues (for example, safety, behavior
management, discipline strategies, and
securing basic health care). Information is
disseminated through the use of radio spots,
local newspaper articles, newsletters distrib-
uted through the schools, mass mailings to
local residents, presentations at community
forums, and a widely publicized website.
Access to this information is open to all
residents willing and able to seek it out. For
those parents interested in more “hands-on”
assistance, Selected Triple P offers brief
parenting advice and contact sessions that are
available to parents through various primary
care facilities such as well-child care, day care,
and preschool settings and in other settings
where parents may have routine contact with
service providers and other professionals who
regularly assist families. In addition to indi-
vidual consultations, Selected Triple P also
involves parenting seminars delivered within
these primary care settings on such topics as
the power of positive parenting; raising
confident, competent children; and raising
resilient children. The seminars are designed
for the general parent population and provide
parenting information as well as raise aware-
ness of the overall initiative.

In addition to its social marketing and general
education component, Triple P seeks to
change parenting standards by ensuring that
when formal services are accessed by fami-
lies, all providers in the community operate
within a shared understanding of key values
and practice principles. Toward this end, it
offers formal training in the Triple P model to
direct service personnel working in a variety
of clinical settings. Standard Triple P offers a
series of broadly focused eight- to ten-week
parenting skill training sessions delivered in
the home, or through group-based sessions,
or self-directed using project material.
Families whose parenting difficulties are
complicated by other problems, such as
domestic violence or mental health concerns,
or who have not been adequately served by
the standard services are offered Enhanced
Triple P, a more intensive behavioral family
intervention.
Although service provision at each level is
supported by a variety of structured unique
protocols, all of the direct services are framed
by a set of common practice principles. These
include ensuring a safe and engaging environ-
ment for children, creating a positive learning
environment, using assertive discipline,
having realistic expectations, and taking care
of oneself as a parent.
Effectiveness. As discussed in the article in
this volume by Richard Barth, repeated
randomized trials of specific Triple P inter-

ventions have consistently demonstrated
positive effects on parenting skills and child
behavior.30 Although these clinical findings
are impressive, few of the studies have
explicitly examined the effects of Triple P’s
multi-layered and universal service approach
on population or community-wide outcomes.
Recently, with funding from the Centers for
Disease Control and Prevention, Ronald
Prinz and his colleagues randomly assigned
eighteen counties in South Carolina to either
the comprehensive Triple P program or a
services-as-usual control group.31 Within the
intervention counties, project staff launched
an intensive social marketing campaign to
raise awareness of the initiative and its
related parenting strategies and support
By building relationships
with families, early care and
education programs can
recognize signs of stress
and strengthen families’
protective factors with timely,
effective help.
V O L . 1 9 / N O . 2 / FA L L 2 0 0 9 7 7
services among the general population. Staff
also identified and contacted state and county
stakeholders who provided such support

services for parents of young children as
education, school readiness, child care,
mental health, social services, and health, in a
variety of settings. Direct service providers
were offered the opportunity to participate in
training on all of the Triple P interventions.
During the project’s first two years, 649
service providers received training in one or
more of the interventions. The result was a
mean of 38.8 trained providers per 50,000
population.
Effects were assessed by comparing trends
between the intervention and comparison
counties on three independently derived
population indicators. These comparisons
yielded statistically significant, large positive
effects. Between the period just before
implementation and twenty-four months
later, intervention counties increased in
substantiated child maltreatment rates by just
8 percent, compared with 35 percent for the
control counties. Out-of-home placements
decreased in intervention counties by 12
percent but increased by 44 percent in
control counties. Hospital admissions for
child injuries decreased by 18 percent in
intervention counties but increased by 20
percent in control counties. This study is the
first to randomize geographical areas to
intervention and control conditions and show
preventive effects on child maltreatment at a
population level. Although these findings are
impressive, it remains unclear how the social
marketing, universal service offers, and
training in the Triple P model to direct

service providers might have produced these
results. Additional analyses regarding poten-
tial variation across the intervention and
comparison counties with respect to both
implementation efforts and outcomes is
needed to understand more fully the mecha-
nisms through which Triple P might affect
maltreatment rates.
Strengthening Families Initiative
Theory of change and implementation. The
Strengthening Families Initiative (SFI)—not
to be confused with a selective individual-
family program to prevent child abuse and
child problem behavior started by Karol
Kumpfer, also called Strengthening Families32
—is designed to reduce child abuse by
enhancing the capacity of child care centers
and early intervention programs to offer
families the support they need to avoid
contact with the child welfare system. Similar
to the Triple P model, Strengthening Families
also seeks to affect parent behavior by using
an existing service delivery system. Specifi-
cally, SFI uses focused assessments, technical
assistance, and collaborative ventures to
enhance the capacity of child care centers to
promote five core protective factors among
their program participants—parental resil-
ience, social connections, knowledge of
parenting and child development, critical
support in times of need, and social and
emotional competence of children. By
building relationships with families, early

care and education programs can recognize
signs of stress and strengthen families’
protective factors with timely, effective help.
Unlike previous training and educational
efforts to engage child care workers in child
abuse prevention, SFI is presented as
“problem solving” rather than “problem
identification.” Families are encouraged to
understand that if they have concerns, they
can go to any staff member at these centers
and receive help or direction. And if they are
reported for suspected maltreatment, the
family can count on the child care center to
serve as their advocate with child welfare
officials.
In 2001, with funding from the Doris Duke
Charitable Foundation, the Center for the
Study of Social Policy (CSSP) began studying
the role that early care and education pro-
grams nationwide can play in strengthening
families and preventing abuse and neglect.
After developing the overall framework
and related training materials, CSSP imple-
mented the model in seven states on a pilot
basis. In each state, officials enhanced their
policies and practices through collaboration
among their early childhood, child abuse pre-
vention, and child protective services sectors.
Several of the states integrated SFI’s five pro-

tective factors and the strategies for achieving
them into the state’s child care quality rating
and improvement systems.
Moving out of the pilot phase, SFI has broad-
ened its focus beyond states’ early care and
education programs to include building links
between these programs and child welfare
departments and building the protective fac-
tors into the training and monitoring systems
governing home-based child care providers.
At present, twenty-three states are participat-
ing in the Strengthening Families National
Network.
Effectiveness. SFI’s primary pathway for
change, enhancing protective factors within
families with young children, has strong
empirical support in both basic and applied
research. No one can disagree that the
initiative’s key protective factors, if in place
and robust, are likely to reduce the odds of
parents’ abusing or neglecting their children.
Parents who have strong social connections,
knowledge of child development, and a sense
of personal efficacy are indeed among those
who have the most rewarding relationships
with their children, and these children are
more likely to have strong self-perceptions
and robust cognitive and social development.
Equally compelling is evidence that enroll-
ment in high-quality early education programs,
particularly those that augment children’s
services with direct support to parents, have
measurable immediate and long-term effects

on child and family outcomes, including the
prevention of child abuse.33
Despite the theoretical promise of this
approach, it is unclear whether these types of
child and family outcomes can be achieved
through SFI’s implementation plan. Six
elements of the theory must still be investi-
gated. The first is assumptions regarding the
number of child care centers with the capac-
ity and motivation to engage in the type of
self-reflection and practice change required
to adopt fully a focus on enhancing protective
factors. The second is the belief that child
care centers have contact with large numbers
of families who need this type of assistance to
avoid abuse. The third is the belief that the
relationship of child care centers with fami-
lies is sufficiently robust to meet the needs of
the high-risk families they do encounter. The
fourth is the view that social networks built
around child care centers can shape norma-
tive standards regarding how to care for a
child, as opposed, for example, to merely
reflecting existing standards that may or may
not be appropriate. The fifth is the assump-
tion that child care centers have access to the
array and quantity of material support and
mental health services that families may need
or request. And the sixth is the assumption
that families have chosen a given child care
center from an array of available options and
therefore have a more personal relationship
with their care provider than they do with
other service providers. Although the pro-
gram has anecdotal evidence to support all of

these assumptions, the ability of the SFI to
achieve normative change within local child
care and early care networks and to provide
V O L . 1 9 / N O . 2 / FA L L 2 0 0 9 7 9
families with sufficient support to reduce
maltreatment rates remains untested. There
are no published reports of program efficacy
using a rigorous design and no known trials
under way.
Durham Family Initiative
Theory of change and implementation.
The Durham Family Initiative (DFI) is a
population-wide effort to expand the consis-
tency and scope of universal assessments
designed to identify high-risk families or
those needing prevention services and then
to link them with appropriate community-
based resources.34 It has two goals. One is to
enhance community social and professional
capital and improve community capacity to
provide evidence-based resources to families.
The other is to increase families’ ability to
access community resources. To reach these
goals it focuses on universal assessment and
referral. Established with funding from the
Duke Endowment in 2002, the initiative
posits that child abuse is best prevented by
addressing the risk factors and barriers that

affect the healthy development of parent-
child relationships. Adopting an ecological
perspective, DFI works to strengthen and
expand the pool of available evidence-based
direct services, to identify and secure mean-
ingful public policy reforms, and to build
local community capacity. Its activities fall
into four main areas. First, it fosters local
interagency cooperation regarding adoption
of a coordinated and consistent preventive
system of care. Second, it increases social
capital within a number of Durham city
neighborhoods through the targeted use of
outreach workers and community engagement
activities. Third, it develops and tests innova-
tive direct service models to improve out-
comes with high-risk families or those already
involved in abuse or neglect, while also
increasing supports for high-risk new parents
through early identification and service
referrals. Finally, it reforms county and state
policies affecting the availability and quality
of child welfare and child protection services.
One of DFI’s most notable features has been
its efforts to nurture local interagency coop-
eration by developing the comprehensive
Durham System of Care (www.durhamsystem
ofcare.org), an integrated network of commu-
nity services and resources to help families
meet the needs of children with serious,
complex behavioral, academic, social, and
safety needs. It is based on the view that key
public and private health and human service
agencies must share a consensus on how best

to identify, engage, and meet the needs of
troubled children and their families. This
consensus has developed gradually, beginning
in 2002 with initial meetings among key
agency directors and their middle manage-
ment. Building on relationships established
during these meetings, the effort has
expanded to provide theory-to-practice
training across a diverse set of local agencies
and community professionals. Most recently,
project staff members assisted the local
system of care leadership team in writing a
cross-agency manual, developing a quality
improvement and evaluation plan, and
expanding the system of care to include an
adult focus. Project staff members also have
used the lessons learned from their collabora-
tion within Durham County to advocate and
support statewide reforms.
The focus on collaboration and capacity
building has been reflected in the project’s
work within its targeted service communities
in the city of Durham. In the early stage of
implementation, DFI supported a number of
community partners or outreach workers in
three of the project’s six target neighbor-
hoods. These outreach workers gathered
information about neighborhood residents

and resources, built relationships among
residents, and developed neighborhood
“teams” to address specific issues of high
interest or concern to local residents. The
process generated such neighborhood
projects as community day activities, resource
centers, language classes, neighborhood
watch programs, and emergency food and
clothing distribution centers. More recently,
efforts to strengthen the informal systems of
support among local residents in these
communities have been fostered through a
leadership training program developed in
partnership with the Durham Housing
Authority and DFI efforts to recruit, train,
and link grandmothers in the community to
women struggling with the care of young
children.
DFI’s most ambitious effort is Durham Con-
nects, a recent attempt to assess the needs of
all newborns and their families in Durham
County and then to link them with supports
to address their needs. Piloting began in July
2007, when DFI began planning an aggres-
sive campaign to provide an initial assessment
and facilitate appropriate service linkages for
the estimated 4,000 babies born each year in
the county. Durham Connects will be grafted
onto existing early-intervention services
that now give approximately 85 percent
of all infants access to a pediatric practice
visit within forty-eight hours of their births.
Its goal is to augment these services with a
more comprehensive psychosocial assess-
ment and to expand coverage to the families

of newborns that are not now offered or do
not accept these visits. The assessment will
be conducted by a nurse, most likely during
a home visit. In addition to completing the
standard risk assessment protocol, the home
visitor will ensure that the family is linked to
a medical provider and that any immediate
needs identified through the risk assessment
are addressed through an appropriate service
referral. By building on the existing network
of well-baby care within Durham County,
DFI staff members believe they can provide
universal coverage to all newborns and effec-
tively link families to needed services.
Effectiveness. Among children from birth
to age seventeen, the rate of substantiated
child maltreatment in Durham County fell
49 percent between 2001–02, the year before
the DFI began, and 2007. In contrast, the
rate for the mean of five demographically
matched comparison counties in North Caro-
lina over the same period fell just 21 percent.
Of particular interest is the recidivism rate,
that is, the rate at which children who have
been assessed for possible maltreatment by
the Division of Social Services must be reas-
sessed within six months. A high rate would
indicate a failure of the professional system
to respond adequately. Among children from
birth to age seventeen, the reassessment rate
in Durham dropped 27 percent between
2001–02 and 2007. In contrast, the rate for
the mean of five demographically matched
comparison counties over the same period

dropped 15 percent.
Strong Communities is
unique in placing primary
emphasis on changing
residential attitudes and
expectations regarding
collective responsibility for
child safety and mutual
reciprocity.
V O L . 1 9 / N O . 2 / FA L L 2 0 0 9 8 1
Independent sources provide additional
information. Anonymous sentinel surveys
were completed with 1,741 family-serving
professionals in Durham and one comparison
county (Guilford) in 2004 and 2006. Pro-
fessionals’ estimates of the proportion of
children who had been abused decreased 11
percent in Durham but increased 2 percent
in Guilford over this period. Estimates of
the proportion of children who had been
neglected decreased 18 percent in Durham
but only 3 percent in Guilford. Estimates
of the proportion of children who had been
spanked fell 11 percent in Durham but rose
4 percent in Guilford. For positive parent-
ing behaviors, professional estimates of the
proportion of children shown love, affection,
or hugs by parents increased 5 percent in

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