Publication year
2015
Citation Title
Identifying high-needs families in the U.S. Air Force New Parent Support Program.
Journal Name
Military Behavioral Health
Journal Volume
3
Issue Number
1
Page Numbers
74-82
DOI
10.1080/21635781.2014.995253
Summary
The risk for child maltreatment may be higher among families who experience high levels of stress. To better understand this risk in U.S. Air Force (USAF) families, the degree to which new or expectant mothers' level of needs predicted future child maltreatment were explored. Level of needs were determined by the USAF New Parent Support Program (NPSP) service providers' clinical judgement as well as by a screener. Findings suggest different types of needs classification are associated with child maltreatment.
Key Findings
Among low-needs mothers, 523 (0.6% of the sample) had a founded maltreatment incident after the assessment, while among high-needs mothers, 584 (2% of the sample) had a subsequent founded maltreatment incident.
When NPSP staff’s clinical assessments differed from that of the screener, changes in classifications from low-needs to high-needs improved the prediction of subsequent maltreatment. However, changes in classifications from high-needs to low-needs did not impact prediction of maltreatment.
The odds of a maltreatment incident by high-needs mothers was significantly greater than low-needs mothers for physical abuse, emotional abuse, and neglect (but not sexual abuse).
Implications for Program Leaders
Offer support groups for military parents who are not new parents and are identified as having high-needs
Continue to educate military families about healthy parenting behaviors and coping with parenting stress
Provide professionals who work with military families advanced training in assessment of factors that contribute to families with high levels of needs and distress
Implications for Policy Makers
Continue to support programs that focus on the identification and prevention of child maltreatment in military families
Recommend partnerships among military-based and community-based programs to improve prevention of child maltreatment among military families
Continue to support programs that teach military families about developmental, social, and psychological consequences of child maltreatment
Methods
Mothers were referred by medical personnel, Family Advocacy Program (FAP) staff, a Commander, or another source to participate in the USAF New Parent Support Program (NPSP).
Once enrolled in NPSP, mothers’ risk factors associated with child maltreatment were assessed via a screener and classified as either low-needs or high-needs based on their responses.
NPSP staff conducted clinical assessments of the family’s needs and these assessments were compared against the responses on the screener and, when discrepant, needs classifications based on staff’s clinical assessments were used.
Participants
The sample consisted of 112,478 new or expectant mothers (68% civilian) who resided on USAF installations worldwide.
Most mothers (75%) were referred to the NPSP through an obstetric orientation or clinic.
No information on mothers' race/ethnicity or age was provided.
Limitations
There was limited information about what comprised the NPSP staff’s home visits, which limits the ability to understand any differences between the screeners and clinical decisions.
No data were presented about differences in maltreatment incidents between mothers who were referred through obstetric-related services and those through other sources.
The lack of demographic data limits the ability to identify patterns of needs classifications by factors such as age, Service member rank, or race/ethnicity.
Avenues for Future Research
Examine the components of clinical assessments used by NPSP staff to better understand how high-needs and low-needs classifications are determined
Collect data about needs from military fathers to analyze the predictive value of needs classification in that population
Explore whether the relationship between needs classifications and maltreatment incidents is influenced by factors such as age or race/ethnicity
Focus
Air Force
Target Population
Population Focus
Military Branch
Military Component
Abstract
The U.S. Air Force (USAF) New Parent Support Program (NPSP) is a voluntary family maltreatment prevention program for expectant parents and parents of young children. NPSP mothers are classified as “low needs” (LN) or “high needs” (HN) based on their Family
Needs Screener (FNS) responses and NPSP service providers’ clinical judgment. Using data from 112,478 mothers, we analyzed classifications based on FNS scores, classifications based on NPSP service providers’ clinical judgments, and whether these classifications
predicted mothers’ subsequent maltreatment of a child. Overall, 75% of mothers were classified as LN based on their FNS responses. Clinical judgments resulted in overrides for the classifications of 6% of cases and, when overrides occurred, mothers’ classifications were
more likely changed from LN to HN than vice versa. Further, both FNS-based HN classifications and clinical overrides from LN to HN predicted subsequent child maltreatment. These data suggest FNS and clinical overrides are useful for predicting child maltreatment within USAF families.
Needs Screener (FNS) responses and NPSP service providers’ clinical judgment. Using data from 112,478 mothers, we analyzed classifications based on FNS scores, classifications based on NPSP service providers’ clinical judgments, and whether these classifications
predicted mothers’ subsequent maltreatment of a child. Overall, 75% of mothers were classified as LN based on their FNS responses. Clinical judgments resulted in overrides for the classifications of 6% of cases and, when overrides occurred, mothers’ classifications were
more likely changed from LN to HN than vice versa. Further, both FNS-based HN classifications and clinical overrides from LN to HN predicted subsequent child maltreatment. These data suggest FNS and clinical overrides are useful for predicting child maltreatment within USAF families.
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