Preventing Child Abuse and Neglect in New Jersey Through a Home Visitation Program

Developing a training program for home visitation services to prevent child abuse and neglect

    • July 14, 2010

Prevent Child Abuse-New Jersey (PCA-NJ), a state chapter of the nonprofit national organization Prevent Child Abuse, began an effort called the New Jersey Academy for Home Visitation Training in 2006 to:

  • Increase the quality and availability of home visitation services in New Jersey as a strategy to reduce child abuse and neglect
  • Support the practices of "evidence-based home visitation" in New Jersey by promoting collaboration and systems-building among programs engaged in home visitation

This project was funded under New Jersey Health Initiatives (NJHI), a program of the Robert Wood Johnson Foundation (RWJF). See Program Results for more information on the program.

What is Evidence-Based Home Visitation? Evidence-based home visitation refers to voluntary programs that meet federally mandated requirements for family-focused services—prenatally through early childhood—delivered in the home environment. These services must be:

  • Research based
  • Taught through intensive training
  • Supervised by program staff
  • Subject to quality assurance and outcomes research

Home visitation services commonly target specific population groups, such as first-time mothers; parents who are young, low income, less educated or substance abusing; or those who have low birthweight or developmentally compromised infants or children.

Research and practice have demonstrated that early home visitation programs for families with very young children can reduce the incidence of child maltreatment and delinquency, and improve the health, social and developmental functioning of mothers and their babies.

Training Recipients: Staff focused their training efforts on employees of three New Jersey affiliates of nationally recognized programs that already used voluntary, evidence-based home visitation practices:

  • Healthy Families (HF), which supports overburdened new and expectant parents by connecting them with well-trained home visitors up until the child's fifth birthday.
  • Nurse-Family Partnership (NFP), which gives ongoing support from RNs who are nurse home visitors to low-income first-time mothers from before their 28th week of pregnancy until the child's second birthday. See Program Results and a Special Report on the work of David Olds, PhD, to build this national and international effort.
  • Parents As Teachers (PAT), which supplies families with information, support and encouragement from pregnancy through a child's fifth birthday. See Program Results on this program.

The training was designed to help these organizations expand the home visiting capacity of their existing New Jersey program sites and, in some instances, achieve new site certification from their national organizations.

Some eight other programs in New Jersey also received training, including Early Head Start, Early Intervention, public health departments (especially nurses) and Special Child Health Services.

Key Results: According to Prevent Child Abuse-New Jersey Chapter, the New Jersey Department of Children and Families played a significant role in the expansion of home visiting capacity by providing much of the direct funding to sites for staffing. By working closely with them, the chapter's New Jersey Academy for Home Visitation Training:

  • Increased the number of New Jersey families that can be reached with evidence-based home visitation during any given year from an estimated 1,690 to 2,755. To achieve this increased service capacity, staff:
    • Conducted 33 training events on relevant topics for employees of home visitation programs from all 21 of New Jersey's counties. Total attendance for all 33 events was 1,075. Seven training events covered "core" subjects essential to evidence-based home visitation, including those required for certification by program sites. They included training in the use of:
      • The Kempe Family Stress Checklist (required by Healthy Families and being piloted by the New Jersey Department of Children and Families in many sites)
      • NCAST Feeding Scales (required by the Nurse Family Partnership national service office for their sites)
      • The Parents as Teachers Born to Learn® program (required by the Parents As Teachers national center for their sites)

      Twenty-six training events covered supplemental topics, including:

      • Developmental Screenings
      • Breastfeeding
      • Domestic Violence
      • Obesity
      • Postpartum Depression
      • Preterm Labor
      • Welfare Issues
  • Met with a number of potential new sites, programs and other stakeholders to promote home visitation—especially evidence-based practices—as a strategy to reduce child abuse and neglect.
  • Spurred collaborations among relatively isolated but similar programs in separate counties, or in separate communities within a county. Collaborations typically focused on efforts to share trainings and move toward shared client intake mechanisms. To educate people working in such programs as well as foster collaborations, staff sponsored six information sessions during the grant period, bringing together 493 home visitation stakeholders—for example, those doing home visitation or representing programs learning about home visitation and state or local health departments.

Lessons Learned:

  • Collaborate with other organizations engaged in home visitation. This can help strengthen advocacy for home visitation and lead to a sharing of the costs of training and services such as client intake. On a more basic level, it lets involved individuals know what home visitation tools are available and helps ensure that they use them in the same way. (Benjamin/Project Director)

Funding: RWJF supported this project from July 2006 through July 2009 with a grant of $304,764 through its NJHI program. The Horizon Foundation for New Jersey and the New Jersey Chapter of the March of Dimes provided additional general funding. The New Jersey Department of Children and Families and the Nicholson Foundation funded some specific training.

Afterward: In 2009, PCA-NJ received a four-year grant from the New Jersey Department of Children and Families to coordinate a central intake system for clients of home visiting and other family support services in Essex County, N.J. The grant of $125,000 per year was supported with a $150,000 annual match from the Nicholson Foundation.

In 2009 and 2010, staff trained home visitors of two newly created home visiting program sites in New Jersey having a combined capacity to serve 91 families.

Staff planned to present a talk on the central client intake system in Essex county and related topics at the Parents As Teachers 2010 national conference.

Staff continued to offer fee-for-service training in family support issues targeted primarily to home visitors. In general, fees covered the additional ancillary costs of this training but not trainers' salaries.