SafeCare Augmented
SafeCare Augmented is an in-home behavioral parenting program that aims to promote positive parent-child interactions, informed caregiver response to childhood illness and injury, and a safe home environment. It is designed for parents and caregivers of children age 5 and younger who are either at-risk for or who have a history of child neglect or physical abuse. The program aims to reduce child maltreatment and to support clinical care by adding training for SafeCare providers.
The SafeCare curriculum includes three modules. The home safety module targets risk factors for environmental neglect and unintentional injury by helping parents and caregivers identify and eliminate common household hazards and teaching them about age-appropriate supervision. The health module targets risk factors for medical neglect by teaching parents and caregivers how to identify and address illness, injury, and health. The parent-child/parent-infant interaction module targets risk factors associated with neglect and physical abuse by teaching parents and caregivers how to positively interact with their child, and how to structure activities to engage their child and promote positive behavior.
SafeCare Augmented is an enhanced version of SafeCare that adds two trainings for SafeCare providers. The motivational interviewing training aims to support providers in using motivational strategies to help parents implement parenting skills and safety planning, address substance abuse, and access resources. The domestic violence training aims to increase providers’ awareness of domestic violence, as well as increase providers’ ability to detect domestic violence and make referrals as needed.
SafeCare Augmented does not currently meet criteria to receive a rating because no studies of the program that achieved a rating of moderate or high on design and execution demonstrated a favorable effect on a target outcome.
A re-review of SafeCare Augmented was conducted in September 2022 based on the availability of a new study. The re-review did not affect the program or service rating because the study did not achieve a rating of moderate or high on design and execution. The additional study is listed in the Studies Reviewed section below under Study 14364.
Date Research Evidence Last Reviewed: Sep 2022
Sources
The program or service description, target population, and program or service delivery and implementation information were informed by the following sources: the program or service manual, the program or service developer’s website, the California Evidence-Based Clearinghouse for Child Welfare, the Home Visiting Evidence of Effectiveness review, and the studies reviewed.
Date Program/Service Description Last Updated: Sep 2022
This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.
Target Population
SafeCare Augmented is designed for parents of children age 5 and younger who are at-risk for or who have a history of child neglect or physical abuse.
Dosage
Providers deliver SafeCare Augmented to families over approximately 18 sessions (six sessions for each of the three modules). However, some parents may need fewer or more sessions to reach skill proficiency. Each session typically lasts 50–90 minutes.
Location/Delivery Setting
Recommended Locations/Delivery Settings
SafeCare Augmented is delivered in the home. Providers can offer services in an alternative setting (e.g., clinic, shelter, or family-based residential treatment center) if services cannot be delivered in the home.
Education, Certifications and Training
There are no educational requirements for SafeCare Augmented providers.
To implement SafeCare Augmented, agencies must first complete the SafeCare Application and a call with the National SafeCare Training and Research Center (NSTRC). NSTRC uses the application and call to learn about the agency and its readiness for implementation. After the call, all provider trainees and supervisors take part in a 3-hour orientation. Supervisors also take part in a 2-hour supervisor mini-training.
Provider trainees then complete a 4-day workshop where they learn to engage caregivers, use structured problem-solving techniques, and implement the three SafeCare modules (home safety, health, and parent-child/parent-infant interaction). After the workshop, trainees are paired with SafeCare coaches for in-field support. Trainees achieve provider certification once they show proficiency in SafeCare skills in the field. Trainees must achieve certification within 6 months. Following certification, SafeCare coaches or trainers conduct monthly fidelity monitoring checks and coaching for a minimum of 2 years. Fidelity monitoring and coaching decreases to quarterly after the 2-year mark.
SafeCare Augmented providers must also complete training in motivational interviewing and domestic violence. The motivational interviewing training should be certified by the Motivational Interviewing Network of Trainers and can be held in-person or online. NSTRC helps sites develop a plan for motivational interviewing training as part of the agency readiness plan. SafeCare encourages providers to take part in ongoing consultation or supervision to become proficient in motivational interviewing. NSTRC recommends that a local domestic violence agency conduct the domestic violence trainings. The trainings must meet the NSTRC’s minimum requirements for content and structure. Domestic violence trainings are expected to take 4–8 hours. SafeCare strongly encourages providers to have annual refresher trainings and continuous access to domestic violence experts for consultation.
Certified providers are eligible to become coaches. Providers must attend a 2-day workshop to learn about the role of a SafeCare coach. Providers achieve coach certification once they pass six coaching units. Providers must achieve certification within 6 months.
Certified coaches are eligible to become trainers. Coaches must complete six pre-workshop webinars/phone calls with an NSTRC training specialist prior to taking part in the 3-day trainer workshop. Coaches achieve trainer certification following a site visit by the NSTRC. During the site visit, the NSTRC observes the trainer trainee providing their first training to provider trainees.
Program or Service Documentation
Book/Manual/Available documentation used for review
The SafeCare Provider Manual is implemented in conjunction with SafeCare Augmented Training Requirements for Motivational Interviewing and Domestic Violence Trainings.
Lutzker, J. R. (2016). Provider manual (Version 4.1.1). National SafeCare Training and Research Center.
National SafeCare Training and Resource Center. (n.d.). SafeCare Augmented training requirements for motivational interviewing and domestic violence trainings. Retrieved July 25, 2022, from https://safecare.publichealth.gsu.edu/safecare-augmented/
Available languages
SafeCare Augmented materials are available in English.
Other supporting materials
SafeCare Augmented – Motivational Interviewing and Domestic Violence Training Standards
For More Information
Website: https://safecare.publichealth.gsu.edu/
Phone: (404) 413-1282
Email: safecare@gsu.edu
Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.
| Results of Search and Review | Number of Studies Identified and Reviewed for SafeCare Augmented |
|---|---|
| Identified in Search | 2 |
| Eligible for Review | 2 |
| Rated High | 1 |
| Rated Moderate | 0 |
| Rated Low | 1 |
| Reviewed Only for Risk of Harm | 0 |
| Outcome | Effect Size
 and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
|---|---|---|---|---|
| Child safety: Child welfare administrative reports |
0.50
19 |
1 (2) | 105 |
Favorable:
0 No Effect: 2 Unfavorable: 0 |
| Child safety: Self-reports of maltreatment |
0.10
4 |
1 (4) | 88 |
Favorable:
0 No Effect: 4 Unfavorable: 0 |
| Child safety: Maltreatment risk assessment |
-0.04
-1 |
1 (1) | 62 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
| Adult well-being: Parent/caregiver mental or emotional health |
-0.03
-1 |
1 (2) | 87 |
Favorable:
0 No Effect: 2 Unfavorable: 0 |
| Adult well-being: Parent/caregiver substance use |
0.05
2 |
1 (3) | 88 |
Favorable:
0 No Effect: 3 Unfavorable: 0 |
| Adult well-being: Family functioning |
0.25
9 |
1 (6) | 147 |
Favorable:
0 No Effect: 6 Unfavorable: 0 |
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes for some outcomes were not able to be calculated by the Prevention Services Clearinghouse.
| Outcome | Effect Size
and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
Months after treatment when outcome measured
|
|---|---|---|---|---|---|
| Child safety: Child welfare administrative reports |
0.50
19 |
1 (2) | 105 |
Favorable:
0 No Effect: 2 Unfavorable: 0 |
- |
| Study 10900 - SafeCare+ (SafeCare Augmented) vs. Business as Usual (Silovsky, 2011) | |||||
| Any Referral to Child Welfare (%) |
0.50
19 |
- | 105 | - | 24 |
| Time to Referral to Child Welfare (Survival Analysis) |
Null
not calculated |
- | 105 | - | 24 |
| Child safety: Self-reports of maltreatment |
0.10
4 |
1 (4) | 88 |
Favorable:
0 No Effect: 4 Unfavorable: 0 |
- |
| Study 10900 - SafeCare+ (SafeCare Augmented) vs. Business as Usual (Silovsky, 2011) | |||||
| Conflict Tactics Scale – Parent-Child: Psychological Aggression |
0.11
4 |
- | 88 | - | 0 |
| Conflict Tactics Scale – Parent-Child: Psychological Aggression |
0.03
1 |
- | 62 | - | 7 |
| Conflict Tactics Scale – Parent-Child: Physical Assault |
0.20
7 |
- | 88 | - | 0 |
| Conflict Tactics Scale – Parent-Child: Physical Assault |
0.08
3 |
- | 62 | - | 7 |
| Child safety: Maltreatment risk assessment |
-0.04
-1 |
1 (1) | 62 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
- |
| Study 10900 - SafeCare+ (SafeCare Augmented) vs. Business as Usual (Silovsky, 2011) | |||||
| Child Abuse Potential Inventory |
-0.04
-1 |
- | 62 | - | 7 |
| Adult well-being: Parent/caregiver mental or emotional health |
-0.03
-1 |
1 (2) | 87 |
Favorable:
0 No Effect: 2 Unfavorable: 0 |
- |
| Study 10900 - SafeCare+ (SafeCare Augmented) vs. Business as Usual (Silovsky, 2011) | |||||
| Beck Depression Inventory-II |
0.09
3 |
- | 87 | - | 0 |
| Beck Depression Inventory-II |
-0.15
-6 |
- | 61 | - | 7 |
| Adult well-being: Parent/caregiver substance use |
0.05
2 |
1 (3) | 88 |
Favorable:
0 No Effect: 3 Unfavorable: 0 |
- |
| Study 10900 - SafeCare+ (SafeCare Augmented) vs. Business as Usual (Silovsky, 2011) | |||||
| Diagnostic Interview Schedule – Self-Report: Alcohol Module |
0.13
5 |
- | 62 | - | 7 |
| Diagnostic Interview Schedule – Self-Report: Alcohol Module |
-0.07
-2 |
- | 88 | - | 0 |
| Diagnostic Interview Schedule – Self-Report: Drug Module |
0.09
3 |
- | 87 | - | 0 |
| Adult well-being: Family functioning |
0.25
9 |
1 (6) | 147 |
Favorable:
0 No Effect: 6 Unfavorable: 0 |
- |
| Study 10900 - SafeCare+ (SafeCare Augmented) vs. Business as Usual (Silovsky, 2011) | |||||
| Family Resource Scale |
-0.04
-1 |
- | 88 | - | 0 |
| Family Resource Scale |
0.48
18 |
- | 62 | - | 7 |
| Study 10900 - SafeCare+ (SafeCare Augmented) vs. Business as Usual (CTS Victimization Responses Requiring Recent Partner) (Silovsky, 2011) | |||||
| Conflict Tactics Scale 2: Victimization, Negotiation |
0.15
5 |
- | 57 | - | 0 |
| Conflict Tactics Scale 2: Victimization, Negotiation |
0.18
7 |
- | 39 | - | 7 |
| Conflict Tactics Scale 2: Victimization, Sexual Coercion |
0.52
19 |
- | 59 | - | 0 |
| Conflict Tactics Scale 2: Victimization, Injury |
0.56
21 |
- | 42 | - | 0 |
*p <.05
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications. Effect sizes for some outcomes were not able to be calculated by the Prevention Services Clearinghouse.
Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.
Full citations for the studies shown in the table are available in the "Studies Reviewed" section.
Studies Rated High
Study 10900Silovsky, J. F., Bard, D., Chaffin, M., Hecht, D., Burris, L., Owora, A., Beasley, L., Doughty, D., & Lutzker, J. (2011). Prevention of child maltreatment in high-risk rural families: A randomized clinical trial with child welfare outcomes. Children and Youth Services Review, 33(8), 1435-1444. https://doi.org/10.1016/j.childyouth.2011.04.023
Studies Rated Low
Study 14364Silovsky, J., Bard, D., Owora, A. H., Milojevich, H., Jorgensen, A., & Hecht, D. (2022). Risk and protective factors associated with adverse childhood experiences in vulnerable families: Results of a randomized clinical trial of SafeCare®. Child Maltreatment. Advance online publication. https://doi.org/10.1177/10775595221100723
This study received a low rating because none of the target outcomes met measurement standards.