SafeCare
SafeCare is an in-home behavioral parenting program that promotes positive parent-child interactions, informed caregiver response to childhood illness and injury, and a safe home environment. SafeCare is designed for parents and caregivers of children birth through five who are either at-risk for or have a history of child neglect and/or physical abuse. The program aims to reduce child maltreatment. The SafeCare curriculum is delivered by trained and certified providers. The curriculum includes three modules: (1) the home safety module targets risk factors for environmental neglect and unintentional injury by helping parents/caregivers identify and eliminate common household hazards and teaching them about age-appropriate supervision; (2) the health module targets risk factors for medical neglect by teaching parents/caregivers how to identify and address illness, injury, and health generally; (3) the parent-child/parent-infant interaction module targets risk factors associated with neglect and physical abuse by teaching parents/caregivers how to positively interact with their infant/child, and how to structure activities to engage their children and promote positive behavior. Each module is designed to be delivered in 6 sessions (18 total), but some families may need fewer or more sessions to reach skill mastery. Each session typically lasts 50 to 90 minutes and is delivered in the family’s home or at another location of the parent’s choice.
SafeCare is rated as a supported practice because at least one study carried out in a usual care or practice setting achieved a rating of moderate or high on design and execution and demonstrated a sustained favorable effect of at least 6 months beyond the end of treatment on at least one target outcome.
Date Research Evidence Last Reviewed: Aug 2020
Sources
The program or service description, target population, and program or service delivery and implementation information was informed by the following sources: The California Evidence-based Clearinghouse for Child Welfare, Home Visiting Evidence of Effectiveness, the program or service developer’s website, the program or service manual, and the studies reviewed.
Program/Service Description Updated: Week of August 24, 2020
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 is designed for parents/caregivers of children 0-5 who are either at-risk for or have a history of child neglect and/or abuse.
Dosage
SafeCare is designed to be completed in approximately 18 sessions, though some parents may need fewer or more sessions to master new skills. During this time, providers deliver three curriculum modules, with each module lasting for six sessions. Providers typically meet with clients weekly for about 50 to 90 minutes.
Location/Delivery Setting
Recommended Locations/Delivery Settings
SafeCare is delivered in the homes of participating parents/caregivers. If services cannot be delivered in the participating parent’s/caregiver’s home, an alternative setting can be used (e.g., clinic, shelter, family-based residential treatment center).
Location/Delivery Settings Observed in the Research
- Home
Education, Certifications and Training
There are no educational requirements for SafeCare training. The National SafeCare Training and Research Center (NSTRC) provides training for providers. All providers are required to participate in 32 hours of workshop training and receive post-workshop coaching to promote fidelity and proficiency in delivering SafeCare to receive their certification. Ongoing coaching is required to keep provider certifications active. NSTRC also provides trainings for coaches and trainers.
Additional information about these trainings can be found on the NSTRC website.
Program or Service Documentation
Book/Manual/Available documentation used for review
Lutzker, J. R. (2016). SafeCare provider manual (version 4.1.1).
Available languages
Materials for SafeCare are available in French, Hebrew, and Spanish.
Other supporting materials
Provider Workshop Reference Packet
For More Information
Website: www.safecare.org
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 |
|---|---|
| Identified in Search | 7 |
| Eligible for Review | 4 |
| Rated High | 0 |
| Rated Moderate | 2 |
| Rated Low | 2 |
| 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 |
0.24
9 |
1 (3) | 369 |
Favorable:
0 No Effect: 3 Unfavorable: 0 |
| Child permanency: Out-of-home placement |
1.69
45 |
1 (1) | 369 |
Favorable:
1 No Effect: 0 Unfavorable: 0 |
| Adult well-being: Family functioning |
0.11
4 |
1 (1) | 259 |
Favorable:
0 No Effect: 1 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.
| 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 |
0.24
9 |
1 (3) | 369 |
Favorable:
0 No Effect: 3 Unfavorable: 0 |
- |
| Quick, 2018 | |||||
| Subsequent Child Protective Services Referral |
0.07
2 |
- | 369 | - | 12 |
| Subsequent Child Protective Services Assessment |
0.16
6 |
- | 369 | - | 12 |
| Subsequent Child Protective Services Founded Assessment |
0.48
18 |
- | 369 | - | 12 |
| Child permanency: Out-of-home placement |
1.69
45 |
1 (1) | 369 |
Favorable:
1 No Effect: 0 Unfavorable: 0 |
- |
| Quick, 2018 | |||||
| Subsequent Out-of-home Placement |
1.69
*
45 |
- | 369 | - | 12 |
| Adult well-being: Family functioning |
0.11
4 |
1 (1) | 259 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
- |
| Whitaker, 2020 | |||||
| Parenting Stress Index-Short Form: Difficult Child |
0.11
4 |
- | 259 | - | 2 |
*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.
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 Moderate
Study 10784Quick-Beachy, K., Lee, C., McConnell, L., Orsi, R., Timpe, Z., & Winokur, M. (2018). SafeCare Colorado program evaluation report 2014-2017. Colorado Office of Early Childhood.
Study 10910Whitaker, D. (2016). Comparative effectiveness trial to reduce child maltreatment, improve client outcomes and examine client burden: Research protocol. Patient Centered Outcomes Research Institute.
Whitaker, D. J., Self-Brown, S., Hayat, M. J., Osborne, M., Weeks, E., Reidy, D., & Lyons, M. (2020). Effect of the SafeCare© intervention on parenting outcomes among parents in child welfare systems: A cluster randomized trial. Preventative Medicine. [Online advance]. https://doi.org/10.1016/j.ypmed.2020.106167
Studies Rated Low
Study 10577Gershater-Molko, R. M., Lutzker, J. R., & Wesch, D. (2002). Using recidivism data to evaluate Project SafeCare: Teaching bonding, safety, and health care skills to parents. Child Maltreatment, 7(3), 277-285. https://doi.org/10.1177/1077559502007003009
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Study 10575
Chaffin, M., Hecht, D., Bard, D., Silovsky, J. F., & Beasley, W. H. (2012). A statewide trial of the SafeCare home-based services model with parents in child protective services. Pediatrics, 129(3), 509-515. https://doi.org/10.1542/peds.2011-1840
Chaffin, M., Bard, D., Bigfoot, D. S., & Maher, E. J. (2012). Is a structured, manualized, evidence-based treatment protocol culturally competent and equivalently effective among American Indian parents in child welfare? Child Maltreatment, 17(3), 242-252. https://doi.org/10.1177/1077559512457239
Hubel, G. S., Rostad, W. L., Self-Brown, S., & Moreland, A. D. (2018). Service needs of adolescent parents in child welfare: Is an evidence-based, structured, in-home behavioral parent training protocol effective? Child Abuse & Neglect, 79, 203-212. https://doi.org/10.1016/j.chiabu.2018.02.005
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Studies Not Eligible for Review
Study 10576
Damashek, A., Bard, D., Hecht, D. (2012). Provider cultural competency, client satisfaction, and engagement in home-based programs to treat child abuse and neglect. Child Maltreatment, 17(1), 56-66. https://doi.org/10.1177/1077559511423570
This study is ineligible for review because it does not report program or service impacts on an eligible target outcome (Study Eligibility Criterion 4.1.5).
Study 10783
Churchill, G. (2015). SafeCare: Evidence from a home based parenting programme for neglect. NSPCC.
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).
Study 10896
Gallitto, E., Romano, E., & Whitaker, D. (2020). Investigating the impact of the SafeCare program on parenting behaviours in child welfare-involved families. Child & Adolescent Social Work Journal. [Online Advance]. https://doi.org/10.1007/s10560-020-00672-6
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).