Final Report
Reporting Period: March 1, 2010 – December 31, 2013
Lead Agency:
File Report Prepared by:
Joyce Dean, Evaluation Liaison
P.O. Box 20400
Salem, Oregon 97307-0400
[email protected]
541-485-1086
Financial Status Report Prepared by:
Marsha Clark, Chief Financial Officer
P.O. Box 20400
Salem, Oregon 97307-0400
[email protected]
503.856.7094
Report Submitted to:
Dr. Charlyn Harper Browne, QIC-EC Project Director
Center for the Study of Social Policy
December 31, 2013
Fostering Hope Initiative
Final Report
Table of Contents
Executive Summary...................................................................................................................... 1
Introduction and Overview .......................................................................................................... 5
Introduction and Project Administration ................................................................................ 5
Overview of the Community, Population, and Problem ....................................................... 19
Overview of the Collaborative Partnership ........................................................................... 69
Overview of the Project Model ............................................................................................. 78
Overview of the Local Evaluation .......................................................................................... 85
Cross-Site Evaluation ............................................................................................................. 94
Project Implementation/Program Strategies ............................................................................ 95
Project Eligibility, Recruitment, Screening, Intake and Termination .................................... 95
Major Strategies and Services Provided.............................................................................. 103
Approach to Program (Model) Fidelity ............................................................................... 106
Use of a Protective Factors Approach ................................................................................. 107
Project Outcomes Evaluation .................................................................................................. 108
Increased Likelihood of Optimal Child Development: Findings ......................................... 108
Increased Family Strengths: Findings .................................................................................. 111
Decreased Likelihood of Child Maltreatment: Findings ...................................................... 135
Additional Local Outcomes: Findings ................................................................................. 140
Relationship among Outcomes ........................................................................................... 141
Community and Societal Domain Outcomes ...................................................................... 141
Sustainability/Integration ........................................................................................................ 143
Cost Tracking ....................................................................................................................... 147
Conclusions .............................................................................................................................. 147
Key Recommendations ............................................................................................................ 152
Dissemination .......................................................................................................................... 156
References ............................................................................................................................... 160
This report was prepared with the support and assistance of Fostering Hope Initiative staff and partners.
Special thanks go to Catholic Community Services staff, including James T. Seymour, Executive Director;
Maureen Casey FHI Director; Teri Alexander, FHI Associate Director, and the home visitors working for
FHI; as well as to all FHI partners, including Carrie Maheu, Salem Leadership Foundation Lightning Rod.
Each of these and all FHI partners contributed to this report and to the rich fabric of the Fostering Hope
Initiative which this report attempts to summarize.
Preparation of this report was supported in part by Subcontract Agreement #100314, Grant #270/QIC.
The material presented does not necessarily reflect the opinions and positions of the Center for the
Study of Social Policy, Quality Improvement Center on Early Childhood.
Final Report
December 31, 2013
I.
Executive Summary
A. Overview of the Project
The Fostering Hope Initiative (FHI) is a neighborhood-based Collective Impact Initiative that
promotes optimum child and youth development by supporting vulnerable families,
encouraging connections between neighbors, strengthening collaboration, intentionally
pursuing quality and accountability, and advocating for family-friendly public policy. The FHI
collaborative is sponsored by Catholic Community Services of the Mid-Willamette Valley and
Central Coast (CCS) and includes state and local government agencies, public and private sector
organizations, local service providers and individuals. FHI’s target population includes families
who reside in selected high-poverty neighborhoods in Marion and Yamhill Counties, Oregon.
B. Summary of Evaluation Findings
Catholic Community Services contracted with Pacific Research and Evaluation (PRE) to
conduct the project evaluation. The evaluation captured process data from program
participants and staff to monitor service provision and attendance rates and document
stakeholder perceptions of implementation quality. A repeated measures quasi-experimental
design compared participants from targeted neighborhoods who received Fostering Hope
Initiative services and families recruited from similar neighborhoods who did not receive
coordinated FHI services. In addition to capturing a variety of demographic data about families
who participated in the research, outcome measures included the Ages and Stages
Questionnaire Third Edition (ASQ3); ASQ Social-Emotional (ASQ SE); Parenting Stress Index
(PSI); Adult-Adolescent Parenting Inventory (AAPI); Self-Report Family Inventory (SRFI); Social
Network Map (SNM); and the Caregiver’s Assessment of Protective Factors (CAPF). Outcome
data were collected at intake and every six months thereafter. Key implementation and
outcome findings are summarized below. There were no significant barriers to implementation.
Implementation Findings
 As a result of a 72.2% retention rate, a total of 70 treatment and 65 comparison
caregivers participated in the study for at least 12 months.
1
 Among study participants, 70.0% of the treatment group and 81.5% of the comparison
group self-identified as Hispanic/Latino. Fewer than 30.0% of participants identified
English as their primary language; 54.4% of treatment and 26.4% of comparison
participants indicated that they were able to speak English.
 Half or more of treatment and comparison group participants reported elementary or
middle school as their highest education level (50% and 58.5%, respectively).
 Almost all caregivers were female (98.6% treatment, 100% of comparison group).
 The majority of caregivers indicated an income of less than $30,000 (88.5% treatment,
92.1% comparison).
 Caregivers receiving coordinated services received 2.4 home visits per month and eight
total referrals, on average.
 In addition to receiving home visiting and resource/referral, 34.7% participated in
parenting education, 17.1% attended at least one community café, and 18.6% attended
at least one community dinner.
 Results of the Caregivers Repeated Measures Survey indicated that caregivers were
generally satisfied with the services they received.
 In addition to the home visiting component, 13,346 caregivers attended Parent Council
meetings, Community Cafés, and community dinners (duplicated count).
Outcome Findings
Caregivers who received at least 12 months of home visiting were included in the outcome
analysis.
 A subset of risk factors decreased. Assessment of protective factors is inconclusive due
to measurement challenges.
• Participants receiving coordinated services demonstrated a statistically
significant decrease in stress associated with parenting as measured with the
Parenting, Child, and Total Stress Domains of the PSI.
• Significant results also were generated with Construct A of the Adult Adolescent
Parenting Inventory which measures the caregiver’s knowledge of the needs and
capabilities of children at various stages of growth and development.
• Due to a ceiling effect, the CAPF did not generate meaningful results, negating
efforts to quantitatively assess change in the protective factors.
 Optimal child development was supported, though to a moderate degree.
2
•
•
•
The PSI Sense of Competence Subscale generated statistically significant results
overall, as well as when data were disaggregated for Marion County and Hispanic
participants.
Statistically significant results generated by the Expectations of Children subscale
of the APPI suggest that the intervention had a small effect in this area.
The local measures (ASQ-3, ASQ SE) found that none of the participating families
were in need of a developmental intervention beyond the addition of learning
activities and continued monitoring, and a very small number of participants
required referral for mental health services.
 The evaluation did not generate robust evidence of increased family strengths.
• The Health/Competence, Conflict, and Cohesion Subscales of the SRFI did not
generate statistically significant results, however, the Expressiveness Subscale,
assessing the expression of warmth, caring, and closeness within the family unit,
approached significance (p=.058), indicating that there may have been some
improvement in this area among caregivers receiving FHI services over and
above that of comparison group participants.
• The items assessed with the Background Information Form (BIF) cannot be
directly attributed to the intervention due to analysis limitations posed by the
categorical data. Results generated with descriptive statistics were generally
positive, however, with the exception of financial solvency.
o With regard to home safety knowledge and practices, as well as
respondents’ use of emergency numbers (BIF item #18), responses for
both the treatment and comparison participants increased for most of
the items queried.
o For all the safety practices addressed in the BIF (item #19), respondents
in the treatment and comparison neighborhoods reported employing
most of the behaviors “all of the time”, on average, at both intake and
one year.
o The majority of both treatment and comparison group respondents
agreed that they would like to remain a resident of their neighborhood,
would be willing to work with people in their neighborhood to improve
the neighborhood, that they like living in their neighborhood, as well as
that they feel safe in their neighborhood (BIF item #17).
o Participants from both study groups reported experiencing a variety of
financial hardships including inadequate funds for rent/mortgage
payments, utility payments, or to buy food. Treatment group participants
did not demonstrate a notable change in this area. The majority of all
caregivers indicated a total household income of less than $30,000, and
almost all were receiving some form of government aid. These results did
not change from intake to one year (BIF Item #s 14-16).
 Data are not yet available from the Department of Human Services to assess change in
child maltreatment rates in the neighborhoods. The Department was able to confirm
3
that none of the study participants in any of the treatment or comparison
neighborhoods had been the subject of a substantiated case of child maltreatment
during the study period.
C. Key Lessons Learned
1. Lessons learned regarding supporting the building of protective factors at the
individual and relationship (family) domains of the social ecology.
• Specifically targeting child care providers, in addition to parents, for outreach
and involvement with increasing the quality of day care settings and
discussing the protective factors had an important impact.
• Sharing information about the protective factors was more effective when it
was infused across a variety of individual, family and neighborhood activities,
goals and supports, using vocabulary and examples that are culturally and
linguistically relevant.
2. Lessons learned regarding the role of the collaborative partnerships in supporting
the building of protective factors at the community domain (i.e., geographic
community, provider community, and/or special caregiver community).
• The collaborative role with school districts, in particular, was essential.
Ensuring that efforts are aligned with kindergarten and school core standards
will increase the probability of school success. The relationship between
young children's social emotional competence and their cognitive
development, language skills, health, mental health and school success needs
to be emphasized, incorporating existing standards.
• Providing temporary respite supports, like those offered by Safe Families for
Children, was an invaluable resource to assist in strengthening family
protective factors.
• The projects had to be alert for natural opportunities to bring in building
protective factors that arise within communities and the various socialecological domains. For example, a neighborhood event might offer a natural
opportunity to share information about protective factors.
3. Lessons learned regarding the role of the collaborative partnerships in supporting
the building of protective factors at the societal domain (i.e., city, county, state,
regional, or national) of the social ecology
• Each person working on the project needed to work in more than one domain
of the social ecology, e.g., home visitors worked at the Individual/Caregiver
level but also supported building protective factors in the Relationship and
Community domains. Administrators may have wanted to focus on advocacy
to change public policy, but to do that they also needed to work with the
Community (Service Provider) domain to ensure that providers were adopting
methods to build protective factors.
4
• Coordinating specific grant-writing efforts with public health entities and
school districts provided useful opportunities to broaden the inclusion of
protective factors.
5
II.
Introduction and Overview
A. Introduction and Project Administration
1. Purpose of the QIC-EC
The National Quality Improvement Center on Early Childhood (QIC-EC) was established in
2008 as a 5-year cooperative agreement between the Children’s Bureau and three partner
organizations: Center for the Study of Social Policy (lead agency); National Alliance of
Children’s Trust and Prevention Funds; and ZERO TO THREE: National Center for Infants,
Toddlers, and Families.
The QIC-EC was established to test evidence-based and evidence-informed approaches that
build protective factors and reduce risk factors in order to promote optimal child development,
increase family strengths, and decrease the likelihood of abuse and neglect among infants and
young children. To this end, the QIC-EC funded four research and demonstration projects. In
addition, funding was provided for five doctoral students whose dissertation research was
related to the focus of the QIC-EC. Through its Learning Network, the QIC-EC engaged a
multidisciplinary group of professionals in dialogue and information exchange on key policy,
research, and practice issues related to the prevention of child maltreatment.
The QIC-EC is funded by the United States Department of Health and Human Services,
Administration for Children, Youth and Families, Office on Child Abuse and Neglect, and is
supported by matching funds from the Doris Duke Charitable Foundation.
2. Rationale for Applying for Funding
“Children’s early development depends on the health and well-being of their parents. Yet
the daily experiences of a significant number of young children are burdened by the
untreated mental health problems of their families, recurrent exposure to family violence,
and the psychological fallout from living in a demoralized and violent neighborhood.”
(Shonkoff & Phillips, 2000, p. 7).
During Federal Fiscal Year 2007, an estimated 794,000 children nationally were determined
to be victims of child abuse or neglect. Of these, 20.7% of victims and 3.8% of non-victims were
placed into foster care (U.S, Department of Health and Human Services, 2009). In two Oregon
counties, a total of nearly 600 children were victims of substantiated child abuse/neglect,
representing nearly 17 per 1000 children in Marion County and 9.3 per 1000 in Yamhill County.
Of these, 6.2 per 1000 and 5.5 per 1000, respectively, suffered recurrence of maltreatment. In
6
Marion County, 2145 (2.53 %) children and 199 (.89%) of Yamhill County children were in foster
care at least once during 2007 (Children First for Oregon, 2008). Based on data provided by
Oregon’s Department of Human Services (DHS), approximately 70 children entered or reentered Marion County foster care every month due to parent drug abuse, cycle of child abuse
and neglect, or other issues making their lives unsafe. Most of those came from neighborhoods
with high rates of poverty and limited assets that allow children and families to thrive.
Economic conditions over the past several years have dramatically increased family stress in
Oregon, where the unemployment rate was 6th worst in the nation, according to the Bureau of
Labor Statistics (http://www.bis.gov/web/laumstrk.htm) at the time of the proposal for this
project. Between November 2007 and November 2008, the number of unemployment claims
in Marion County rose 52%.
Catholic Community Services (CCS) believes families have a responsibility to protect and
nurture their children and the community has a responsibility to support families to do that.
The Center for Disease Control’s Injury Center recognizes communities that support parents
and take responsibility for preventing abuse as a “Community Protective Factor” (CDC, 2010).
Failure to meet these responsibilities occurs at a tremendous cost to families, communities, and
society.
Supporting families reduces costs now and over time. At the time of the proposal, it was
estimated by the state Children and Families Commission that the cost of placing one child in
foster care for one year was $18,000, considering the cost of caseworkers from DHS, protective
services investigations, and the cost of foster care itself. In 2013, at a meeting sponsored by the
governor’s office to develop a legislative strategy for “Pay for Prevention,” the average cost of
one year of foster care was given as $29,000. Neither figure includes the cost of the other
systems that must step in when children fail to thrive in foster care, e.g., psychiatric hospitals,
detention centers, remedial education, mental health services, addictions services, and medical
services to restore physical health. Fostering Hope Initiative partners believe that reducing child
maltreatment will lead to safely reducing the need for foster care, which will result in significant
cost reductions for public systems. FHI wants to convince government to reinvest those funds
into strengthening families programs that protect and promote optimum child development,
thus further reducing child maltreatment. The governor’s Pay for Prevention initiative is
evidence that vision is now closer to becoming a reality.
The point at which CCS submitted the FHI proposal was a unique time when we felt we
might be close to a “tipping point” (Gladwell, 2002) for producing radical change:
• Casey Family Programs had funded Oregon’s Department of Human Services and the
Oregon Commission on Children and Families to carry out a $2,000,000 project to
reduce child maltreatment and safely reduce the need for foster care in Oregon.
• Marion County was one of several counties to receive support from the Casey project.
The Fostering Hope Initiative (FHI) was a key element of the county’s Casey plan.
• The Oregon Department of Human Services (DHS) itself had several active projects
working to reduce child maltreatment and foster care.
7
•
•
•
•
Local media coverage in the year prior to the application had dramatically raised
community awareness of needs related to child maltreatment and foster care.
Government leaders—such as then Oregon Governor Ted Kulongoski; The Honorable
Paul DeMuniz, then chief justice of the Oregon Supreme Court (official spokesperson for
the Fostering Hope Initiative); Bruce Goldberg, M.D., DHS director; and Mickey Lansing,
then executive director of the Oregon Commission on Children and Families—were
speaking out about the issues of child abuse/neglect and foster care and how the
community must come together to address the problem.
Local business leaders were stepping up to take action to improve the experience of
families and children. Businesses supported the development and start-up of FHI, have
spoken on our behalf, and provided funding for FHI efforts.
With leadership from the Marion County Children and Families Commission, local social
services organizations, schools, faith communities, businesses and neighborhood
leaders realized the benefits of collaboration for reducing child maltreatment.
Project partners believed this was a window of opportunity and it was time to act. It was
time to take on a coordinated high-impact initiative that relied on the rich network of resources
available in selected neighborhoods so that families would find the supports they needed to
raise their children well and keep their families together. The QIC-EC request for proposals
gave FHI an opportunity to study the processes and outcomes of our work to support future
replication.
3. Funders
Since its inception, FHI has relied on a blending of funding from different sources plus inkind contributions of services, staff time and space. As FHI has matured, the project has come
to use the following funding model:
• Direct services. FHI primarily relies on existing service funding streams to fund direct
services such as home visiting for residents of FHI neighborhoods. Project partners hold
contracts with government agencies for providing services to the target population.
• Backbone organization functions. Based on a collective impact model, backbone support
functions are funded primarily through foundation grants and donor gifts, but also
through administrative overhead charged to programs within CCS.
• Evaluation. FHI has used a variety of funding to support FHI evaluation—foundations,
donor gifts, and government grants. Nearly all proposals now submitted by CCS related
to FHI include external evaluation, and thus include requests for funding to support
those evaluation efforts. The most substantial of these evaluations has been the project
funded by the QIC-EC.
• Research. FHI has required funding from federal grantors (or subcontractors) to support
research studies to obtain publishable data confirming the results of FHI.
4. Overall Organizational/Management Structure of Project
8
FHI’s management structure has evolved over the past four years. In the early years of FHI,
CCS management staff and consultants made decisions on behalf of FHI, sometimes based on
input from partners. A group of mid-managers from partner organizations attended a monthly
Participatory Evaluation and Planning Team meeting in which data were shared and strategies
developed for improving project performance. This structure ended in the spring of 2013,
primarily because the participants, being mid-managers, were unable to commit their
organizations to decisions made in the group. Therefore, FHI established a new FHI Executive
Council for Marion County. This council consists of the Executive Directors of each of the
partner organizations that provide services in Marion County, and some of them also provide
services in Yamhill and Polk Counties, as well. The Council has taken over the participatory
evaluation and planning process as well as overall leadership for FHI. Because the number of
service providers is smaller in Polk and Yamhill County, leadership in those counties is primarily
conducted in meetings with the providers there. See Figure 1 for a current organizational chart.
5. The Lead Organization of the Project
For 75 years, CCS has offered a variety of programs for children, youth, and families at-risk,
as well as for adults with intellectual and developmental disabilities (I/DD). CCS—dedicated to
providing the highest quality services using research-based practices and accredited since 1998
by the national Council on Accreditation (COA) for children and families programs— served as
the lead entity for this project, received and managed grant funds, and provided project
management. Known for innovative solutions, CCS opened the first counseling center in the
mid-Willamette Valley more than 50 years ago; brought the treatment foster care concept to
Oregon nearly 30 years ago; and pioneered the Community Homes for Children concept 15
years ago. CCS now serves approximately 2000 children and adults each year and has an annual
budget of approximately $14,000,000.
 CCS Mission. Catholic Community Services is a faith-based organization whose mission
is: “A Forever Home for Everyone – an opportunity to live responsibly in a nurturing
home and caring community you call your own.”
CCS Vision. Children, families, adults with knowledge, ability and desire to take control
of their own lives, and live responsibly with others in a just society.
CCS Goal. Promote and protect optimum human development: child safety; knowledge,
skills, attributes to succeed at home, school, work, and community; good health; and
financial self-sufficiency.
 Key Staff
James T. Seymour has been the Executive Director of CCS for over 30 years. Karen Ross is the
Director of Quality. The current director for Fostering Hope is Maureen Casey, Ph.D. The FHI
Director position changed a few times during the course of the project. Teri Alexander is the
Associate Director of FHI.
9
10
Catholic Community Services
Board of Directors
FHI Strategy Council
(Blue Ribbon Advisory Council
that advocates for policy
change, raises money,
addresses barriers)
• Community Leaders
• Business Leaders
• Philanthropists
FHI Executive Council
Marion County
Catholic Community Services
Executive Director
(Backbone Organization and
Lead Agency for research
project funded by QIC-EC)
Evaluation
Liaison
FHI Project Director
(Collective Impact Coordinator)
Planning, Implementation,
Supervision, Communications
FHI Executive Council
Polk County (Planned)
FHI Executive Council
Yamhill County (Planned)
Partner Service Providers
e.g., Options Counseling,
Family Building Blocks
FHI Associate
Director and
Program
Coordinator
for Safe
Families for
Children
Neighbor
Connectors
(The Ford
Family
Foundation)
Neighborhood
Mobilization
Subcontracts
• Salem
Leadership
Foundation
• Mano a Mano
Family Center
Pacific
Research and
Evaluation
(External
Evaluation)
Home
Visitors*
* Home Visitors are
now provided by
partners, not by CCS,
and do not report to
the Project Director
Figure 1. Organizational chart for the Fostering Hope Initiative as of the end of the project.
11
 Other Work
CCS’s current children, youth and families programs include treatment foster care; the
Cavazos Center for adjudicated Hispanic/Latino youth; Center Court Commons, a supportive
apartment community for youth transitioning out of foster care; Community Homes for
Children in long-term foster care; the Community Counseling Center; Father Taaffe Homes for
pregnant and parenting teen mothers; Independent Living for Teens; Rainbow Family Services
in Yamhill County; Rainbow Lodge Respite Center for youth; and Safe Families for Children,
offering volunteer supports to at-risk families. The programs for adults with intellectual/
developmental disabilities are residential—including nursing—employment and brokerage
services. The annual CCS operating budget is about $14,000,000. CCS has approximately 370
staff and 120 volunteers. CCS’s major funding sources include government contracts,
foundation grants, and corporate and individual donations.
CCS also sponsors another initiative, known as “Living the Dream”: Assuring a voice and
choice for people with developmental disabilities. The initiative’s vision is: “People with
developmental disabilities enjoy the rights and responsibilities of self-determination: the
freedom to enjoy a meaningful life of one’s choice.” This initiative includes components related
to workforce investment, employment, education, kin and kith connections, appropriate
housing, civic and cultural community life, and information technology.
Catholic Community Services Foundation (CCSF) was established in 1987 to support and
assure financial sustainability of Catholic Community Services and its programs and develop and
maintain facilities to house CCS programs. CCSF has now developed expertise in property
development and management, and is a community resource for affordable housing. The
organization now offers more than 100 rental units and a home ownership assistance program
while managing more than 300,000 square feet of office and living space.
6. The Local Evaluation of the Project in Terms of its:
• General Approach to Project Evaluation
• Fit with the Needs of the Project
Catholic Community Services contracted with Pacific Research and Evaluation (PRE) to
conduct the project evaluation. The evaluation captured process data from program
participants and staff to monitor service provision and attendance rates and to document
stakeholder perceptions of implementation quality. A repeated measures quasi-experimental
design compared participants from targeted neighborhoods who received Fostering Hope
Initiative services and families recruited from similar neighborhoods who did not receive
coordinated FHI services. In addition to capturing a variety of demographic data about families
who participated in the research, outcome measures included the Ages and Stages
Questionnaire Third Edition (ASQ3); ASQ Social-Emotional (ASQ SE); Parenting Stress Index
(PSI); Adult-Adolescent Parenting Inventory (AAPI); Self-Report Family Inventory (SRFI); Social
12
Network Map (SNM); and the Caregiver’s Assessment of Protective Factors (CAPF). Data were
collected at intake and every six months thereafter.
During Participatory Evaluation and Planning (PEP) meetings that occurred monthly over the
course of the project, evaluation staff worked with the CCS Evaluation Liaison to present data
to the PEP Team (composed of project leaders and staff from CCS and the partner agencies) for
the dual purposes of project monitoring and identifying opportunities to improve
implementation and outcomes. This approach was chosen for evaluating the Fostering Hope
Initiative because CCS, as the backbone organization of the Collective Impact Initiative, was
deeply vested in engaging the partnership in regular discussions about data in order to move
the partnership toward greater levels of shared measurement. Additionally, because partner
organizations were responsible for recruiting comparison group participants in the study and
submitting service tracking data about the neighborhood services provided through the
Initiative, ongoing meetings to ensure implementation was on-track also were expected to be
beneficial.
In addition to the program-level evaluation, common measures were collected for the
purpose of contributing to the cross-site evaluation conducted on behalf of the QIC-EC by
InSites. The combination of evaluation activities effectively met the needs of both the local
project (including the collaborative partners) and the national cross-site evaluation.
7. Essential Project Implementers/Staff and Their Roles
Table1 includes the essential project implementers and their roles, credentials, experience,
time assigned to the project, and type.
Table 1
Key Project Implementers
Project
Credentials and
Implementers
Experience
and Type
CCS Staff
James T. Seymour, 30 years as CCS Exec. Dir. ;
M.P.A.
recognized leader in Child
Professional
and Family Services,
appointed by Gov. to
several statewide
committees.
Maureen Casey,
Ph.D.,
Professional
Ph. D. in Educational
Psychology with minor in
Deafness Rehabilitation;
Role and
Time on
Project
CCS Executive
Director;
Part time on
FHI
Collective
Impact
Coordinator,
13
Role Description
Overall leadership, communications with funders. Ensure the
integrity of collaborative
relationships. Serve on FHI
Executive Council; support the
Parents’ and Youth Councils, PEP
team. Ensure project research,
evaluation and are conducted in
an ethical, competent, complete
and timely manner.
Manage project goals &
objectives. Ensure compliance
with grant requirements. Deepen
Project
Implementers
and Type
(Position
previously held by
Tedra Stuart,
James Seymour,
and Heiko Junge)
Joyce Dean, M.Ed.
Nicole Fierro,
Professional
Elizabeth
Underwood,
M.S.Wa
Professional
Teri Alexander,
M.S., Professional
Jeni Bastida,
Adriana Islas and
Brittani Padilla
Parent Leaders
Partner Staff
Kay Cepeda,
Family Building
Blocks
Professional
Maria Lemus,
Mano a Mano
Role and
Time on
Project
Credentials and
Experience
MA in Communication
Disorders, MS in
Counseling
30 years senior research
assistant at University of
Oregon; author/coauthor
on books, articles on
methods of Quality
Improvement and services
for people with
intellectual/developmental
disabilities
Bilingual Spanish/English
Experienced Healthy
Families America Home
Visitor
FHI Project
Director
Full Time on
FHI
Evaluation
Liaison; Part
time on FHI
Home Visitor
Supervisor;
Parent
educator; Full
time FHI
15 years of experience with
Healthy Start; HFA peer
reviewer; 19 years as a
clinical social worker
MS in Management and
Organizational Leadership;
Developed/managed CCS
volunteer programs,
including Safe Families for
Children
Parents
Healthy Start
Program
Director, Part
time FHI
Program
Coordinator
Safe Families
for Children;
FHI Associate
Director
Facilitator for
Neighborhood
Community
Café; Part-time
on FHI
Mid-Manager
FHI/FBB
Liaison;
Part-time on
FHI
Outreach;
Part-time on
Bilingual Spanish/English
Community Worker
14
Role Description
relationships with partners,
develop new partners.
Develop/improve systems for
collective impact. Attend PEP,
support Executive Council.
Work with PRE, CCS staff and
partners to establish data
collection systems. Lead for all
narrative reporting on the project.
Assist with systems, materials and
form development. Plan/attend
PEP meetings.
Support and supervise home
visitors. Provide HV data to PRE.
Provide parenting education
classes. Coordinate with
neighborhood resources and
organizations in Marion Count.
Attend PEP meetings.
Manage the Healthy Start home
visitors/parent educators assigned
to FHI. Ensure fidelity to HFA
model, train staff. Attend PEP.
Recruit faith communities and
Host Families for SFFC program,
and coordinate services provided.
Assist project director in carrying
out project responsibilities. Attend
PEP meetings.
Plan logistics and facilitate
neighborhood meetings to discuss
how to support families to build
Protective Factors (Swegle).
Coordinate FBB activities related
to FHI. Attend PEP meetings.
Recruit participants in target and
comparison neighborhoods.
Project
Implementers
and Type
Professional
FHI
Levi HerreraLopez, Mano a
Mano
Professional
Carrie Maheu,
Salem Leadership
Foundation
Professional
Executive Director
Bilingual Spanish/English
Sam Skillern,
Salem Leadership
Foundation
Professional
Graciela Jaquez
Options
Counseling
Professional
Executive Director
Christopher Hupp,
Options
Counseling
Professional
Steven Rider,
Ph.D., Pacific
Research &
Evaluation (PRE)
Professional
Mid-Manager
Katie Winters,
M.A, PRE,
Professional
Role and
Time on
Project
Credentials and
Experience
McKay area “Lightning
Rod”
Bilingual Spanish/English
Ph.D. Clinical Psychology.
More than 20 years of
research and program
evaluation experience.
Director of several
federally funded research/
evaluation projects. Author
of journal articles, book
chapters; research
presentations; taught
college classes. Expertise in
qualitative and quantitative
designs and methods,
statistical analysis.
MA in Applied Psychology
More than a decade
conducting evaluations for
community-based, state
Project
leadership;
Part-time on
FHI
Neighborhood
mobilization;
Part-time on
FHI
Project
leadership;
Part-time on
FHI
Washington
neighborhood
Community
Café; Part-time
on FHI
Liaison; Parttime on FHI
Role Description
Support neighborhood activities,
including activities at La Casita.
Attend PEP meetings.
Outreach. Advise project on
cultural competency. Attend PEP
meetings, Executive Council.
Develop and coordinate
opportunities that arise through
neighborhood faith communities,
e.g., La Casita and the Community
Dinners. Attend PEP meetings.
Relationships with faith
community, outreach. Attend PEP
Meetings, Executive Council.
Plan, organize logistics, and
facilitate Community Cafés in the
Washington Neighborhood.
Supervise Options Counseling staff
working with FHI. Coordinate with
FHI. Attend PEP meetings
Subcontract:
External
Evaluator;
Part-time on
FHI
Lead the utilization-focused
evaluation, including data analysis,
interpretation, and reporting.
Present data to PEP team,
Executive Council. Coordinate with
cross-site evaluation. Lead on
ZERO to THREE article. Present
project results at conferences and
national project meetings. Attend
grantee meetings.
Subcontract:
External
Evaluator;
Part-time on
Work with CCS and partner staff
to conduct the utilization-focused
evaluation, including data analysis,
interpretation, and reporting.
15
Project
Implementers
and Type
and national organizations.
a
Role and
Time on
Project
Credentials and
Experience
Role Description
FHI
Present data to PEP team,
Executive Council. Assist in
developing/giving presentations.
Attend grantee meetings.
This position was later filled by Tedra Stuart who had similar credentials and responsibilities.
8. Workforce Recruitment, Training, Supervision, Retention, and Project Staff
 Procedures for Recruiting Project Staff
The Fostering Hope Initiative built on existing programs. Therefore, the home visiting
component, based on the Healthy Families America model, began with existing home visitors
within Catholic Community Services and, for the first few years of the project, Yamhill County’s
Healthy Start program. Recruitment for replacement staff followed typical CCS procedures,
including internal posting of positions, external posting on a website, and recruitment through
other avenues such as English and Spanish language newspapers, and personal contacts.
Project leaders and evaluators were recruited primarily through personal contacts.
In 2013, through a donation from a local philanthropist, CCS developed a part-time “Parish
Liaison” position to identify people attending a local Catholic parish who are called to providing
caregiving services, such as foster parents or personal assistance aides. The position has been
so successful in that parish, it is now being expanded to a second local Catholic parish.
 Initial Training and Orientation of Staff, Particularly about The Protective Factors
Framework
In addition to the training required by the Healthy Families America model for home
visitors, staff received training in facilitating Community Cafés, in the Strengthening Families
Protective Factors, and in the Asset-Based Community Development approach to communitybuilding. Depending on the skills of local residents, the power of local associations, and the
supportive functions of local institutions, Asset-Based Community Development draws on
existing community strengths to build stronger, more sustainable communities for the future.
Once FHI was invited to join Harvard’s Center on the Developing Child’s Frontiers of Innovation
group, training also included information on the effects of toxic stress, the development of
executive function, and on building parental capacities. During the project, CCS developed a
team to lead implementation of the Sanctuary Model, and began training on Sanctuary.
Sanctuary supports an organizational culture that understands the effects of trauma on servicerecipients and staff alike, and uses methods to reduce the consequences of that trauma.
 Staff Supervision Procedures and Opportunities
16
Home visitor supervision met the criteria for Healthy Families America, with at least 1.5-2
hours each week of one-on-one supervision, reviewing each family on each home visitor’s
caseload. The Healthy Start~Healthy Families director at CCS provided model supervision to the
home visitor working in Yamhill County, when no credentialed supervisor was available there,
and to ensure consistency across home visiting in the two counties. CCS parenting education
class instructors, who in many cases also were home visitors, also received supervision through
the Healthy Start~Healthy Families Director.
Management staff was supervised through CCS’ Fostering Hope Initiative Management
Team, or through individual meetings with the Executive Director or Project Director.
Supervision included review of task assignments, progress, due dates, and discussion of issues,
including discussion of strategies for building family Protective Factors, reducing toxic stress,
Asset-Based Community Development, and mobilizing neighborhoods to support families.
Supervision meetings with the Executive Director focused on implementation problems that
required reallocation of resources and strategic issues. For example, FHI provided catalytic
leadership designed to mobilize FHI neighborhood leaders to build “protective factors” in the
neighborhood. When leaders from a neighborhood church stepped forward and offered FHI a
“little house” owned by the church, there was no budget to help cover remodeling and utility
costs. As the backbone organization CCS took on this challenge on and met it.
 Staff Retention Plan
CCS has adopted several strategies to support staff retention. These include:
• Revised the staff evaluation format so that it includes a review of how staff
members are supported in their work, applying the Performance Engineering Matrix
approach (Albin, 1992) to supporting staff performance.
• Improved training for supervisors.
• Implemented the Employee Stewardship Team system, which gives employees the
opportunity to review data on program performance in seven outcome areas,
identify needed improvements, and implement strategies to improve performance.
These teams, organized by department, ensure that employees have a voice and
that staff support issues are addressed.
• Improved core competency training for new staff.
• Incorporating the Sanctuary Model, related to trauma-informed care and traumasensitive organizations, into the culture of CCS. We believe once this approach is
fully integrated, we will experience a decrease in staff turnover.
 Opportunities for Staff Professional Development
FHI used several strategies related to staff professional development.
• All CCS staff members identify desired training opportunities during their annual
performance review. CCS also provides annual diversity training, including content
related to poverty, disability, race and ethnicity.
17
•
•
•
Home visitors participated in the staff development sessions provided as part of the
Healthy Start-Healthy Families program.
FHI participated in webinars provided by Harvard University’s Center on the
Developing Child related to, e.g., toxic stress, executive function and self-regulation,
and by the Center for the Study of Social Policy, on its funded research projects.
Since 2011, CCS has sponsored the Fostering Hope: Closing the Gap Summit, which
brought to Salem researchers in neuroscience, child development, family protective
factors, community-building, collective impact, and other fields so that FHI partners
and staff could learn about the science underlying best practices in early childhood
services.
 Technical Assistance Accessed
FHI received substantial technical assistance from the Quality Improvement Center on Early
Childhood and the Center for the Study of Social Policy. Technical assistance was provided
through annual site visits, phone and email support, and grantee meetings. Throughout the
project, the Center provided research and evaluation resources, shared results of other
successful projects, and communicated about promising practices. In addition, QIC assisted in
providing Community Café training, helped to connect CCS and FHI with Harvard’s Frontiers of
Innovation project (see below), as well as supporting proposals to other funding sources and
assisting in developing a measurement instrument to assess levels of protective factors in
families.
In January 2012, CCS applied to and was selected to become a participant in the Frontiers of
Innovation Project, a project of Harvard University’s Center on the Developing Child. This
project provided technical assistance for improving FHI’s theory of change, as well as support
for understanding that one science underlies long-term educational, health and financial selfsufficiency outcomes.
Throughout the project, CCS contracted with a former University of Oregon research
assistant to act as a liaison between CCS and the external evaluators. This consultant had
worked with CCS for more than a dozen years, was familiar with CCS staff and procedures, and
so could assist CCS personnel to better understand what was required of them to participate in
a formal research project, and assist the external evaluators to access information and people
within CCS. In addition, the evaluation liaison provided training and technical assistance on the
Shewhart Cycle and other methods of continuous quality improvement.
The former director of the Neighborhoods Department in the City of Salem provided
consultation related to neighborhood mobilization—both in devising a method for assessing
social capital in neighborhoods, and in working with Neighbor Connectors—primarily in rural
communities where FHI was not funded by QIC-EC.
CCS also contracted with an employee of PeaceHealth, a non-profit health care organization
which operates nine hospitals in the Western United States. This consultant helped CCS to
18
understand how to approach health care professionals and met with local health care leaders
related to expanding the Fostering Hope Initiative to include a larger presence in health care.
 Staff Turnover that Occurred during the Project and How Staff Turnover was Handled
FHI experienced turnover in two key project positions: Project Director and Healthy
Start~Healthy Families Program Director. However the Executive Director, Healthy Start
supervisor, some of the home visitors, evaluators and evaluation liaison were with the project
throughout its funded period.
When the original Project Director, Heiko Junge, left CCS, Jim Seymour assumed the
responsibilities of Project Director. This allowed continuity in approach during the transition to
a new director. In addition, at that time the Healthy Start~Healthy Families Director assumed a
larger role to include FHI. CCS has for many years used consultants to complete work that is
difficult for program staff to take on—e.g., systems development and data analysis. Therefore,
during this time two consultants assumed larger roles: Jan Calvin, a former City of Salem
department manager, and Joyce Dean, formerly a University of Oregon researcher. Ms. Calvin
led the Neighborhood Mobilization strategies, and Ms. Dean assumed responsibilities related to
evaluation and systems improvement. Both helped in providing continuity for the project.
When the Meyer Memorial Trust funded a proposal for a full time Collective Impact
Coordinator in November 2012, it offered an opportunity to have a full time project director
again. Maureen Casey, Ph.D. initially took on the role of Collective Impact Coordinator
(February 2013), and a few months later became FHI Project Director.
10. Challenges and How They Were Handled
 Management
• Challenge: Balancing speedy decision-making with including FHI partners in FHI
management decisions. This issue was raised most directly related to proposals
submitted to foundations to fund expansion or improvement of FHI. As a result,
CCS backbone staff presented information at each monthly PEP meeting related
to planned and active proposals, and invited partners to join in proposal-planning
and development.
 Garnering Support for the Project
• Challenge: Gaining the trust of a wide range of service providers and funders. At
times, some service providers and funders were hesitant to support FHI, viewing
it as “empire-building” by CCS rather than a true collaborative. Over time, much
of this distrust has faded. When CCS decided to no longer compete for service
funding in early childhood—so that it could focus on its role as a backbone
organization and not compete with its partners for services funding—it helped
remove another barrier to trust.
19
 Implementing Aspects of the Project across the Domains of the Social Ecology
• Challenge: Individual/Family/Caregiver Domain. The transient nature of the
families being served presented challenges. Because FHI is a place-based initiative
and a research project, it had to clearly define families “in” and “not in” the
neighborhood. This was challenging for home visitors, particularly when families
lived in their car; or moved in, out, and back into the neighborhood; as well as
when families moving “out” had only moved a block or two but were outside the
formal boundary for the target neighborhoods.
• Challenge: Relationships (Neighborhood) Domain. Each FHI neighborhood has its
own culture, assets, and issues. For FHI, it was important to develop relationships
with local leaders in each neighborhood—both formal and informal leaders—and
make sure that the FHI design and approach in each neighborhood fit that
neighborhood.
• Challenge: Community Domain (Service Providers). “Collaboration” and “partner”
are concepts that exist along a continuum. Each organization in the collaboration
invested at a different level in the goals of the project. Language became difficult
because of that continuum. Some “partners” had participated in discussions of
the goals and methods of FHI and indicated, “Yes, we support that” but had no
other investment. Others contributed services to the collaboration, participated
in its management, and/or worked to extend the partnership to other
organizations. It is important to work with partners to clearly define the
expectations of the partner and of the collaborative, and to follow-up to ensure
these expectations are met.
• Challenge: Public Policy and Social Norms Domain. CCS has had an active
advocacy effort across many years. However it is always difficult to find
appropriate funding to support advocacy and, and particularly, lobbying efforts.
During this project, CCS submitted a proposal to the Robert Wood Johnson
Foundation’s Roadmaps to Health competition, which would have funded a
comprehensive advocacy effort. Unfortunately, the proposal was not funded.
Therefore, the work to advocate for changes in public policy has been funded by a
private donor, allowing CCS to hire a lobbyist. The increased presence with
legislators led to successfully getting a bill passed to expand Healthy Start to all
births, not just first birth families. Getting financial support to work at the Public
Policy level is difficult, given rules related to lobbying connected to many funding
opportunities.
 Other Important Challenges
• Challenge: The geography which FHI wanted to impact presented challenges. FHI
now exists across three counties—Marion, Yamhill (which were part of this QICEC project) and now Polk. When the project first started, FHI held one
Participatory Evaluation and Planning (PEP) meeting each month, with
expectations that Yamhill County partners would travel to Salem to participate in
these meetings. While they did that for quite a while, it became clear that the
20
•
Salem PEP meeting was not working well for the Yamhill County partners.
Therefore, FHI leaders started attending existing meetings in those two counties,
which has resulted in improved relationships.
Challenge: The changing landscape in early learning services and finding FHI’s
role in that. It is a very exciting time in Oregon related to early learning services.
The governor has led a major initiative to change the way early learning services
are structured and funded. A new state Early Learning Council (ELC) now oversees
funding and programs that previously had been managed through separate
departments. In August, 2013, the ELC released a request for applications (RFA)
for organizations and consortia interested in providing “early learning hub”
services for a defined region. After many discussions, CCS and FHI decided not to
apply to become a hub, and rather to collaborate with a new organization formed
by Marion County service providers to respond to the RFA, Early Learning Hub,
Inc. (ELH). CCS provided proposal-writing support for the application. The ELC has
now announced the successful applicants, which included ELH. CCS and FHI will
continue to work with ELH to ensure that FHI and ELH are operating in alignment.
In Yamhill County, CCS was asked to serve as the facilitator for their county team
to respond to the RFA and design their proposed aligned early learning system.
The FHI Collective Impact Coordinator served as the facilitator and their plan
incorporated the Strengthening Families Protective Factors. They also were
selected, along with Marion County, as one of six initial Early Learning Hubs.
B. Overview of the Community, Population, and Problem
1. How “Community” is Defined in the Project
FHI used a neighborhood-based service delivery model that was chosen intentionally in
response to research highlighting the benefits of providing services in this way. For the
purposes of this project, it was important to distinguish between community-based and
neighborhood-based interventions. Early on, Bruner and Chavez (1998) defined the term
“community” to “…refer to the local political jurisdiction (and its boundaries) that is used by the
community collaborative to define its overall territory. ‘Neighborhood’ is used to refer to
distinct (and not so distinct) areas within that community with which residents identify.”
Neighborhoods within a larger community often differ with respect to ethnicity, culture, class,
opportunity, and the current outcomes being experienced by children. In addition, parents
from different neighborhoods within a given community may hold opposing views in terms of
what constitutes child abuse and neglect (Korbin et. al., 2000). Finally, research had not
produced clear data to delineate the relationships between neighborhoods and child
maltreatment (Coulton et. al., 2007). It therefore follows that research addressing a
neighborhood-based intervention is of the utmost relevance. By designing FHI to concentrate
on neighborhood-specific rather than community-wide needs, it served as a clear opportunity
to contribute to research in this area.
21
Korbin et. al. (2000) also summarized sociological and political research that seeks to
differentiate between communities and neighborhoods and identifies additional benefits to
neighborhood-based programming. More specifically, they summarize Susan Keller’s
sociological definition describing neighborhoods as having “social networks” and Robert
Chaskin’s political perspective which emphasizes that neighborhoods, “…are connected by a
complex web of relationships, needs, priorities, and concerns and, further, that they recognize,
or have the potential to recognize, their common concerns and that they have the ability to act
upon these concerns as a unit.” According to the authors, it is these qualities, specific to
neighborhoods and often differing from the larger communities where they are nested, that
can facilitate greater outcomes in the social services sector. They argue that neighborhoodbased efforts are more likely to increase social capital, bringing neighborhood members
together to support each other and collectively influence neighborhood wellbeing.
2. The Geographic Region(s) in which the Project Provides Services
 Geographic Scope
For this project, the Fostering Hope Initiative selected a total of six high-poverty
neighborhoods in Marion and Yamhill counties in northwestern Oregon. The project defined
the specific neighborhoods based on elementary school catchment areas. Therefore, treatment
neighborhoods were Swegle and Washington in Salem, Marion County, Oregon, and the Sue
Buel neighborhood in McMinnville, Yamhill County, Oregon. Comparison neighborhoods,
selected based on their similarity to the treatment neighborhoods, were Hoover and Hallman in
Salem. Because McMinnville (population 32,451) did not contain another neighborhood similar
to Sue Buel, the project selected the Edwards neighborhood in Newberg (population 22,244),
15 miles away but also in Yamhill County.
 Type
Both Marion and Yamhill counties include both urban (cities and small cities) and rural
areas. The neighborhoods selected for focus in the initiative are in urban areas, the city of
Salem (population 156,244), which is the capitol of Oregon, and McMinnville, a much smaller
city at about 32,000 residents. With the support of The Ford Family Foundation and the
region’s United Way, FHI has now expanded into two rural neighborhoods in Polk County (in
Dallas and Independence), and one additional rural neighborhood in Marion County (in
Woodburn).
 Demographic Characteristics
At the start of the project, economic conditions had dramatically increased family stress in
Oregon, where the unemployment rate was 6th worst in the nation, according to the Bureau of
Labor Statistics at that time (http://www.bis.gov/web/laumstrk.htm). Between November
2007 and November 2008, the number of unemployment claims in Marion County rose 52%.
In 2009, Salem Leadership Foundation (SLF) completed an analysis of ten elementary school
neighborhoods in Salem: nine in the McKay High School feeder district, and one (Hoover) that
is on the border of the McKay area and ranked at the top of Need, Readiness, and Proximity,
22
compared with other schools district-wide. The purpose of the analysis was to make a
recommendation on which neighborhoods should be selected for FHI. During their review, SLF
staff assessed the following factors:
• Need: SLF assessed the level of need based on free/reduced price lunch rates, the
Oregon Department of Education Report Card and federal Annual Yearly Progress
rankings, neighborhood crime rates, the number of non-English-speaking students,
and the number of foster children in each neighborhood.
• Proximity: SLF considered whether the school relied on busing and parent
transportation to get the children to campus, or if students and families lived in
close proximity to the school, providing a stronger “center of gravity” for FHI.
• Readiness: For the five neighborhoods that made it past SLF’s first cut, SLF assessed
the building blocks the neighborhoods had in place related to “neighborhood
efficacy.” These included whether the neighborhood surrounding the school had a
local neighborhood association, as well as the principal’s interest, the involvement
of each school’s Community School Outreach Coordinator, the school’s volunteer
programs and its demonstrated partnerships with the surrounding neighborhood.
Tables 2 and 3 summarize the data related to each of the neighborhoods considered. Based
on these reviews, SLF recommended three neighborhoods as finalists: Washington, Swegle,
and Hallman. They also presented information on each possible pairing, for selecting two
neighborhoods. SLF presented the report to the steering committee, which selected the Salem
area neighborhoods.
FHI’s steering committee selected four high poverty neighborhoods in Marion County—
Hallman and Hoover (comparison), Washington and Swegle (treatment sites). All are in highpoverty northeast Salem, where approximately 80% of students qualify for free and reduced
lunch. In addition, the neighborhoods ranked in the top 30% of neighborhoods in the city for
crime. Approximately 78% of students in these schools reported an ethnicity other than white,
as compared with an average of 30% across Oregon schools, with about 61% Hispanic students
(18% average across Oregon schools). 1 About 50% of the students in these schools were in
English as a Second Language programs. The high levels of unemployment, poverty, and crime
within these neighborhoods put the child population at increased risk for child maltreatment.
According to the Data Book from Children First for Oregon, 1287 children in Marion County
were victims of child abuse or neglect in 2008, representing 17 of every 1000 children.
Table 2
Comparison of Neighborhoods Considered for FHI, School-based Measures
Elementary
Enroll
%
% in ESL
Federal
% FRL
Report Card
-ment
Minority
Program
AYP
School
Did Not
Hallman 450
87.5%
82.3%
56.8%
Low
Meet
Hammond 500
54.6%
52.3%
17.5%
Exceptional Met
Hayesville 515
64.7%
75.8%
47.4%
Satisfactory Did Not
1
Proximity
Middle
School
Walk
Waldo
Walk
Bus
Stephens
Stephens
Drawn from school district records and http://www.publicschoolreview.com/school_ov/school_id/65055 on
January 12, 2010
23
Elementary
School
Enroll
-ment
%
Minority
% FRL
% in ESL
Program
Report Card
Federal
AYP
Proximity
Middle
School
Meet
Met
Walk
Parrish
Did Not
Lamb 480
76.7%
78.1%
45.1%
Walk
Stephens
Meet
Middle Grove 185
81.6%
81.0%
45.9%
Strong
Met
Bus
Stephens
Did Not
Scott 600
66.1%
68.2%
40.0%
Satisfactory
Bus
Waldo
Meet
Swegle 500
70.9%
78.8%
36.5%
Strong
Met
Walk
Waldo
Satisfactory Did Not
Washington 450
76.4%
74.8%
56.6%
Walk
Waldo
Meet
Yoshikai 525
65.9%
69.5%
30.3%
Satisfactory Met
Bus
Stephens
Note. FRL = Free/Reduced Lunch; ESL = English as a Second Language; AYP = Annual Yearly Progress.
Table 3
Comparison of Neighborhoods Considered for FHI, Community Measures
# in Foster
# Foster Homes
Crime Incidents
Crime Incidents
Elementary School
Care
in Area
2008
2007
Hallman
30
8
1812
1990
Hammond
2
9
1812
1990
Hayesville
21
11
County
County
Hoover
37
9
1629
1875
Lamb
11
7
1139
1447
Middle Grove
9
2
1139
1447
Scott
25
15
1139
1447
Swegle
24
9
1042
1020
Washington
17
8
762
807
Yoshikai
21
11
County
County
TOTAL
197
89
Hoover
605
84.0%
95.4%
59.2%
Satisfactory
Satisfactory
In addition, the project selected two neighborhoods in Yamhill County: around Sue Buel
Elementary school in McMinnville (treatment neighborhood), and around Edwards Elementary
in Newberg (comparison neighborhood). Although less data were available on the specific
neighborhoods, the mayor, chief of police and superintendent of schools identified these as
their city’s high-poverty, high-crime neighborhood.
Tables 4-7 present data on median income, child welfare, unemployment rate, and ethnicity
for each county and/or FHI neighborhood.
Table 4
Estimated Median Income for a Family of Four
Estimated
Source
Median Income
http://www.liheap.ncat.org/profiles/povertytables/FY2011/orsmi.htm
Oregon
$71,541
http://www.salarylist.com/company/Marion-County-OregonMarion County
$79,518
Geographic Area
24
Salary.htm
http://www.city-data.com/city/Salem-Oregon.html
http://www.city-data.com/county/Yamhill_County-OR.html
http://www.city-data.com/city/McMinnville-Oregon.html
Salem 2009: $42,035
Yamhill County 2009: $51,441
McMinnville
2009: $41,003
(Treatment)
http://www.city-data.com/city/Newberg-Oregon.html
Newberg
2011: $52,853 (drawn 10/15/2013)
(Comparison)
Note. Child Welfare summary for 2010, from the Children First for Oregon, Oregon County Data Book
(drawn 6/15/2012 from http://www.cffo.org/images /pdf_downloads /county_data_books/)
Table 5
Child Welfare Data by County
Reports of child abuse/neglect
% of reports assessed
% of assessed reports founded
# of children in the county who been in foster care at
least once in the past year
% of founded abuse/neglect/threat of harm referrals
were related to domestic violence
…related to substance abuse
# youth aged out of foster care
Marion County
Yamhill County
9,033 (region)
38%
22%
1,686
28%
35%
1,680
232
20.3%
14.3%
46.7%
45
39.9%
7
Table 6
Unemployment Rates July 2013
Geographic Area
Oregon
Marion County
Yamhill County
Source
Drawn 10/15/2013
Unemployment Rates
8.1%
8.8%
7.8%
http://www.bls.gov/lau/
http://www.bls.gov/lau/laucntycur14.txt
http://www.bls.gov/lau/laucntycur14.txt
The ethnic composition for each elementary school, from which the program boundary areas
were defined, is presented in Table 7.
Table 7
Ethnicity of FHI Treatment and Comparison Neighborhoods at the Start of the Study
Marion County
Program
Ethnicity
Washington Swegle
Caucasian/White
26.7%
29.7%
Hispanic/Latino
58.6%
43.8%
Asian/ Pacific Islander
6.2%
7.8%
Comparison
Hallman
Hoover
19.4%
16.5%
73.0%
74.7%
1.6%
1.3%
25
Yamhill County
Program
Sue Buel
65.8%
29.1%
2.0%
Comparison
Edwards
59.5%
37.9%
0.8%
American Indian/
Alaska Native
2.1%
1.0%
2.0%
1.5%
0.8%
Black
0.5%
1.2%
0.7%
0.7%
0.8%
Note. Marion County and Edwards Elementary data drawn from
http://www.schoolmatters.com/schools on April 25, 2010. Sue Buel data drawn from
http://www.msd.k12.or.us/district/fast-facts on April 25, 2010.
0.8%
1.0%
3. Demographic Characteristics, Needs, and Size of the Target Population of
Children and/or Families Served by the Project
The target population for this study consisted of high-risk families with children under the
age of 24 months and for whom there had been no substantiated report of abuse/neglect at
the time of enrollment. Families meeting these criteria and residing in the selected
neighborhoods were eligible for home visiting under the auspices of the Initiative. However, all
neighborhood residents were eligible to participate in other programs provided in the
treatment neighborhoods, including parent education classes, Community Cafés, community
dinners, and other neighborhood engagement activities. The purpose of this policy was to
reduce any potential stigma that might be attached to participation. The target population did
not change during the project. However, the composition of the staff responsible for outreach
did result in overrepresentation of Hispanic/Latino caregivers in the study population, discussed
in greater detail in subsequent sections of this report.
Tables 8 – 89 below summarize demographic data for the program participants who
received home visiting and for the comparison group study participants. Data were captured
with the Background Information Form developed by the QIC-EC. The tables display data only
for those participants who were enrolled in the study for at least 12 months. Two sets of tables
are presented for each demographic item. The first table organizes the results by county and
overall. The second table presents results by neighborhood. For a subset of demographic items,
additional tables presenting data for Hispanic/Latino participants also are included.
26
Caregiver Demographics
As shown in Tables 8 - 10 below, participants from both study groups were most apt to be
between 30 and 39 years of age. All were the mother or father of the child enrolled in the study
(data not tabled).
Table 8
Caregiver Age Overall and by County
Caregiver Age
Study Group
Under 20
20-24
25-29
30-39
40+
Overall
Marion County
Yamhill County
Treatment
(n=70)
Comparison
(n=65)
Treatment
(n=55)
Comparison
(n=49)
Treatment
(n=15)
Comparison
(n=16)
15.7%
12.9%
27.1%
40.0%
4.3%
4.6%
15.4%
35.4%
38.5%
6.2%
12.7%
12.7%
29.1%
40.0%
5.5%
2.0%
16.3%
34.7%
38.8%
8.2%
26.7%
13.3%
20.0%
40.0%
0.0%
12.5%
12.5%
37.5%
37.5%
0.0%
Table 9
Caregiver Age Overall and by County – Hispanic/Latino Participants
Caregiver Age
Overall
Marion County
Yamhill County
Treatment Comparison Treatment Comparison Treatment Comparison
(n=50)
(n=53)
(n=36)
(n=43)
(n=14)
(n=10)
Study Group
Under 20
20-24
25-29
30-39
40+
16.0%
12.0%
24.0%
42.0%
6.0%
1.9%
17.0%
34.0%
39.6%
7.5%
11.1%
11.1%
25.0%
44.4%
8.3%
0.0%
18.6%
32.6%
39.5%
9.3%
28.6%
14.3%
21.4%
35.7%
0.0%
10.0%
10.0%
40.0%
40.0%
0.0%
Table 10
Caregiver Age by Neighborhood
Caregiver Age
Study Group
Neighborhood
Under 20
20-24
25-29
30-39
40+
Marion County
Treatment
Yamhill County
Comparison
Treatment
Comparison
Washington
(n=27)
Swegle
(n=28)
Hallman
(n=29)
Hoover
(n=20)
Sue Buel
(n=15)
Edwards
(n=16)
7.4%
18.5%
25.9%
40.7%
7.4%
17.9%
7.1%
32.1%
39.3%
3.6%
3.4%
17.2%
34.5%
37.9%
6.9%
0.0%
15.0%
35.0%
40.0%
10.0%
26.7%
13.3%
20.0%
40.0%
0.0%
12.5%
12.5%
37.5%
37.5%
0.0%
27
Almost all participants were female, regardless of county or neighborhood (Tables 11 and 12).
Table 11
Caregiver Gender Overall and by County
Caregiver Gender
Study Group
Female
Male
Overall
Marion County
Yamhill County
Treatment
(n=70)
Comparison
(n=65)
Treatment
(n=55)
Comparison
(n=49)
Treatment
(n=15)
Comparison
(n=16)
98.6%
1.4%
100.0%
0.0%
98.2%
1.8%
100.0%
0.0%
100.0%
0.0%
100.0%
0.0%
Table 12
Caregiver Gender by Neighborhood
Caregiver Gender
Study Group
Neighborhood
Female
Male
Marion County
Treatment
Washington
Swegle
(n=27)
(n=28)
96.3%
3.7%
Yamhill County
Comparison
Hallman
Hoover
(n=29)
(n=20)
100.0%
0.0%
100.0%
0.0%
100.0%
0.0%
Treatment
Sue Buel
(n=15)
Comparison
Edwards
(n=16)
100.0%
0.0%
100.0%
0.0%
The majority of participants were Hispanic/Latino (62.5-93.3%), both by county and overall
(Table 13), and within each neighborhood (Table 14).
Table 13
Caregiver Race Overall and by County
Caregiver Racial/Ethnic Identification
Study Group
Overall
Tx.
(n=70)
Comp.
(n=65)
Marion County
Tx.
(n=55)
Comp.
(n=49)
Yamhill County
Tx.
(n=15)
Comp.
(n=16)
African American/Black
1.4%
0.0%
1.8%
0.0%
0.0%
0.0%
Asian/Asian American
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Caribbean Islander/African National
0.0%
1.5%
0.0%
0.0%
0.0%
6.3%
Caucasian/White/European American 21.4%
16.9%
25.5%
12.2%
6.7%
31.3%
Hispanic/Latino 71.4%
81.5%
65.5%
87.8%
93.3%
62.5%
Native American/Alaska Native
1.4%
0.0%
1.8%
0.0%
0.0%
0.0%
Native Hawaiian/Pacific Islander
5.7%
0.0%
7.3%
0.0%
0.0%
0.0%
Middle Eastern
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Multi-racial/Biracial
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Other
1.4%
0.0%
1.8%
0.0%
0.0%
0.0%
Note. Participants could select more than one response. Tx. = Treatment; Comp. = Comparison.
28
Table 14
Caregiver Race by Neighborhood
Caregiver Racial/
Ethnic Identification
Study Group
Neighborhood
Marion County
Treatment
Washington
Swegle
(n=27)
(n=28)
Yamhill County
Comparison
Hallman
Hoover
(n=29)
(n=20)
Tx.
Sue Buel
(n=15)
Comp.
Edwards
(n=16)
African American/Black
0.0%
3.6%
0.0%
0.0%
0.0%
0.0%
Asian/Asian American
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Caribbean Islander/
0.0%
0.0%
0.0%
0.0%
0.0%
6.3%
African National
Caucasian/White/
29.6%
21.4%
13.8%
10.0%
6.7%
31.3%
European American
Hispanic/Latino
66.7%
64.3%
86.2%
90.0%
93.3%
62.5%
Native American/Alaska
3.7%
0.0%
0.0%
0.0%
0.0%
0.0%
Native
Native Hawaiian/Pacific
3.7%
10.7%
0.0%
0.0%
0.0%
0.0%
Islander
Middle Eastern
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Multi-racial/Biracial
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Other
3.7%
0.0%
0.0%
0.0%
0.0%
0.0%
Note. Participants could select more than one response. Tx. = Treatment; Comp. = Comparison.
Less than one third of participants reported that English was their primary language when
disaggregated by County (12.5-37.5%, Table 15), and by neighborhood (10.0-37.5%, Table 16).
Table 15
Caregiver Primary Language Overall and by County - % Yes
Language
Study Group
Overall
Treatment
(n=70)
Is English your main
27.1%
language? % Yes
Note. Comp. = Comparison.
Marion County
Yamhill County
Comparison
(n=64)
Treatment
(n=55)
Comparison
(n=48)
Treatment
(n=15)
Comp.
(n=16)
18.8%
30.9%
12.5%
13.3%
37.5%
Table 16
Caregiver Primary Language by Neighborhood - % Yes
Language
Study Group
Neighborhood
Is English your main
language? % Yes
Marion County
Treatment
Washington
Swegle
(n=27)
(n=28)
33.3%
28.6%
Yamhill County
Comparison
Hallman Hoover
(n=28)
(n=20)
14.3%
29
10.0%
Treatment
Sue Buel
(n=15)
Comparison
Edwards
(n=16)
13.3%
37.5%
Among treatment group participants, approximately half indicated that they were able to
speak or read English (51.2-64.3%, Table 17). Comparison group participants were considerably
less apt to report the ability to speak or read English (10-30.2%, Table 17). Participants from
the Hoover and Edwards comparison neighborhoods were the least likely to report the ability
to speak or read English (10-20%, Table 18).
Table17
Caregiver Ability to Speak and Read English Overall and by County - % Yes
Language
Study Group
Overall
Treatment
(n=55)
Marion County
Comparison
(n=53)
If English is not your
main language, can you
54.5%
26.4%
speak English? % Yes
If English is not your
main language, can you
54.5%
28.3%
read English? % Yes
Note. Tx. = Treatment; Comp. = Comparison.
Yamhill County
Treatment
(n=41)
Comp.
(n=43)
Tx.
(n=14)
Comp.
(n=10)
51.2%
30.2%
64.3%
10.0%
53.7%
30.2%
57.1%
20.0%
Table 18
Caregiver Ability to Speak and Read English by Neighborhood - % Yes
Language
Study Group
Neighborhood
If English is not your main
language, can you speak
English? % Yes
If English is not your main
language, can you read
English? % Yes
Marion County
Treatment
Washington Swegle
(n=19)
(n=22)
Yamhill County
Comparison
Hallman Hoover
(n=25)
(n=18)
Treatment
Sue Buel
(n=14)
Comparison
Edwards
(n=10)
47.4%
54.5%
40.0%
16.7%
64.3%
10.0%
52.6%
54.5%
40.0%
16.7%
57.1%
20.0%
Approximately half of the respondents, both overall and by county, were married to the
father or mother of the child in the project at the time they were surveyed. The Edwards
neighborhood contained both the smallest proportion of caregivers who had never been
married and the largest proportion of respondents who were not married but residing with the
father or mother or the child in the project (Tables 19-21).
30
Table 19
Caregiver Marital Status Overall and by County
Overall
Marital Status
Marion County
Yamhill County
Tx.
(n=70)
Comp.
(n=65)
Tx.
(n=55)
Comp.
(n=49)
Tx.
(n=15)
Comp.
(n=16)
Never married
Divorced
Separated
Widowed
24.3%
4.3%
1.4%
0.0%
18.5%
1.5%
3.1%
0.0%
23.6%
5.5%
1.8%
0.0%
20.4%
0.0%
4.1%
0.0%
26.7%
0.0%
0.0%
0.0%
12.5%
6.3%
0.0%
0.0%
Married to father or mother of child in
the project
47.1%
47.7%
47.3%
53.1%
46.7%
31.3%
Married, but not to the father or
mother of the child in the project
2.9%
1.5%
3.6%
0.0%
0.0%
6.3%
Not married, but living with the father
or mother of the child in the project
20.0%
27.7%
18.2%
22.4%
26.7%
43.8%
Not married, but living with boyfriend,
girlfriend, or partner who is not the
parent of the child in the project
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Study Group
Note. Tx. = Treatment; Comp. = Comparison.
Table 20
Caregiver Marital Status Overall and by County – Hispanic/Latino Participants
Marital Status
Overall
Marion County
Yamhill County
Tx.
(n=50)
Comp.
(n=53)
Tx.
(n=36)
Comp.
(n=43)
Tx.
(n=14)
Comp.
(n=10)
Never married
Divorced
Separated
Widowed
22.0%
2.0%
0.0%
0.0%
13.2%
0.0%
3.8%
0.0%
19.4%
2.8%
0.0%
0.0%
14.0%
0.0%
4.7%
0.0%
28.6%
0.0%
0.0%
0.0%
10.0%
0.0%
0.0%
0.0%
Married to father or mother of child in the
project
50.0%
50.9%
52.8%
58.1%
42.9%
20.0%
Married, but not to the father or mother of
the child in the project
2.0%
0.0%
2.8%
0.0%
0.0%
0.0%
24.0%
32.1%
22.2%
23.3%
28.6%
70.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Study Group
Not married, but living with the father or
mother of the child in the project
Not married, but living with boyfriend,
girlfriend, or partner who is not the parent of
the child in the project
Note. Tx. = Treatment; Comp. = Comparison.
31
Table 21
Caregiver Marital Status by Neighborhood
Marital Status
Study Group
Neighborhood
Never married
Divorced
Separated
Widowed
Married to father or
mother of child in the
project
Married, but not to the
father or mother of the
child in the project
Not married, but living
with the father or mother
of the child in the project
Not married, but living
with boyfriend, girlfriend,
or partner who is not the
parent of the child in the
project
Marion County
Treatment
Yamhill County
Comparison
Treatment
Comparison
Washington
(n=27)
22.2%
11.1%
3.7%
0.0%
Swegle
(n=28)
25.0%
0.0%
0.0%
0.0%
Hallman
(n=29)
20.7%
0.0%
6.9%
0.0%
Hoover
(n=20)
20.0%
0.0%
0.0%
0.0%
Sue Buel
(n=15)
26.7%
0.0%
0.0%
0.0%
Edwards
(n=16)
12.5%
6.3%
0.0%
0.0%
40.7%
53.6%
62.1%
40.0%
46.7%
31.3%
0.0%
7.1%
0.0%
0.0%
0.0%
6.3%
22.2%
14.3%
10.3%
40.0%
26.7%
43.8%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
As demonstrated by data displayed in Table 22, few respondents indicated completing
education beyond high school or a GED. Overall, half or more of treatment and comparison
group participants reported elementary or middle school as their highest education level (50%
and 58.5%, respectively). Respondents from the Hallman and Hoover comparison
neighborhoods reported the lowest education levels as compared to other study
neighborhoods (Table 24).
32
Table 22
Caregiver Education Level Overall and by County
Highest Education Level Completed
Overall
Marion County
Yamhill County
Tx.
(n=68)
Comp.
(n=65)
Tx.
(n=53)
Comp.
(n=49)
Tx.
(n=15)
Comp.
(n=16)
Completed elementary school 19.1%
Completed middle school/junior high 30.9%
Completed high school 26.5%
Earned GED
8.8%
Completed trade/technical school
8.8%
Received 2-year college degree
4.4%
(Associate's)
Received 4-year college degree
1.5%
(Bachelor's)
Received a graduate degree
0.0%
Note. Tx. = Treatment; Comp. = Comparison.
27.7%
30.8%
27.7%
6.2%
6.2%
17.0%
34.0%
24.5%
9.4%
9.4%
28.6%
38.8%
20.4%
8.2%
2.0%
26.7%
20.0%
33.3%
6.7%
6.7%
25.0%
6.3%
50.0%
0.0%
18.8%
1.5%
3.8%
2.0%
6.7%
0.0%
0.0%
1.9%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Study Group
Table 23
Caregiver Education Level Overall and by County – Hispanic/Latino Participants
Highest Education Level Completed
Overall
Marion County
Yamhill County
Tx.
(n=48)
Comp.
(n=53)
Tx.
(n=34)
Comp.
(n=43)
Tx.
(n=14)
Comp.
(n=10)
Completed elementary school 27.1%
Completed middle school/junior high 27.1%
Completed high school 29.2%
Earned GED 10.4%
Completed trade/technical school 4.2%
Received 2-year college degree 2.1%
(Associate's)
Received 4-year college degree 0.0%
(Bachelor's)
Received a graduate degree 0.0%
Note. Tx. = Treatment; Comp. = Comparison.
34.0%
32.1%
26.4%
7.5%
0.0%
0.0%
26.5%
29.4%
29.4%
11.8%
2.9%
0.0%
32.6%
37.2%
20.9%
9.3%
0.0%
0.0%
28.6%
21.4%
28.6%
7.1%
7.1%
7.1%
40.0%
10.0%
50.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Study Group
33
Table 24
Caregiver Education Level by Neighborhood
Highest Education
Level Completed
Marion County
Study Group
Treatment
Washington Swegle
Neighborhood
(n=27)
(n=26)
Completed elementary school
22.2%
11.5%
Completed middle school/junior
29.6%
38.5%
high
Completed high school
25.9%
23.1%
Earned GED
7.4%
11.5%
Completed trade/technical
14.8%
3.8%
school
Received 2-year college degree
0.0%
7.7%
(Associate's)
Received 4-year college degree
(Bachelor's)
Yamhill County
Comparison
Hallman Hoover
(n=29)
(n=20)
34.5%
20.0%
Tx.
Comp.
Sue Buel Edwards
(n=15)
(n=16)
26.7%
25.0%
24.1%
60.0%
20.0%
6.3%
31.0%
6.9%
5.0%
10.0%
33.3%
6.7%
50.0%
18.8%
0.0%
5.0%
6.7%
0.0%
3.4%
0.0%
6.7%
0.0%
0.0%
3.8%
0.0%
0.0%
0.0%
0.0%
Received a graduate degree
0.0%
Note. Tx. = Treatment; Comp. = Comparison.
0.0%
0.0%
0.0%
0.0%
0.0%
Program group participants were more likely to indicate that they or a member of their
family had a drinking problem (Table 25). These findings held when data were disaggregated for
Marion County. With regard to neighborhood, drinking and drug problems were reported most
often by caregivers residing in the Washington treatment neighborhood (Table 26).
Table 25
Caregiver & Family Member Drinking and Drug Use Overall and by County - % Yes
Drinking and Drugs
Study Group
Have you ever had a drinking or drug
problem? % Yes
Overall
Marion County
Yamhill County
Tx.
(n=70)
Comp.
(n=65)
Tx.
(n=55)
Comp.
(n=49)
Tx.
(n=15)
Comp.
(n=16)
14.3%
4.6%
14.5%
4.1%
13.3%
6.3%
23.1%
36.4%
20.4%
20.0%
31.3%
0.0%
3.6%
0.0%
0.0%
0.0%
Has any family member ever had a
32.9%
drinking or drug problem? % Yes
Do you feel that you have a drinking
or drug problem now?
2.9%
% Yes
Note. Tx. = Treatment; Comp. = Comparison.
34
Table26
Caregiver & Family Member Drinking and Drug Use by Neighborhood - % Yes
Drinking and Drugs
Marion County
Study Group
Neighborhood
Have you ever had a
drinking or drug problem?
% Yes
Has any family member
ever had a drinking or drug
problem? % Yes
Do you feel that you have
a drinking or drug problem
now? % Yes
Note. Comp. = Comparison.
Treatment
Yamhill County
Comparison
Treatment
Comp.
Washington
(n=27)
Swegle
(n=28)
Hallman
(n=29)
Hoover
(n=20)
Sue Buel
(n=15)
Edwards
(n=16)
18.5%
10.7%
3.4%
5.0%
13.3%
6.3%
40.7%
32.1%
17.2%
25.0%
20.0%
31.3%
7.4%
0.0%
0.0%
0.0%
0.0%
0.0%
Fewer than 15% of respondents were concerned about the types of violence queried in the
Background Information Form, overall as well as by county and neighborhood (Tables 27 and
28). The only exception was in the Sue Buel comparison neighborhood in Yamhill County, where
20% of caregivers were worried that someone might attack them with a weapon (Table 28).
Table 27
Caregiver Concerns about Violence Overall and by County - % Yes
Concerns about Violence: Are you
currently worried that…
Study Group
Overall
Tx.
(n=70)
Someone might attack you with a gun,
knife, stick, bottle, or other weapon? 11.4%
% Yes
Someone might hurt you by striking
you, beating you, or otherwise 10.0%
physically abusing you? % Yes
Someone might force you to engage in
4.3%
sexual acts against your will? % Yes
Note. Tx. = Treatment; Comp. = Comparison.
35
Marion County
Yamhill County
Comp.
(n=65)
Tx.
(n=55)
Comp.
(n=49)
Tx.
(n=15)
Comp.
(n=16)
6.2%
9.1%
6.1%
20.0%
6.3%
3.1%
9.1%
4.1%
13.3%
0.0%
0.0%
3.6%
0.0%
6.7%
0.0%
Table 28
Caregiver Concerns about Violence by Neighborhood - % Yes
Concerns about Violence: Are you
currently worried that…
Study Group
Marion County
Treatment
Wash. Swegle
(n=27) (n=28)
Neighborhood
Yamhill County
Comparison
Hallman Hoover
(n=29)
(n=20)
Treatment
Sue Buel
(n=15)
Comp.
Edwards
(n=16)
Someone might attack you with a
gun, knife, stick, bottle, or other
weapon? % Yes
7.4%
10.7%
6.9%
5.0%
20.0%
6.3%
Someone might hurt you by striking
you, beating you, or otherwise
physically abusing you? % Yes
7.4%
10.7%
0.0%
10.0%
13.3%
0.0%
0.0%
0.0%
6.7%
0.0%
Someone might force you to engage
in sexual acts against your will? % 7.4%
0.0%
Yes
Note. Comp. = Comparison. Wash. = Washington
Child Demographics
Similar to the tables in the previous section, the following pages present data summarizing
child demographics overall, as well as by county and neighborhood. In alignment with the
requirements of the QIC-EC grant, all children enrolled in the study were under 24 months of
age at baseline (Tables 29 and 30).
Table 29
Child Age Overall and by County
Child Age in Months
Study Group
Overall
Treatment
(n=68)
Minimum
0
Maximum
24
Mean
8.90
Note. Comp. = Comparison.
Marion County
Yamhill County
Comparison
(n=64)
Treatment
(n=53)
Comp.
(n=48)
Treatment
(n=15)
Comp.
(n=16)
0
22
9.39
0
24
8.26
0
20
9.19
0
22
11.13
0
22
10.00
36
Table 30
Child Age by Neighborhood
Child Age in Months
Study Group
Marion County
Treatment
Washington
Swegle
(n=26)
(n=27)
Neighborhood
Minimum
Maximum
Mean
0
24
10.19
Yamhill County
Comparison
Hallman
Hoover
(n=28)
(n=20)
0
19
6.41
0
19
10.46
0
20
7.40
Treatment
Sue Buel
(n=15)
Comparison
Edwards
(n=16)
0
22
11.13
0
22
10.00
As shown in Table 31, over half of children enrolled in the study were male, both overall and
across Marion and Yamhill Counties. This held true in five of six study neighborhoods. In the
Hoover comparison neighborhood, however, 60% of participating children were female (Table
32).
Table 31
Child Gender Overall and by County
Child Gender
Study Group
Female
Male
Overall
Marion County
Yamhill County
Treatment
(n=68)
Comparison
(n=64)
Treatment
(n=53)
Comparison
(n=48)
Treatment
(n=15)
Comparison
(n=16)
36.8%
63.2%
45.3%
54.7%
35.8%
64.2%
47.9%
52.1%
40.0%
60.0%
37.5%
62.5%
Table 32
Child Gender by Neighborhood
Child Gender
Study Group
Neighborhood
Female
Male
Marion County
Treatment
Washington
Swegle
(n=26 )
(n=27 )
34.6%
65.4%
37.0%
63.0%
Yamhill County
Comparison
Hallman
Hoover
(n=28)
(n=20)
39.3%
60.7%
60.0%
40.0%
Treatment
Sue Buel
(n=15)
Comparison
Edwards
(n=16)
40.0%
60.0%
37.5%
62.5%
Table 33 demonstrates that, similar to parent/caregiver data presented previously, most
children were Hispanic/Latino (75.7-84.6%, overall). As shown in Table 34, Swegle was the most
diverse study neighborhood with notable representation from several racial/ethnic groups.
Table 33
Child Race Overall and by County
Child Racial/Ethnic Identification
Study Group
African American/Black
Overall
Marion County
Yamhill County
Tx.
(n=70)
Comp.
(n=65)
Tx.
(n=55)
Comp.
(n=49)
Tx.
(n=15)
Comp.
(n=16)
4.3%
1.5%
5.5%
0.0%
0.0%
6.3%
37
Asian/Asian American
1.4%
0.0%
1.8%
0.0%
0.0%
0.0%
Caribbean Islander/African National
1.4%
0.0%
1.8%
0.0%
0.0%
0.0%
Caucasian/White/European American
20.0%
16.9%
21.8% 10.2% 13.3%
37.5%
Hispanic/Latino
75.7%
84.6%
70.9% 89.8% 93.3%
68.8%
Native American/Alaska Native
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Native Hawaiian/Pacific Islander
7.1%
0.0%
9.1%
0.0%
0.0%
0.0%
Middle Eastern
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Multi-racial/Biracial
4.3%
3.1%
5.5%
4.1%
0.0%
0.0%
Other
1.4%
0.0%
1.8%
0.0%
0.0%
0.0%
Note. Participants could select more than one response. Tx. = Treatment; Comp. = Comparison.
Table 34
Child Race by Neighborhood
Child Racial/Ethnic
Identification
Study Group
Neighborhood
Marion County
Treatment
Washington Swegle
(n=27 )
(n=28 )
Yamhill County
Comparison
Hallman
Hoover
(n=29)
(n=20)
African American/Black
3.7%
7.1%
0.0%
Asian/Asian American
0.0%
3.6%
0.0%
Caribbean Islander/
0.0%
3.6%
0.0%
African National
Caucasian/White/
22.2%
21.4%
13.8%
European American
Hispanic/Latino
74.1%
67.9%
89.7%
Native American/Alaska
0.0%
0.0%
0.0%
Native
Native Hawaiian/Pacific
3.7%
14.3%
0.0%
Islander
Middle Eastern
0.0%
0.0%
0.0%
Multi-racial/Biracial
3.7%
7.1%
3.4%
Other
0.0%
3.6%
0.0%
Note. Participants could select more than one response.
Treatment
Sue Buel
(n=15)
Comparison
Edwards
(n=16)
0.0%
0.0%
0.0%
0.0%
6.3%
0.0%
0.0%
0.0%
0.0%
5.0%
13.3%
37.5%
90.0%
93.3%
68.8%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
5.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
When asked to indicate with whom the target child lives, 50% or more of respondents, both
overall and across counties, reported that their child lives with a relative, typically in addition to
the primary caregiver and the child’s other parent (Table 35). Hispanic/Latino children were
notably more likely to reside with both parents and a relative (Table 36).
38
Table 35
With Whom the Child Lives Overall and by County
Right now, who does your child
live with?
Overall
Tx.
(n=70)
Study Group
Marion County
Comp.
(n=65)
Tx.
(n=55)
Yamhill County
Comp.
(n=49)
Tx.
(n=15)
Comp.
(n=16)
Project participant
84.3%
93.8%
80.0%
91.8%
100.0%
100.0%
Other parent
51.4%
75.4%
43.6%
75.5%
80.0%
75.0%
A relative
54.3%
63.1%
50.9%
67.3%
66.7%
50.0%
Child is currently hospitalized
2.9%
7.7%
3.6%
8.2%
0.0%
6.3%
A friend
1.4%
0.0%
0.0%
0.0%
6.7%
0.0%
Child is in foster care
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Other
1.4%
1.5%
1.8%
2.0%
0.0%
0.0%
Note. Participants could select more than one response. Tx. = Treatment; Comp. = Comparison.
Table 36
With Whom the Child Lives Overall and by County – Hispanic/Latino Participants
Right now, who does your
child live with?
Overall
Yamhill County
Comp.
(n=53)
Tx.
(n=36)
Comp.
(n=43)
Tx.
(n=14)
Comp.
(n=10)
88.0%
92.5%
Project participant
62.0%
81.1%
Other parent
62.0%
69.8%
A relative
2.0%
7.5%
Child is currently hospitalized
2.0%
0.0%
A friend
0.0%
0.0%
Child is in foster care
2.0%
1.9%
Other
Note. Tx. = Treatment; Comp. = Comparison.
83.3%
55.6%
61.1%
2.8%
0.0%
0.0%
2.8%
90.7%
79.1%
69.8%
7.0%
0.0%
0.0%
2.3%
100.0%
78.6%
64.3%
0.0%
7.1%
0.0%
0.0%
100.0%
90.0%
70.0%
10.0%
0.0%
0.0%
0.0%
Study Group
Tx.
(n=50)
Marion County
Table 37
With Whom the Child Lives by Neighborhood
Right now, who does
your child live with?
Study Group
Neighborhood
Project participant
Other parent
A relative
Child is currently
Marion County
Treatment
Yamhill County
Comparison
Treatment
Comparison
Washington
(n= 27)
Swegle
(n=28 )
Hallman
(n=29)
Hoover
(n=20)
Sue Buel
(n=15)
Edwards
(n=16)
81.5%
44.4%
55.6%
0.0%
78.6%
42.9%
46.4%
7.1%
89.7%
72.4%
58.6%
3.4%
95.0%
80.0%
80.0%
15.0%
100.0%
80.0%
66.7%
0.0%
100.0%
75.0%
50.0%
6.3%
39
hospitalized
A friend
0.0%
0.0%
0.0%
Child is in foster care
0.0%
0.0%
0.0%
Other
0.0%
3.6%
0.0%
Note: Participants could select more than one response
0.0%
0.0%
5.0%
6.7%
0.0%
0.0%
0.0%
0.0%
0.0%
Over 90% children were insured at the baseline data collection time-point, overall, by
county, and when disaggregated by neighborhood (Tables 38 and 39).
Table 38
Child Health Insurance Overall and by County - % Yes
Does your child have any health
insurance now?
Overall
Marion County
Yamhill County
Tx.
(n=66)
Comp.
(n=64)
Tx.
(n=52)
Comp.
(n=48)
Tx.
(n=14)
Comp.
(n=16)
% Yes 93.9%
Note. Tx. = Treatment; Comp. = Comparison.
98.4%
94.2%
97.9%
92.9%
100.0%
Study Group
Table 39
Child Health Insurance by Neighborhood - % Yes
Does your child have any
health insurance now?
Study Group
Neighborhood
% Yes
Marion County
Treatment
Washington Swegle
(n=25)
(n=27)
96.0%
92.6%
Comparison
Hallman Hoover
(n=29)
(n=19)
96.6%
100.0%
Yamhill County
Treatment
Sue Buel
(n=14)
92.9%
Comparison
Edwards
(n=16)
100.0%
The majority of caregivers reported that their children’s health was “good,” “very good,” or
“excellent” across all counties and neighborhoods (Tables 40 -42). The child health item also
was analyzed with repeated measures analysis of variance (ANOVA), which did not produce
significant results overall, by county, or by race.
40
Table 40
Child Health Overall and by County
In general, how good
is your child's health?
Overall
Treatment
(n=61)
Study Group
Marion County
Yamhill County
Comparison
(n=61)
Treatment
(n=46)
Comp.
(n=45)
Treatment
(n=15)
Comp.
(n=16)
36.1%
16.4%
37.7%
9.8%
0.0%
37.0%
23.9%
32.6%
6.5%
0.0%
35.6%
15.6%
37.8%
11.1%
0.0%
46.7%
13.3%
20.0%
20.0%
0.0%
37.5%
18.8%
37.5%
6.3%
0.0%
Excellent
39.3%
Very good
21.3%
Good
29.5%
Fair
9.8%
Poor
0.0%
Note. Comp. = Comparison.
Table 41
Child Health Overall and by County – Hispanic/Latino Participants
In general, how good
is your child's health?
Study Group
Overall
Treatment
(n=45)
Marion County
Yamhill County
Comparison
(n=49)
Treatment
(n=31)
Comp.
(n=39)
Treatment
(n=14)
Comp.
(n=10)
24.5%
18.4%
44.9%
12.2%
0.0%
29.0%
29.0%
35.5%
6.5%
0.0%
30.8%
15.4%
41.0%
12.8%
0.0%
42.9%
14.3%
21.4%
21.4%
0.0%
0.0%
30.0%
60.0%
10.0%
0.0%
Excellent
33.3%
Very good
24.4%
Good
31.1%
Fair
11.1%
Poor
0.0%
Note. Comp. = Comparison.
Table 42
Child Health by Neighborhood
In general, how good is
your child's health?
Study Group
Marion County
Treatment
Neighborhood
Excellent
Very good
Good
Fair
Poor
Yamhill County
Comparison
Treatment
Comparison
Washington
(n=23)
Swegle
(n=23)
Hallman
(n=26)
Hoover
(n=19)
Sue Buel
(n=15)
Edwards
(n=16)
34.8%
30.4%
30.4%
4.3%
0.0%
39.1%
17.4%
34.8%
8.7%
0.0%
38.5%
15.4%
34.6%
11.5%
0.0%
31.6%
15.8%
42.1%
10.5%
0.0%
46.7%
13.3%
20.0%
20.0%
0.0%
37.5%
18.8%
37.5%
6.3%
0.0%
41
Most respondents indicated that they use a clinic for their child’s regular check-ups and
illness. Program participants in Yamhill County, however, were almost equally likely to take
their child to a doctor’s office (Tables 43 and 44).
Table 43
Child Health Service Location Overall and by County
What type of place do you usually take
your child for regular check-ups or
when he/she is sick?
Study Group
Overall
Tx.
(n=70)
Comp.
(n=65)
Marion County
Yamhill County
Tx.
(n=55)
Tx.
(n=15)
Comp.
(n=49)
Comp.
(n=16)
Doctor's office 24.3%
27.7%
23.6%
20.4% 26.7%
Emergency room or urgent care unit
2.9%
1.5%
0.0%
2.0%
13.3%
Clinic 77.1%
75.4%
74.5%
81.6% 86.7%
Other
1.4%
0.0%
1.8%
0.0%
0.0%
Note. Participants could select more than one response. Tx. = Treatment; Comp. = Comparison.
50.0%
0.0%
56.3%
0.0%
Table 44
Child Health Service Location by Neighborhood
What type of place do you usually take
your child for regular check-ups or
when he/she is sick?
Marion County
Yamhill County
Study Group
Treatment
Comparison
Tx.
Comp.
Wash. Swegle Hallman Hoover Sue Buel Edwards
Neighborhood
(n=27) (n=28)
(n=29)
(n=20)
(n=15)
(n=16)
Doctor's office 18.5%
28.6%
13.8%
30.0%
26.7%
50.0%
Emergency room or urgent care unit
0.0%
0.0%
0.0%
5.0%
13.3%
0.0%
Clinic 74.1%
75.0%
82.8%
80.0%
86.7%
56.3%
Other
0.0%
3.6%
0.0%
0.0%
0.0%
0.0%
Note. Participants could select more than one response. Tx. = Treatment; Comp. = Comparison; Wash. =
Washington
Overall, fewer than 5% of caregivers indicated that their child has special health care needs.
Caregivers from the Washington treatment neighborhood were most likely to report special
health care needs for their children (13%).
Table 45
Child Special Health Care Needs Overall and by County - % Yes
Does your child have any special
health care needs?
Study Group
Overall
Tx.
(n=61)
% Yes
4.9%
Note. Tx. = Treatment; Comp. = Comparison.
Marion County
Yamhill County
Comp.
(n=61)
Tx.
(n=46)
Comp.
(n=45)
Tx.
(n=15)
Comp.
(n=16)
3.3%
6.5%
4.4%
0.0%
0.0%
42
Table 46
Child Special Health Care Needs by Neighborhood - % Yes
Does your child have any
special health care needs?
Marion County
Study Group
Neighborhood
Treatment
Washington
(n=23)
% Yes
13.0%
Note. Tx. = Treatment; Comp. = Comparison.
Yamhill County
Comparison
Tx.
Comp.
Swegle
(n=23)
Hallman
(n=26)
Hoover
(n=19)
Sue Buel
(n=15)
Edwards
(n=16)
0.0%
7.7%
0.0%
0.0%
0.0%
Health conditions that caregivers reported for their children were:
• Anemia (n=4)
• Asthma (n=9)
• Blind or visually impaired (n=1)
• Deaf or hearing impaired (n=1)
• Heart disease or heart condition (n=1)
• Other (n=12)
Approximately one third of caregivers reported having taken their child to the emergency
room in the past 12 months (33.3-38.6%, overall). Emergency room visits were most common
in the Swegle and Sue Buel program neighborhoods (42.9%).
Table 47
Child Emergency Room Visits Overall and by County - % Yes
During the past 12 months, has
your child visited a hospital
emergency room to receive
medical care for any reason?
Overall
Marion County
Yamhill County
Tx.
(n=57)
Comp.
(n=60)
Tx.
(n=43)
Comp.
(n=44)
Tx.
(n=14)
Comp.
(n=16)
% Yes
38.6%
Note. Tx. = Treatment; Comp. = Comparison.
33.3%
37.2%
36.4%
42.9%
25.0%
Study Group
Table 48
Child Emergency Room Visits by Neighborhood - % Yes
During the past 12 months, has
your child visited a hospital
emergency room to receive
medical care for any reason?
Study Group
Neighborhood
Marion County
Treatment
Washington Swegle
(n=22)
(n=21)
% Yes
31.8%
Note. Tx. = Treatment; Comp. = Comparison.
42.9%
43
Yamhill County
Comparison
Hallman Hoover
(n=26)
(n=18)
38.5%
33.3%
Tx.
Sue Buel
(n=14)
Comp.
Edwards
(n=16)
42.9%
25.0%
Among caregivers who had taken their child to the emergency room, 85% or more reported
two or fewer visits in the past 12 months when responses were analyzed overall (Table 49).
One third of caregivers in the Hoover neighborhood who had used the emergency room had
done so three times in the past 12 months and 25% of respondents from Edwards had used the
emergency room six or more times (Table 50).
Table 49
Number of Emergency Room Visits Overall and by County
If your child has visited a hospital emergency
room to receive medical care over the past 12
months, how many times?
Study Group
One time
Two times
Three times
Four times
Five times
Six or more times
Note. Tx. = Treatment; Comp. = Comparison.
Overall
Marion County
Yamhill County
Tx.
(n=22)
Comp.
(n=20)
Tx.
(n=16)
Comp.
(n=16)
Tx.
(n=6)
Comp.
(n=4)
72.7%
18.2%
9.1%
0.0%
0.0%
0.0%
65.0%
20.0%
10.0%
0.0%
0.0%
5.0%
68.8%
25.0%
6.3%
0.0%
0.0%
0.0%
62.5%
25.0%
12.5%
0.0%
0.0%
0.0%
83.3%
0.0%
16.7%
0.0%
0.0%
0.0%
75.0%
0.0%
0.0%
0.0%
0.0%
25.0%
Table 50
Number of Emergency Room Visits by Neighborhood
If your child has visited a
hospital emergency room to
receive medical care over the
past 12 months, how many
times?
Study Group
Neighborhood
Marion County
Treatment
Washington
(n=7)
One time
57.1%
Two times
28.6%
Three times
14.3%
Four times
0.0%
Five times
0.0%
Six or more times
0.0%
Note. Tx. = Treatment; Comp. = Comparison.
Yamhill County
Comparison
Swegle
(n=9)
Hallman
(n=10)
Hoover
(n=6)
77.8%
22.2%
0.0%
0.0%
0.0%
0.0%
60.0%
40.0%
0.0%
0.0%
0.0%
0.0%
66.7%
0.0%
33.3%
0.0%
0.0%
0.0%
44
Tx.
Comp.
Sue Buel Edwards
(n=6)
(n=4)
83.3%
0.0%
16.7%
0.0%
0.0%
0.0%
75.0%
0.0%
0.0%
0.0%
0.0%
25.0%
Caregivers’ reasons for taking their child to the emergency room are summarized in Tables
51 and 52. Ear infections, high fever, and HIV/AIDS were the reasons mentioned most often.
The CDC reports that an estimated 3.1% of black/African American women, 0.9% of
Hispanic/Latino women, and 0.2% of white women will be diagnosed with HIV infection at some
point during their lifetime. Also, in 2010, young women between the ages of 25 and 44 made
up for the majority of new HIV infections among women 2. As the majority of study participants
were young women of color, these statistics may help explain the frequency at which caregivers
reported visiting the emergency room for HIV/AIDS-related reasons. None of the black/African
American program participants reported having taken their child to the emergency room in the
past year for reasons related to HIV/AIDS, although it should be noted that this study included a
small representation of black/African American participants. A disproportionately high
percentage of Hispanic/Latino and Caucasian participants fell into this category, with 10.7% of
Hispanic/Latino participants and 7.7% of Caucasian participants reporting having taken their
child to the emergency room in the past year for reasons related to HIV/AIDS.
Table 51
Reasons for Emergency Room Visits Overall and by County
If your child has visited a hospital
emergency room to receive medical care
over the past 12 months, indicate the
reason
Study Group
Overall
Tx.
(n=70)
Comp.
(n=65)
Marion County
Tx.
(n=55)
Comp.
(n=49)
Yamhill County
Tx.
(n=15)
Comp.
(n=16)
Acute pain from sickle cell anemia 0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Allergies 1.4%
0.0%
0.0%
0.0%
6.7%
0.0%
Asthma attack 1.4%
3.1%
1.8%
4.1%
0.0%
0.0%
Colic 0.0%
1.5%
0.0%
0.0%
0.0%
6.3%
Digestive problems 1.4%
0.0%
1.8%
0.0%
0.0%
0.0%
Ear infections 5.7%
4.6%
5.5%
4.1%
6.7%
6.3%
Eczema or other skin problems 1.4%
1.5%
1.8%
2.0%
0.0%
0.0%
Fall or other injury 1.4%
0.0%
1.8%
0.0%
0.0%
0.0%
Frequent or repeated vomiting 1.4%
9.2%
1.8%
8.2%
0.0%
12.5%
Frequent or repeated diarrhea 1.4%
4.6%
1.8%
6.1%
0.0%
0.0%
Head injury 0.0%
1.5%
0.0%
0.0%
0.0%
6.3%
High fever 7.1%
9.2%
5.5%
10.2%
13.3%
6.3%
Respiratory or breathing problems 0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
HIV/AIDS 10.0%
9.2%
10.9%
8.2%
6.7%
12.5%
Seizures 1.4%
1.5%
1.8%
0.0%
0.0%
6.3%
Wouldn't stop crying 0.0%
1.5%
0.0%
0.0%
0.0%
6.3%
Other 10.0%
7.7%
9.1%
8.2%
13.3%
6.3%
Note. Participants could select more than one response. Tx. = Treatment; Comp. = Comparison.
2
http://www.cdc.gov/hiv/pdf/risk_women.pdf
45
Table 52
Reasons for Emergency Room Visits by Neighborhood
If your child has visited a hospital
emergency room to receive
medical care over the past 12
months, indicate the reason
Study Group
Neighborhood
Marion County
Treatment
Washington
(n=27)
Swegle
(n=28)
Yamhill County
Comparison
Hallman Hoover
(n=29)
(n=20)
Tx.
Comp.
Sue Buel Edwards
(n=15)
(n=16)
Acute pain from sickle cell anemia
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Allergies
0.0%
0.0%
0.0%
0.0%
6.7%
0.0%
Asthma attack
0.0%
3.6%
3.4%
5.0%
0.0%
0.0%
Colic
0.0%
0.0%
0.0%
0.0%
0.0%
6.3%
Digestive problems
0.0%
3.6%
0.0%
0.0%
0.0%
0.0%
Ear infections
7.4%
3.6%
0.0%
10.0%
6.7%
6.3%
Eczema or other skin problems
0.0%
3.6%
3.4%
0.0%
0.0%
0.0%
Fall or other injury
3.7%
0.0%
0.0%
0.0%
0.0%
0.0%
Frequent or repeated vomiting
3.7%
0.0%
6.9%
10.0%
0.0%
12.5%
Frequent or repeated diarrhea
0.0%
3.6%
6.9%
5.0%
0.0%
0.0%
Head injury
0.0%
0.0%
0.0%
0.0%
0.0%
6.3%
High fever
7.4%
3.6%
13.8%
5.0%
13.3%
6.3%
Respiratory or breathing problems
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
HIV/AIDS
11.1%
10.7%
6.9%
10.0%
6.7%
12.5%
Seizures
3.7%
0.0%
0.0%
0.0%
0.0%
6.3%
Wouldn't stop crying
0.0%
0.0%
0.0%
0.0%
0.0%
6.3%
Other
11.1%
7.1%
10.3%
5.0%
13.3%
6.3%
Note. Participants could select more than one response. Tx. = Treatment; Comp. = Comparison.
Employment, Income, and Financial Indicators
The Background Information Form also included a number of items addressing employment,
income, and various other financial indicators of family wellbeing. The tables below present
results overall, by county, and by neighborhood. As shown in Table 53, less than one third of
the caregivers surveyed were currently working, both overall and by county. In the Washington
neighborhood, however, 37% of caregivers were employed (Table 54).
Table 53
Employment Status– Do You Have a Job - % Yes Overall and by County
Employment
Overall
Marion County
Yamhill County
Tx.
(n=70)
Comp.
(n=64)
Tx.
(n=55)
Comp.
(n=48)
Tx.
(n=15)
Comp.
(n=16)
Do you currently have a job? % Yes 28.6%
Note. Tx. = Treatment; Comp. = Comparison.
12.5%
29.1%
10.4%
26.7%
18.8%
Study Group
46
Table 54
Employment Status–Do You Have a Job - % Yes by Neighborhood
Employment
Marion County
Study Group
Neighborhood
Treatment
Yamhill County
Comparison
Treatment
Comparison
Washington
(n=27)
Swegle
(n=28)
Hallman
(n=29)
Hoover
(n=19)
Sue Buel
(n=15)
Edwards
(n=16)
37.0%
21.4%
10.3%
10.5%
26.7%
18.8%
Do you currently
have a job? % Yes
Among caregivers who were employed, notable differences were reported between
treatment and comparison group participants. Overall, about half of employed treatment group
participants were employed full-time whereas comparison group caregivers were more likely to
work part-time (Table 55).
Table 55
Employment Status– Part-time or Full-time Overall and by County
Employment: part time or full time
Overall
Marion County
Yamhill County
Tx.
(n=20)
Comp.
(n=8)
Tx.
(n=16)
Comp.
(n=5)
Tx.
(n=4)
Comp.
(n=3)
Is your job full-time? 55.0%
Is your job part-time? 45.0%
Note. Tx. = Treatment; Comp. = Comparison.
12.5%
87.5%
56.3%
43.8%
20.0%
80.0%
50.0%
50.0%
0.0%
100.0%
Study Group
Neighborhood level data for part-time and full-time employment status are presented in
Table 56
Table 56
Employment Status– Part-time or Full-time by Neighborhood
Employment: part time
or full time
Study Group
Marion County
Treatment
Washington Swegle
Neighborhood
(n=10)
(n= 6)
Is your job full-time?
80.0%
16.7%
Is your job part-time?
20.0%
83.3%
Comparison
Hallman Hoover
(n=3)
(n=2)
0.0%
50.0%
100.0%
50.0%
Yamhill County
Treatment
Sue Buel
(n=4)
50.0%
50.0%
Comparison
Edwards
(n=3)
0.0%
100.0%
Caregivers who indicated that they were employed most often reported stable employment
(Tables 57 and 58).
47
Table 57
Employment Status– Temporary or Stable Overall and by County
Employment: temporary or stable
Overall
Marion County
Yamhill County
Tx.
(n=20)
Comp.
(n=8)
Tx.
(n=16)
Comp.
(n=5)
Tx.
(n=4)
Comp.
(n=3)
Is your job temporary? 10.0%
Is your job stable? 90.0%
Note. Tx. = Treatment; Comp. = Comparison.
25.0%
75.0%
12.5%
87.5%
20.0%
80.0%
0.0%
100.0%
33.3%
66.7%
Study Group
Table 58
Employment Status– Temporary or Stable by Neighborhood
Employment:
temporary or stable
Study Group
Neighborhood
Is your job temporary?
Is your job stable?
Note. Comp. = Comparison.
Marion County
Treatment
Washington Swegle
(n=10)
(n=6)
10.0%
16.7%
90.0%
83.3%
Comparison
Hallman
Hoover
(n=3)
(n=2)
33.3%
0.0%
66.7%
100.0%
Yamhill County
Treatment
Sue Buel
(n=4)
0.0%
100.0%
Comp.
Edwards
(n=3)
33.3%
66.7%
The survey queried numerous types of financial problems. As shown in Tables 59-67,
respondents reported a variety of financial hardships including inadequate funds for
rent/mortgage payments, utility payments, or to buy food. Results are presented by county and
neighborhood for both the intake and one year time-points. Among the treatment
neighborhoods, residents of the Washington neighborhood demonstrated the biggest
improvement from intake to one year, with fewer participants indicating that they experienced
eleven out of the twelve financial hardships at the one year time-point.
48
Table 59
Financial Problems in the Past 12 Months - % Yes – Overall
Financial Problems: In the past 12 months, was there
ever a time when... (% Yes)
Study Group
Overall
Tx. (n=68-70)
Time-point
You did not pay the full amount of the rent or mortgage
because you didn't have enough money?
You were evicted from your home or apartment for not
paying the rent or mortgage?
You missed a payment or were late with the gas,
electricity, or water bill because you didn't have enough
money?
Your gas, electric, or water service was disconnected
because payments were not made?
Your home phone or cell phone was disconnected
because payments were not made?
You or your child needed to see a medical doctor or go
to the hospital but did not go because you did not have
the money?
You ran short of money to buy food?
Comp. (n=64-65)
Intake
1 Year
Intake
1 Year
30.0%
30.0%
30.8%
17.2%
4.3%
1.4%
0.0%
1.6%
62.9%
60.0%
72.3%
54.7%
18.8%
25.7%
9.2%
10.9%
38.6%
38.6%
40.6%
26.6%
20.0%
8.6%
20.0%
9.4%
38.6%
28.6%
39.1%
25.0%
You received free food or meals from a food pantry,
food bank, or meal program?
You received free food or meals from family members or
friends because you didn't have enough money to buy
food?
You or your child went hungry because there wasn't
enough money to buy food?
52.9%
51.4%
56.9%
56.3%
34.3%
38.6%
41.5%
26.6%
11.4%
2.9%
3.1%
3.1%
You moved in with other people, even for a little while,
because of financial problems?
15.7%
20.0%
10.8%
1.6%
You stayed at a shelter, in an abandoned building, a car,
or any other place not meant for regular housing, even
for one night, because you didn't have enough money
for a place to live?
2.9%
2.9%
4.6%
1.6%
Note. Tx. = Treatment; Comp. = Comparison.
49
Table 60
Financial Problems in the Past 12 Months - % Yes – Marion County
Financial Problems: In the past 12 months, was
there ever a time when... (% Yes)
Study Group
Time-point
Marion County
Treatment
Intake
One Year
(n=54-55) (n=53-55)
You did not pay the full amount of the rent or
mortgage because you didn't have enough
money?
You were evicted from your home or apartment
for not paying the rent or mortgage?
Comparison
Intake
One Year
(n=48-49) (n=48-49)
30.9%
27.3%
26.5%
16.7%
5.5%
1.8%
0.0%
2.1%
69.1%
63.6%
73.5%
60.4%
20.4%
30.9%
12.2%
12.5%
41.8%
40.0%
40.8%
29.2%
You or your child needed to see a medical doctor
or go to the hospital but did not go because you
did not have the money?
21.8%
9.1%
14.3%
6.3%
You ran short of money to buy food?
41.8%
27.3%
37.5%
22.9%
You received free food or meals from a food
pantry, food bank, or meal program?
49.1%
47.3%
51.0%
54.2%
You received free food or meals from family
members or friends because you didn't have
enough money to buy food?
30.9%
34.5%
44.7%
25.0%
You or your child went hungry because there
wasn't enough money to buy food?
10.9%
3.8%
4.1%
4.2%
You moved in with other people, even for a little
while, because of financial problems?
16.4%
21.8%
12.2%
2.1%
You stayed at a shelter, in an abandoned
building, a car, or any other place not meant for
regular housing, even for one night, because you
didn't have enough money for a place to live?
3.6%
3.6%
6.1%
2.1%
You missed a payment or were late with the gas,
electricity, or water bill because you didn't have
enough money?
Your gas, electric, or water service was
disconnected because payments were not
made?
Your home phone or cell phone was
disconnected because payments were not
made?
50
Table 61
Financial Problems in the Past 12 Months - % Yes – Yamhill County
Financial Problems: In the past 12 months, was
there ever a time when... (% Yes)
Yamhill County
Study Group
Treatment
Comparison
Intake
(n=15)
One Year
(n=16)
Intake
(n=15-16)
One Year
(n=15)
26.7%
40.0%
43.8%
18.8%
0.0%
0.0%
0.0%
0.0%
You missed a payment or were late with the gas,
electricity, or water bill because you didn't have
enough money?
40.0%
46.7%
68.8%
37.5%
Your gas, electric, or water service was
disconnected because payments were not made?
13.3%
6.7%
0.0%
6.3%
Your home phone or cell phone was disconnected
because payments were not made?
26.7%
33.3%
40.0%
18.8%
You or your child needed to see a medical doctor
or go to the hospital but did not go because you
did not have the money?
13.3%
6.7%
37.5%
18.8%
You ran short of money to buy food?
26.7%
33.3%
43.8%
31.3%
You received free food or meals from a food
pantry, food bank, or meal program?
66.7%
66.7%
75.0%
62.5%
You received free food or meals from family
members or friends because you didn't have
enough money to buy food?
46.7%
53.3%
62.5%
31.3%
You or your child went hungry because there
wasn't enough money to buy food?
13.3%
0.0%
0.0%
0.0%
You moved in with other people, even for a little
while, because of financial problems?
13.3%
13.3%
6.3%
0.0%
You stayed at a shelter, in an abandoned building,
a car, or any other place not meant for regular
housing, even for one night, because you didn't
have enough money for a place to live?
0.0%
0.0%
0.0%
0.0%
Time-point
You did not pay the full amount of the rent or
mortgage because you didn't have enough money?
You were evicted from your home or apartment for
not paying the rent or mortgage?
51
Table 62
Financial Problems in the Past 12 Months - % Yes – Washington Treatment Neighborhood
(Marion Co.)
Financial Problems: In the past 12 months, was there ever a time when...
(% Yes)
Washington
Intake
(n=26-27)
One Year
(n=26-27)
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
25.9%
22.2%
You were evicted from your home or apartment for not paying the rent or
mortgage?
7.4%
0.0%
You missed a payment or were late with the gas, electricity, or water bill
because you didn't have enough money?
74.1%
63.0%
Your gas, electric, or water service was disconnected because payments
were not made?
34.6%
33.3%
44.4%
33.3%
29.6%
14.8%
51.9%
29.6%
48.1%
44.4%
37.0%
40.7%
18.5%
0.0%
22.2%
18.5%
7.4%
3.7%
Time-point
Your home phone or cell phone was disconnected because payments were
not made?
You or your child needed to see a medical doctor or go to the hospital but
did not go because you did not have the money?
You ran short of money to buy food?
You received free food or meals from a food pantry, food bank, or meal
program?
You received free food or meals from family members or friends because
you didn't have enough money to buy food?
You or your child went hungry because there wasn't enough money to buy
food?
You moved in with other people, even for a little while, because of
financial problems?
You stayed at a shelter, in an abandoned building, a car, or any other
place not meant for regular housing, even for one night, because you
didn't have enough money for a place to live?
52
Table 63
Financial Problems in the Past 12 Months - % Yes – Swegle Treatment Neighborhood (Marion
County)
Financial Problems: In the past 12 months, was there ever a time when...
(% Yes)
Time-point
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
Swegle
Intake
(n=28)
One Year
(n=27-28)
35.7%
32.1%
You were evicted from your home or apartment for not paying the rent or
mortgage?
You missed a payment or were late with the gas, electricity, or water bill
because you didn't have enough money?
Your gas, electric, or water service was disconnected because payments
were not made?
3.6%
3.6%
64.3%
64.3%
7.1%
28.6%
Your home phone or cell phone was disconnected because payments were
not made?
39.3%
46.4%
14.3%
3.6%
32.1%
25.0%
50.0%
50.0%
25.0%
28.6%
3.6%
7.4%
10.7%
25.0%
0.0%
3.6%
You or your child needed to see a medical doctor or go to the hospital but
did not go because you did not have the money?
You ran short of money to buy food?
You received free food or meals from a food pantry, food bank, or meal
program?
You received free food or meals from family members or friends because
you didn't have enough money to buy food?
You or your child went hungry because there wasn't enough money to buy
food?
You moved in with other people, even for a little while, because of
financial problems?
You stayed at a shelter, in an abandoned building, a car, or any other
place not meant for regular housing, even for one night, because you
didn't have enough money for a place to live?
53
Table 64
Financial Problems in the Past 12 Months - % Yes – Hallman Comparison Neighborhood (Marion
County)
Financial Problems: In the past 12 months, was there ever a time when...
(% Yes)
Hallman
Intake
(n=29)
One Year
(n=28)
27.6%
21.4%
0.0%
0.0%
72.4%
57.1%
17.2%
10.7%
31.0%
21.4%
13.8%
7.1%
41.4%
21.4%
You received free food or meals from a food pantry, food bank, or meal
program?
51.7%
67.9%
You received free food or meals from family members or friends because
you didn't have enough money to buy food?
37.9%
25.0%
You or your child went hungry because there wasn't enough money to buy
food?
6.9%
0.0%
You moved in with other people, even for a little while, because of
financial problems?
6.9%
0.0%
You stayed at a shelter, in an abandoned building, a car, or any other
place not meant for regular housing, even for one night, because you
didn't have enough money for a place to live?
3.4%
3.6%
Time-point
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
You were evicted from your home or apartment for not paying the rent or
mortgage?
You missed a payment or were late with the gas, electricity, or water bill
because you didn't have enough money?
Your gas, electric, or water service was disconnected because payments
were not made?
Your home phone or cell phone was disconnected because payments were
not made?
You or your child needed to see a medical doctor or go to the hospital but
did not go because you did not have the money?
You ran short of money to buy food?
54
Table 65
Financial Problems in the Past 12 Months - % Yes – Hoover Comparison Neighborhood (Marion
County)
Financial Problems: In the past 12 months, was there ever a time when...
(% Yes)
Hoover
Intake
(n=19-20)
One Year
(n=20)
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
25.0%
10.0%
You were evicted from your home or apartment for not paying the rent or
mortgage?
0.0%
5.0%
You missed a payment or were late with the gas, electricity, or water bill
because you didn't have enough money?
75.0%
65.0%
Your gas, electric, or water service was disconnected because payments
were not made?
5.0%
15.0%
55.0%
40.0%
15.0%
5.0%
31.6%
25.0%
50.0%
35.0%
30.0%
25.0%
0.0%
10.0%
20.0%
5.0%
10.0%
0.0%
Time-point
Your home phone or cell phone was disconnected because payments were
not made?
You or your child needed to see a medical doctor or go to the hospital but
did not go because you did not have the money?
You ran short of money to buy food?
You received free food or meals from a food pantry, food bank, or meal
program?
You received free food or meals from family members or friends because
you didn't have enough money to buy food?
You or your child went hungry because there wasn't enough money to buy
food?
You moved in with other people, even for a little while, because of
financial problems?
You stayed at a shelter, in an abandoned building, a car, or any other
place not meant for regular housing, even for one night, because you
didn't have enough money for a place to live?
55
Table 66
Financial Problems in the Past 12 Months - % Yes – Sue Buel Treatment Neighborhood (Yamhill
County
Financial Problems: In the past 12 months, was there ever a time when...
(% Yes)
Sue Buel
Intake
(n=15)
One Year
(n=15)
26.7%
40.0%
0.0%
0.0%
40.0%
46.7%
13.3%
6.7%
26.7%
33.3%
13.3%
6.7%
26.7%
33.3%
You received free food or meals from a food pantry, food bank, or meal
program?
66.7%
66.7%
You received free food or meals from family members or friends because
you didn't have enough money to buy food?
46.7%
53.3%
You or your child went hungry because there wasn't enough money to buy
food?
13.3%
0.0%
You moved in with other people, even for a little while, because of
financial problems?
13.3%
13.3%
You stayed at a shelter, in an abandoned building, a car, or any other
place not meant for regular housing, even for one night, because you
didn't have enough money for a place to live?
0.0%
0.0%
Time-point
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
You were evicted from your home or apartment for not paying the rent or
mortgage?
You missed a payment or were late with the gas, electricity, or water bill
because you didn't have enough money?
Your gas, electric, or water service was disconnected because payments
were not made?
Your home phone or cell phone was disconnected because payments were
not made?
You or your child needed to see a medical doctor or go to the hospital but
did not go because you did not have the money?
You ran short of money to buy food?
56
Table 67
Financial Problems in the Past 12 Months - % Yes – Edwards Comparison Neighborhood (Yamhill
County)
Financial Problems: In the past 12 months, was there ever a time when...
(% Yes)
Edwards
Intake
(n=15-16)
One Year
(n=16)
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
43.8%
18.8%
You were evicted from your home or apartment for not paying the rent or
mortgage?
0.0%
0.0%
You missed a payment or were late with the gas, electricity, or water bill
because you didn't have enough money?
68.8%
37.5%
Your gas, electric, or water service was disconnected because payments
were not made?
0.0%
6.3%
Your home phone or cell phone was disconnected because payments were
not made?
40.0%
18.8%
You or your child needed to see a medical doctor or go to the hospital but
did not go because you did not have the money?
37.5%
18.8%
You ran short of money to buy food?
43.8%
31.3%
You received free food or meals from a food pantry, food bank, or meal
program?
75.0%
62.5%
You received free food or meals from family members or friends because
you didn't have enough money to buy food?
62.5%
31.3%
You or your child went hungry because there wasn't enough money to buy
food?
0.0%
0.0%
You moved in with other people, even for a little while, because of
financial problems?
6.3%
0.0%
You stayed at a shelter, in an abandoned building, a car, or any other
place not meant for regular housing, even for one night, because you
didn't have enough money for a place to live?
0.0%
0.0%
Time-point
Overall and across Marion and Yamhill Counties, apartments and public housing were the
most commonly reported types of living arrangements (Table 68). Within the Edwards
comparison neighborhood in Yamhill County, 75% of respondents resided in an apartment or
public housing (Table 69). Additionally, a notable proportion of treatment respondents (25.7%)
reported residing with a family member.
57
Table 68
Current Living Arrangements Overall and by County
What are your current living arrangements?
Study Group
In a house or mobile home that I am buying
In a house or mobile home that I am renting
In an apartment or public housing
In a group home or treatment center
On a military base
With a family member
With a friend
In a shelter (homeless or abused)
Other
Note. Tx. = Treatment; Comp. = Comparison.
Overall
Marion County
Yamhill County
Tx.
(n=70)
Comp.
(n=65)
Tx.
(n=55)
Comp.
(n=49)
Tx.
(n=15)
Comp.
(n=16)
15.7%
16.9%
14.5%
18.4%
20.0%
12.5%
27.1%
34.3%
1.4%
21.5%
60.0%
1.5%
29.1%
34.5%
1.8%
24.5%
55.1%
2.0%
20.0%
33.3%
0.0%
12.5%
75.0%
0.0%
0.0%
25.7%
2.9%
1.4%
2.9%
0.0%
4.6%
1.5%
0.0%
1.5%
0.0%
27.3%
1.8%
1.8%
1.8%
0.0%
4.1%
2.0%
0.0%
2.0%
0.0%
20.0%
6.7%
0.0%
6.7%
0.0%
6.3%
0.0%
0.0%
0.0%
Table 69
Current Living Arrangements by Neighborhood
What are your current living
arrangements?
Study Group
Neighborhood
Marion County
Treatment
Washington Swegle
(n=27)
(n=28)
Yamhill County
Comparison
Hallman Hoover
(n=29)
(n=20)
Tx.
Comp.
Sue Buel Edwards
(n=15)
(n=16)
In a house or mobile home that I
am buying
22.2%
7.1%
20.7%
15.0%
20.0%
12.5%
In a house or mobile home that I
am renting
29.6%
28.6%
24.1%
25.0%
20.0%
12.5%
In an apartment or public housing
25.9%
42.9%
51.7%
60.0%
33.3%
75.0%
3.7%
0.0%
3.4%
0.0%
0.0%
0.0%
0.0%
25.9%
0.0%
0.0%
28.6%
3.6%
0.0%
6.9%
0.0%
0.0%
0.0%
5.0%
0.0%
20.0%
6.7%
0.0%
6.3%
0.0%
3.7%
0.0%
0.0%
0.0%
0.0%
0.0%
Other
3.7%
Note. Tx. = Treatment; Comp. = Comparison.
0.0%
3.4%
0.0%
6.7%
0.0%
In a group home or treatment
center
On a military base
With a family member
With a friend
In a shelter (homeless or abused)
58
When asked how many times they had moved in the past 12 months, the majority of
caregivers reported that they had not moved. More than a quarter had moved one or two
times (Tables 70-72).
Table 70
Moves in the Past 12 Months Overall and by County
How many times have you moved in the
past 12 months?
Overall
Study Group
1 Time
2 Times
3 Times
4 or More Times
I have not moved in the past 12 months
Note. Tx. = Treatment; Comp. = Comparison.
Marion County
Yamhill County
Tx.
(n=68)
Comp.
(n=64)
Tx.
(n=53)
Comp.
(n=48)
Tx.
(n=15)
Comp.
(n=16)
23.5%
11.8%
2.9%
2.9%
58.8%
25.0%
3.1%
3.1%
0.0%
68.8%
26.4%
11.3%
1.9%
3.8%
56.6%
22.9%
4.2%
4.2%
0.0%
68.8%
13.3%
13.3%
6.7%
0.0%
66.7%
31.3%
0.0%
0.0%
0.0%
68.8%
Table 71
Moves in the Past 12 Months Overall and by County – Hispanic/Latino Participants
How many times have you moved in the past
12 months?
Study Group
1 Time
2 Times
3 Times
4 or More Times
I have not moved in the past 12 months
Note. Tx. = Treatment; Comp. = Comparison.
Overall
Marion County
Yamhill
County
Tx.
(n=48)
Comp.
(n=52)
Tx.
(n=34)
Comp.
Tx.
Comp.
(n=42) (n=14) (n=10)
20.8%
10.4%
4.2%
0.0%
64.6%
21.2%
1.9%
0.0%
0.0%
76.9%
23.5%
8.8%
2.9%
0.0%
64.7%
19.0%
2.4%
0.0%
0.0%
78.6%
14.3%
14.3%
7.1%
0.0%
64.3%
30.0%
0.0%
0.0%
0.0%
70.0%
Table 72
Moves in the Past 12 Months by Neighborhood
How many times have you moved in
the past 12 months?
Study Group
Neighborhood
Marion County
Treatment
Wash.
(n=26)
Swegle
(n=27)
Yamhill County
Comparison
Hallman
(n=28)
1 Time 19.2% 33.3%
32.1%
2 Times 11.5% 11.1%
7.1%
3 Times 3.8%
0.0%
3.6%
4 or More Times 3.8%
3.7%
0.0%
I have not moved in the past 12 mos 61.5% 51.9%
57.1%
Note. Tx. = Treatment; Comp. = Comparison.; Wash. = Washington
59
Hoover
(n=20)
10.0%
0.0%
5.0%
0.0%
85.0%
Tx.
Comp.
Sue Buel Edwards
(n=15)
(n=16)
13.3%
13.3%
6.7%
0.0%
66.7%
31.3%
0.0%
0.0%
0.0%
68.8%
Tables 73 through 80 present the number of children within various age ranges and adults
residing within the household. For each category, the majority of caregivers indicated one or
two.
Table 73
Children under 5 Years Old Residing in the Home Overall and by County
Number of children, 5 years old or younger,
currently living in your household (including
the project child)
Overall
Study Group
1
2
3
4
5
6 or more
Note. Tx. = Treatment; Comp. = Comparison.
Tx.
(n=67)
47.8%
40.3%
7.5%
3.0%
1.5%
0.0%
Comp.
(n=63)
34.9%
44.4%
14.3%
6.3%
0.0%
0.0%
Marion County
Yamhill County
Tx.
(n=52)
44.2%
44.2%
7.7%
1.9%
1.9%
0.0%
Tx.
(n=15)
60.0%
26.7%
6.7%
6.7%
0.0%
0.0%
Comp.
(n=47)
40.0%
36.2%
17.0%
6.4%
0.0%
0.0%
Comp.
(n=16)
18.8%
68.8%
6.3%
6.3%
0.0%
0.0%
Table 74
Children under 5 Years Old Residing in the Home by Neighborhood
Number of children, 5 years old or
younger, currently living in your
household (including the project child)
Study Group
Marion County
Treatment
Wash. Swegle
(n=26) (n=26)
Neighborhood
1 34.6%
2 61.5%
3 3.8%
4 0.0%
5 0.0%
6 or more 0.0%
Note. Tx. = Treatment; Comp. = Comparison.
53.8%
26.9%
11.5%
3.8%
3.8%
0.0%
Yamhill County
Comparison
Hallman Hoover
(n=27)
(n=20)
48.1%
25.9%
18.5%
7.4%
0.0%
0.0%
30.0%
50.0%
15.0%
5.0%
0.0%
0.0%
Tx.
Comp.
Sue Buel Edwards
(n=15)
(n=16)
60.0%
26.7%
6.7%
6.7%
0.0%
0.0%
18.8%
68.8%
6.3%
6.3%
0.0%
0.0%
Table 75
Children 6-12 Years Old Residing in the Home Overall and by County
Number of children, 6 - 12 years old,
currently living in your household
Overall
Study Group
1
2
Tx.
(n=39)
56.4%
33.3%
60
Comp.
(n=35)
54.3%
31.4%
Marion County
Yamhill County
Tx.
(n=31)
54.8%
32.3%
Tx.
(n=8)
62.5%
37.5%
Comp.
(n=28)
50.0%
35.7%
Comp.
(n=7)
71.4%
14.3%
3 10.3%
4
0.0%
5
0.0%
6 or more
0.0%
Note. Tx. = Treatment; Comp. = Comparison.
11.4%
2.9%
0.0%
0.0%
12.9%
0.0%
0.0%
0.0%
10.7%
3.6%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
14.3%
0.0%
0.0%
0.0%
Table 76
Children 6-12 Years Old Residing in the Home by Neighborhood
Number of children, 6 - 12 years
old, currently living in your
household
Study Group
Neighborhood
Marion County
Treatment
Washington Swegle
(n=16)
(n=15)
1
50.0%
2
37.5%
3
12.5%
4
0.0%
5
0.0%
6 or more
0.0%
Note. Tx. = Treatment; Comp. = Comparison.
Yamhill County
Comparison
Hallman Hoover
(n=19)
(n=9)
60.0%
26.7%
13.3%
0.0%
0.0%
0.0%
52.6%
26.3%
15.8%
5.3%
0.0%
0.0%
Tx.
Comp.
Sue Buel Edwards
(n=8)
(n=7)
44.4%
55.6%
0.0%
0.0%
0.0%
0.0%
62.5%
37.5%
0.0%
0.0%
0.0%
0.0%
71.4%
14.3%
14.3%
0.0%
0.0%
0.0%
Table 77
Teenagers 13-18 Years Old Residing in the Home Overall and by County
Number of teenagers, 13-18 years old,
currently living in your household
Overall
Marion County
Yamhill County
1
2
3
4
5
Tx.
(n=23)
56.5%
26.1%
13.0%
0.0%
4.3%
Comp.
(n=12)
66.7%
25.0%
0.0%
8.3%
0.0%
Tx.
(n=19)
57.9%
26.3%
10.5%
0.0%
5.3%
Comp.
(n=10)
70.0%
30.0%
0.0%
0.0%
0.0%
Tx.
(n=4)
50.0%
25.0%
25.0%
0.0%
0.0%
Comp.
(n=2)
50.0%
0.0%
0.0%
50.0%
0.0%
6 or more
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Study Group
Note. Tx. = Treatment; Comp. = Comparison.
61
Table 78
Teenagers 13-18 Years Old Residing in the Home by Neighborhood
Number of teenagers, 1318 years old, currently
living in your household
Study Group
Neighborhood
1
2
3
4
5
6 or more
Marion County
Treatment
Yamhill County
Comparison
Treatment
Comparison
Washington
(n=10)
Swegle
(n=9)
Hallman
(n=4)
Hoover
(n=6)
Sue Buel
(n=4)
Edwards
(n=2)
50.0%
30.0%
20.0%
0.0%
0.0%
0.0%
66.7%
22.2%
0.0%
0.0%
11.1%
0.0%
75.0%
25.0%
0.0%
0.0%
0.0%
0.0%
66.7%
33.3%
0.0%
0.0%
0.0%
0.0%
50.0%
25.0%
25.0%
0.0%
0.0%
0.0%
50.0%
0.0%
0.0%
50.0%
0.0%
0.0%
Table 79
Adults Older than 18 Residing in the Home Overall and by County
Number of adults older than 18 currently
living in your household
Overall
Marion County
Yamhill County
Tx.
(n=66)
Comp.
(n=61)
Tx.
(n=51)
Comp.
(n=45)
Tx.
(n=15)
Comp.
(n=16)
1 59.1%
2 22.7%
3
9.1%
4
3.0%
5
3.0%
6 or more
3.0%
Note. Tx. = Treatment; Comp. = Comparison.
75.4%
11.5%
11.5%
1.6%
0.0%
0.0%
54.9%
27.5%
7.8%
3.9%
2.0%
3.9%
73.3%
13.3%
13.3%
0.0%
0.0%
0.0%
73.3%
6.7%
13.3%
0.0%
6.7%
0.0%
81.3%
6.3%
6.3%
6.3%
0.0%
0.0%
Study Group
Table 80
Adults Older than 18 Residing in the Home by County and Neighborhood
Number of adults older than 18
currently living in your household
Study Group
Marion County
Treatment
Washington Swegle
(n=24)
(n=27)
Neighborhood
1
2
3
4
5
6 or more
50.0%
33.3%
4.2%
4.2%
0.0%
8.3%
59.3%
22.2%
11.1%
3.7%
3.7%
0.0%
62
Yamhill County
Comparison
Hallman Hoover
(n=26)
(n=19)
73.1%
15.4%
11.5%
0.0%
0.0%
0.0%
73.7%
10.5%
15.8%
0.0%
0.0%
0.0%
Tx.
Comp.
Sue Buel Edwards
(n=15)
(n=16)
73.3%
6.7%
13.3%
0.0%
6.7%
0.0%
81.3%
6.3%
6.3%
6.3%
0.0%
0.0%
Almost all caregivers indicated that they are the parent of one or more children under the
age of five and residing within the household (Tables 83 and 84).
Table 81
Respondent is Parent of Children 5 Years Old and Younger Overall and by County
Are you the parent, stepparent, or
guardian of the children who are 5 years
old or younger?
Overall
Marion County
Yamhill County
Tx.
(n=68)
Comp.
(n=65)
Tx.
(n=53)
Comp.
(n=49)
Tx.
(n=15)
Comp.
(n=16)
% Yes 97.1%
Note. Tx. = Treatment; Comp. = Comparison.
98.5%
96.2%
98.0%
100.0%
100.0%
Study Group
Table 82
Respondent is Parent of Children 5 Years Old and Younger by Neighborhood
Are you the parent,
stepparent, or
guardian of the
children who are 5
years old or younger?
Study Group
Neighborhood
% Yes
Marion County
Treatment
Yamhill County
Comparison
Treatment
Comparison
Washington
(n=26)
Swegle
(n=27)
Hallman
(n=29)
Hoover
(n=20)
Sue Buel
(n=15)
Edwards
(n=16)
100.0%
92.6%
96.6%
100.0%
100.0%
100.0%
Caregivers were most apt to indicate parenting two or fewer children under the age of five
(Tables 83 - 85).
Table 83
Number of Children under 5 the Caregiver is Guardian of Overall and by County
If you are the parent, stepparent, or guardian
of the children who are 5 years old or younger,
indicate how many children:
Study Group
1
2
3
4
5
6 or more
Note. Tx. = Treatment; Comp. = Comparison.
Overall
Marion County
Yamhill County
Tx.
(n=66)
Comp.
(n=62)
Tx.
(n=51)
Comp.
(n=46)
Tx.
(n=15)
Comp.
(n=16)
51.5%
36.4%
10.6%
0.0%
0.0%
1.5%
40.3%
48.4%
6.5%
4.8%
0.0%
0.0%
52.9%
35.3%
9.8%
0.0%
0.0%
2.0%
45.7%
41.3%
8.7%
4.3%
0.0%
0.0%
46.7%
40.0%
13.3%
0.0%
0.0%
0.0%
25.0%
68.8%
0.0%
6.3%
0.0%
0.0%
63
Table 84
Number of Children under 5 the Caregiver is Guardian of Overall and by County –
Hispanic/Latino Participants
If you are the parent, stepparent, or
guardian of the children who are 5
years old or younger, indicate how
many children:
Overall
Marion County
Yamhill County
Tx.
(n=48)
Comp.
(n=50)
Tx.
(n=34)
Comp.
(n=40)
Tx.
(n=14)
Comp.
(n=10)
1 52.1%
2 35.4%
3 12.5%
4
0.0%
5
0.0%
6 or more
0.0%
Note. Tx. = Treatment; Comp. = Comparison.
38.0%
48.0%
8.0%
6.0%
0.0%
0.0%
52.9%
35.3%
11.8%
0.0%
0.0%
0.0%
40.0%
45.0%
10.0%
5.0%
0.0%
0.0%
50.0%
35.7%
14.3%
0.0%
0.0%
0.0%
30.0%
60.0%
0.0%
10.0%
0.0%
0.0%
Study Group
Table 85
Number of Children under 5 the Caregiver is Guardian of by Neighborhood
If you are the parent, stepparent,
or guardian of the children who
are 5 years old or younger,
indicate how many children:
Study Group
Neighborhood
Marion County
Treatment
Washington Swegle
(n=26)
(n=25)
1
42.3%
2
46.2%
3
7.7%
4
0.0%
5
0.0%
6 or more
3.8%
Note. Tx. = Treatment; Comp. = Comparison.
64.0%
24.0%
12.0%
0.0%
0.0%
0.0%
64
Yamhill County
Comparison
Hallman Hoover
(n=26)
(n=20)
50.0%
30.8%
15.4%
3.8%
0.0%
0.0%
40.0%
55.0%
0.0%
5.0%
0.0%
0.0%
Tx.
Comp.
Sue Buel Edwards
(n=15)
(n=16)
46.7%
40.0%
13.3%
0.0%
0.0%
0.0%
25.0%
68.8%
0.0%
6.3%
0.0%
0.0%
Neighborhood Characteristics
Caregivers were asked to respond to a number of items addressing neighborhood
characteristics. Most reported living in suburban areas. In the Sue Buel neighborhood, a
notable proportion also indicated that they live in a rural locale (Tables 86 and 87).
Table 86
Population Density of Residential Area Overall and by County
What type of area do you live in?
Study Group
Overall
Treatment
(n=66)
Urban
16.7%
Suburban
75.8%
Rural
7.6%
Note. Tx. = Treatment; Comp. = Comparison.
Marion County
Yamhill County
Comparison
(n=65)
Tx.
(n=53)
Comp.
(n=49)
Tx.
(n=13)
Comp.
(n=16)
16.9%
78.5%
4.6%
18.9%
81.1%
0.0%
18.4%
77.6%
4.1%
7.7%
53.8%
38.5%
12.5%
81.3%
6.3%
Table 87
Population Density of Residential Area by Neighborhood
What type of area do you live
in?
Study Group
Neighborhood
Marion County
Treatment
Washington Swegle
(n=26)
(n=27)
Urban
23.1%
Suburban
76.9%
Rural
0.0%
Note. Tx. = Treatment; Comp. = Comparison.
14.8%
85.2%
0.0%
Yamhill County
Comparison
Hallman Hoover
(n=29)
(n=20)
24.1%
69.0%
6.9%
10.0%
90.0%
0.0%
Tx.
Sue Buel
(n=13)
Comp.
Edwards
(n=16)
7.7%
53.8%
38.5%
12.5%
81.3%
6.3%
Survey items also invited caregivers to indicate the types of programs and services available
to them in their community. Health centers, food banks, and education programs were the
services most frequently identified as being available in the project neighborhoods. Rent/utility
assistance programs, shelters/emergency housing, and employment programs were also
identified by some respondents as available, though were less likely than the previous set of
items to be selected. Responses by neighborhood in Table 89 demonstrate a need for
additional programs or services, as well as a lack of knowledge (or variation in awareness) of
services that are currently available.
65
Table 88
Availability of Services or Programs Overall and by County
Are any of the following
services or programs available
in your community? (% Yes)
Study Group
Overall
Tx.
(n=69-70)
Health center
88.6%
Childbirth classes
65.7%
Parenting classes
70.0%
Shelters or emergency
46.4%
housing
Mental health center
60.0%
Legal aid services
67.1%
Food banks
82.9%
Rent or utility assistance
55.7%
programs
Education programs
80.0%
Employment programs
57.1%
Child care programs
61.4%
Note. Tx. = Treatment; Comp. = Comparison.
Marion County
Yamhill County
Comp.
(n=64-65)
Tx.
(n=54-55)
Comp.
(n=48-49)
Tx.
(n=15)
Comp.
(n=15-16)
83.1%
49.2%
50.8%
85.5%
61.8%
72.7%
83.7%
44.9%
40.8%
100.0%
80.0%
60.0%
81.3%
62.5%
81.3%
30.8%
40.7%
28.6%
66.7%
37.5%
43.8%
49.2%
87.7%
60.0%
63.6%
78.2%
44.9%
44.9%
85.7%
60.0%
80.0%
100.0%
40.0%
62.5%
93.8%
53.8%
52.7%
53.1%
66.7%
56.3%
75.4%
35.4%
54.7%
80.0%
50.9%
58.2%
69.4%
32.7%
52.1%
80.0%
80.0%
73.3%
93.8%
43.8%
62.5%
Table 89
Availability of Services or Programs by Neighborhood
Are any of the following services
or programs available in your
community? (% Yes)
Marion County
Study Group
Treatment
Wash.
Swegle
Neighborhood
(n=27) (n=27-28)
Health center 85.2%
85.7%
Childbirth classes 70.4%
53.6%
Parenting classes 77.8%
67.9%
Shelters or emergency housing 40.7%
40.7%
Yamhill County
Comparison
Hallman
Hoover
(n=19-20)
(n=29)
82.8%
85.0%
51.7%
35.0%
37.9%
45.0%
Tx.
Sue Buel
(n=15)
100.0%
80.0%
60.0%
Comp.
Edwards
(n=15-16)
81.3%
62.5%
81.3%
34.5%
20.0%
66.7%
37.5%
Mental health center
Legal aid services
Food banks
Rent or utility assistance
programs
66.7%
66.7%
74.1%
53.6%
60.7%
82.1%
41.4%
44.8%
86.2%
50.0%
45.0%
85.0%
60.0%
80.0%
100.0%
40.0%
62.5%
93.8%
63.0%
42.9%
65.5%
35.0%
66.7%
56.3%
Education programs
Employment programs
Child care programs
85.2%
51.9%
70.4%
75.0%
50.0%
46.4%
75.9%
34.5%
55.2%
60.0%
30.0%
47.4%
80.0%
80.0%
73.3%
93.8%
43.8%
62.5%
66
Families faced a wide range of needs, well-known to families in poverty. Families, for
example, faced food and housing insecurity, fears and barriers related to their immigration
status, domestic violence, or had limited knowledge of child development. One source of
information about target population needs is self-report data about service use. A site-specific
measure, the Caregivers Repeated Measures Survey, invited respondents to indicate all of the
community services and resources they had used in the last six months. Table 90 presents
intake and one year data for treatment and comparison group participants enrolled in the
program/study for at least 12 months. Results demonstrate a great need for (and use of) food
assistance and health insurance/services. Of interest, use of almost all the programs and
services queried increased among treatment group participants from intake to one year, likely
as a result of the resource and referral support provided by the home visitors.
Table 90
Services Used in the Past Six Months
Treatment
Program or Service
Comparison
Intake
(n=70)
One Year
(n=70)
Intake
(n=65)
One Year
(n=64)
Financial assistance/public assistance/welfare
Energy/utility/heating assistance
Clothing (free or low cost)
Food bank/WIC/food stamps/meals
Furniture/household supplies
Housing assistance
Transportation assistance
Children's programs or services
Child care
Child support enforcement
Family resource centers
Parent support/play groups
Parenting classes
Relief nursery
Alcohol/drug services
Mental health/counseling
Crisis services
Domestic violence
Oregon Health Plan/other health insurance
Public health services
Well-child check-ups
30.0%
14.3%
25.7%
97.1%
5.7%
7.1%
7.1%
17.1%
11.4%
10.0%
2.9%
7.1%
15.7%
0.0%
2.9%
8.6%
0.0%
0.0%
94.3%
30.0%
68.6%
38.6%
18.6%
45.7%
94.3%
20.0%
17.1%
15.7%
31.4%
20.0%
11.4%
15.7%
25.7%
24.3%
0.0%
1.4%
10.0%
4.3%
1.4%
97.1%
28.6%
88.6%
49.2%
32.3%
20.0%
98.5%
7.7%
6.2%
12.3%
18.5%
1.5%
1.5%
3.1%
10.8%
16.9%
0.0%
1.5%
9.2%
0.0%
0.0%
98.5%
35.4%
56.8%
26.6%
37.5%
32.8%
98.4%
6.3%
9.4%
7.8%
26.6%
7.8%
7.8%
9.4%
10.9%
9.4%
0.0%
0.0%
6.3%
0.0%
0.0%
96.9%
31.3%
76.6%
Education (GED, ESL, Adult Education)
18.6%
22.9%
12.3%
18.8%
Employment assistance
1.4%
8.6%
4.5%
9.4%
Legal assistance
2.9%
12.9%
1.5%
9.4%
Library
34.3%
51.4%
40.0%
45.3%
Recreation
40.0%
80.0%
24.6%
67.2%
Multi-cultural services
7.1%
22.9%
6.2%
15.6%
67
Target population needs also can be described with resource and referral data collected by
the home visitors. Resources and referrals were coded as alcohol and drug services, basic
needs, child development services, domestic violence, education, health/dental, job assistance,
mental health, safety, and “other”. A Fostering Hope Initiative Community Referral Data Report
developed in September 2012 and contained in Appendix A summarizes referral types and
completion rates for the first 15 months of the project.
Table 91 presents referral data collected from home visiting participants during their first
year of service. Specifically, the table displays the minimum, maximum, and average number of
referrals received during that time period that resulted in a service being received, both by
referral type and overall. Data are displayed for the first six months of enrollment (1-6 months)
and for the second six months of enrollment (7-12 months). As shown, basic needs and
referrals to health/dental resources were most common. “Other” referrals also were popular,
many of which were for community events. The mean number of referrals changed little from
the first to the second six month enrollment periods, suggesting that participants’ needs did not
change substantially over the course of their first year of participation in the Initiative.
Table 91
Referrals Resulting in Services Received During the First Year of Enrollment – Treatment Group
Referrals (n=55)
Date Range
Minimum
Maximum
1-6 months
0
13
7-12 months
0
6
1-6 months
0
1
Child Development Services
7-12 months
0
1
1-6 months
0
2
Education
7-12 months
0
2
1-6 months
0
6
Health/Dental
7-12 months
0
4
1-6 months
0
2
Job Assistance
7-12 months
0
0
1-6 months
0
2
Mental Health
7-12 months
0
3
1-6 months
0
10
Other
7-12 months
0
6
1-6 months
0
1
Safety
7-12 months
0
2
1-6 months
0
14
All referrals
7-12 months
0
10
Note. The data include only those referrals that resulted in a service being received
Basic Needs
68
Mean
1.38
1.20
0.07
0.11
0.36
0.18
0.78
0.49
0.07
0.00
0.11
0.16
1.04
1.45
0.04
0.07
3.85
3.67
4. Purpose, Specific Research Question(s), and Overview/Summary of the Project
High-risk families in high-poverty neighborhoods face multiple risks for child maltreatment,
at both the family and community levels. These neighborhoods have higher substantial rates of
child maltreatment and few assets for supporting families to thrive. In a paper commissioned
by RAND Child Policy, Carrasco (2008) states that the historical orientation of intervention to
high-risk families at the end-stage of the continuum of maltreatment—rather than
prevention—is too expensive to achieve marked declines in child abuse rates. In addition, in
studies that verified the effectiveness of models, those who agreed to participate are often the
least likely to be those with the highest risk of negative outcomes.
Carrasco continues by saying we need to invest in developing community engagement,
changing community environments to promote a sense of community responsibility for
children, families, and neighbors. Using a public health approach, this would mean looking at
the issue as one of greater child well-being rather than only as intervention that takes place one
person at a time. The full RAND Child Policy Working Paper, based on papers by Carrasco and
five other experts and a web-based survey of professionals working in the field of child abuse
and neglect, listed home-visiting and parent education as the strategies viewed as having the
greatest promise for prevention (Shaw & Kilburn, 2009).
Thus, collaborators designed FHI to focus on specific neighborhoods; improve neighborhood
engagement in prevention of child maltreatment; improve neighborhood assets for supporting
families and child well-being; use non-threatening, non-stigmatizing methods to attract the
families with the highest risk of negative outcomes to participate; provide ongoing parent
education and support groups available to all parents in the focus neighborhoods; provide
professional home visitors for high-risk families to provide in-home parenting education,
information on child development, and access to other services and supports. These reflect the
fundamental design of the Fostering Hope Initiative as an intervention to reduce the incidence
of child maltreatment.
 How the Project Responds to the Overarching QIC-EC Research Question
The overarching QIC-EC research question is:
“How and to what extent do collaborations that increase protective factors and
decrease risk factors in core areas of the social ecology result in optimal child
development, increased family strengths, and decreased likelihood of child
maltreatment, within families of young children at high-risk for child
maltreatment?”
FHI directly responded to this research question through strategies directly focused on each
level of the social ecology:
Primary Caregiver and Target Child (Individual Domain). FHI provided direct supports to
the parents/caregivers directly responsible for the target child. The project used the risk factors
69
included in eligibility screening for Healthy Start~Healthy Families as one criterion for project
eligibility. Home visiting, based on the Healthy Families America model, included support for
the family in all areas of the Strengthening Families Protective Factors, while assisting the
family to decrease risk factors.
Social Support (Relationship Domain)—Neighborhoods. FHI used a neighborhood-based
service delivery model that was intentionally chosen in response to research highlighting the
benefits of providing services in this way. As of the start of the study, research had not
produced clear data to delineate the relationships between neighborhoods and child
maltreatment (Coulton, Crampton, Irwin, Spilsbury, Korbin, 2007). By designing FHI to
concentrate on neighborhood-specific rather than community-wide needs, it contributes to
research in this area.
FHI’s neighborhood mobilization strategies focused on high-risk neighborhoods and
included Community Cafés, in which neighborhood residents were invited to discuss their
experiences related to the protective factors and consider how they might improve support for
the protective factors within their neighborhood to make their neighborhood a safe, healthy
place in which to raise children. In addition, FHI supported other neighborhood mobilization
efforts that occurred within each neighborhood. For example, the Swegle neighborhood
developed a weekly free Community Dinner that was held at a neighborhood church. In the
Washington neighborhood, the Holy Cross Lutheran Church donated the use of a small house—
La Casita—to serve as a neighborhood center for activities. FHI also participated in Annual Night
Out parties, Family Literacy Nights, play groups, coffee clubs, community gardens,
neighborhood restoration projects, and walking groups, for example.
Community Connections (Community Level)—The Service System. Research analyzing the
benefits and challenges of collaborative service delivery has been voluminous. As a result,
interagency collaboration, when meeting certain criteria, is generally presumed to improve the
quality of service delivery in programs that serve young children (Gardner & Young, 2009). By
coordinating services rather than operating in isolation, providers can offer comprehensive
programming that is better able to meet the needs of their clients. The collaborative
partnership underlying FHI was already well developed at the start of the project, having spent
over a year in collective planning. FHI is now a Collective Impact Initiative, in which
organizations representing different sectors come together around a common purpose, sharing
a common agenda, using shared measurement, carrying out mutually reinforcing activities, with
consistent and open communication and backbone support. CCS has served as the backbone
organization, supporting both accountability for outcomes and improved performance.
Public Policy and Social Norms (Systems Level). Although not a formal part of the QIC-EC
research project, FHI developed an active advocacy effort. That effort, in the 2013 legislative
session, resulted in a law that changed the eligibility for the Healthy Start~Healthy Families
program in Oregon. As a result of the change, any family with a new infant and meeting criteria
for risk factors can now receive Healthy Families Oregon services; previously, only first birth
families were eligible. In 2010, CCS, a local business advocate and the Department of Human
70
Services worked with the Senate President to craft and pass Senate Bill 991 to make Safe
Families for Children possible. This bill removed regulatory barriers that prevented private
organizations from providing voluntary respite care for children. The bill was lauded as a
successful bipartisan effort with the proposed legislation winning unanimous support.
The measures employed in the quasi-experimental design, which focused on levels 1 and 2
of the social ecology as they are listed above, attended to the overarching research question.
Specifically, data were captured that addressed child development, family strengths, and risk
for child maltreatment.
 How the Project Responds to the Needs of the Target Population
Families served by FHI experienced issues such as substance abuse or HIV/AIDS-affected
caregivers; psychological distress; family disorganization, dissolution and violence; lack of social
cohesion; social isolation; lack of understanding of children’s needs, child development and
parenting skills; parent history of child abuse in family of origin; young, single parents; poverty,
and unemployment or lack of education. FHI served pregnant women, as well as infants and
children up to age 5 and their primary caregivers, offering a variety of services (home visits,
resource and referral, parent education classes and support groups) designed to increase
protective factors and decrease risk factors associated with child maltreatment.
 What the Project is Trying to Accomplish to Address its Specific Outcomes and the QICEC’s Cross-site Outcomes
The project was an excellent fit for the QIC-EC research and demonstration project in that
the Initiative was designed to support optimal child development, strengthen families, and
reduce maltreatment rates in the targeted neighborhoods.
5. Significant Contextual Conditions, Events, or Community Changes or
Characteristics Not Previously Described that Occurred during the Grant Period
which Impacted the Families Served, the Project or the Outcomes Measured
Exciting work has been underway in Oregon in early childhood and health care over the last two
years. The governor has promoted a redesign of the education system from pre-kindergarten
through college. His new Early Learning Council is now implementing a multi-faceted plan to
address all early childhood domains. Backed by legislation, in August 2013, the Early Learning
Council issued a request for applications for organizations wanting to become regional hubs for
early learning services. The governor also has changed how Oregon Health Plan services are
managed—creating a system of regional Coordinated Care Organizations (CCO) to manage funding
at local levels, related to physical and behavioral health, and soon, dental health as well. CCS has
developed a strong relationship with the local CCOs for Marion, Polk and Yamhill Counties—
Willamette Valley Community Health and the Yamhill County Care Organization. CCS
representatives participated on committees in all three counties related to both initiatives during
their development. CCS provided a grant writer to assist the local organization—Early Learning
Hub, Inc.,--in preparing their application to become the hub for the Marion County area, and a
71
facilitator to lead planning in Yamhill County. CCS has informed the Governor’s Office about FHI,
and has had discussions with his staff on the social determinants of lifelong health.
Oregon, like many other states, has had struggles related to Immigration status and
undocumented workers. During the last legislative session, one positive change did occur:
undocumented persons now can obtain a permit to drive, which allows them to be able to drive
to work. Although not a full drivers’ license, the permit is a step forward for families that have
many other barriers to supporting their children well.
C. Overview of the Collaborative Partnership
FHI’s vision is that every child and youth in every neighborhood lives in a safe, stable
nurturing home; is healthy; succeeds at school; and goes on to financial self-sufficiency.
Together, partners provide a continuum of services and supports to strengthen families and
create better neighborhoods—building the infrastructure to improve and scale up the programs
proven to have high impact results for children, youth and adults. FHI partners include
representatives from education, the business community, Latino organizations, faith-based
groups, the public and private sector social services network, and health care.
1. The Collaborative Partnership
 The Lead Organization’s Role in Forming or Supporting the Collaborative Partnership
In the spring of 2008, the CCS executive director was invited to join a delegation from
Oregon to attend a conference where the Casey Family Programs shared their 2020 vision:
“Safely reduce foster care by 50% by 2020.” The delegation included DHS Child Welfare, a
judge, a state legislator and others.
The CCS Forever Home Youth Council, composed of foster youth, embraced the Casey 2020
vision and advocated for CCS to convene a planning group. A community planning group began
meeting around the question, “How can we build a neighborhood-based system of family
support strong enough to reduce the need for foster care by 50% by 2020?” When Oregon was
subsequently selected as a Casey Family Programs project state, CCS had already begun work
around planning the neighborhood-based initiative to reduce child maltreatment and foster
care.
As the initial vision grew, CCS invited additional organizations to the table that had a stake
in preventing child maltreatment and reducing foster care. By April, 2008, CCS engaged a high
profile community leader—a former school superintendent—to act as “champion” to lead the
meetings. This group worked diligently into 2009 to define FHI’s vision, goals, and strategies,
and to address FHI’s cross-agency procedures. A summary of their work from these original
discussions is included in Appendix B. While there have been changes over time, much of what
the participants developed is still very relevant to FHI.
 History of Collaboration between the Lead Organization and Collaborative Partners
72
FHI is based upon the belief that a neighborhood-based, collective impact initiative that
promoted protective factors would lead to breakthrough outcomes for poor and vulnerable
young children and their families as evidenced by improved child safety, health, and
kindergarten readiness. CCS has had a long history of successful collaborations with many
organizations critical to achieving this vision, including important work with neighborhood
associations, community progress teams, funders, parents, and community-based human
service organizations.
CCS’s strong relationships with local and State partners are key to its capacity to operate
programs. These relationships expand outreach into the community, enrich leadership and
strengthen the capacity to provide additional services for families. Because it has operated
since 1938, has had the same executive director for 30 years, and has run programs for infants
and toddlers, children, youth, adults, and families, CCS has long-standing connections with both
the community and the public/private service delivery system for children and families. For
example, CCS and the Salem Leadership Foundation have collaborated often on joint projects to
strengthen families and neighborhoods. These projects have included co-sponsoring a “Future
Search” in the Grant and Highland neighborhoods, which helped lead to today's communitywide emphasis on family support and foster care, and FHI’s focus on concentrating services in
high poverty neighborhoods. The North Neighborhoods Community Progress Team grew out of
this Future Search with the support of SLF and CCS. SLF and CCS also worked to help resurrect
the struggling Salem-Keizer Community Development Corporation, which owns affordable
housing in high-needs areas. CCS works diligently to build community relationships related to
specific projects and programs. CCS’ Community Homes for Children, for example, provide longterm foster care for children and youth who have lost ties with families and are unlikely to be
adopted. The development process includes working with Neighborhood Associations and
doing “Knock-and-Talks” to meet neighborhood families, answer questions, and gain support.
FHI requires the active collaboration of services and supports provided by several different
organizations and programs. These organizations, their roles and responsibilities in FHI, and the
contributions they have brought to the project are provided below.
• Salem Leadership Foundation (SLF) has worked with CCS since the initial stages of
Fostering Hope, including completing the analysis of high-poverty neighborhoods in
Salem, Oregon, to identify those that should be prioritized for being the focus of
Fostering Hope Initiative efforts in Marion County. SLF provided neighborhood outreach
coordination for Fostering Hope.
• Mano a Mano Family Center staff provided neighborhood outreach coordination for
Fostering Hope in Marion County, focusing on the Latino community. Mano-A-Mano
was invited to participate in Fostering Hope because of their success in organizing
parents in support of student success in the high school catchment area that includes
the project’s targeted neighborhoods. Mano a Mano uses a parents-supporting-parents
approach, with hundreds of Latino/Hispanic parents volunteering in Salem
neighborhoods. Mano a Mano also has been a valuable resource to ensure that
73
•
•
•
•
•
•
•
Fostering Hope Initiative processes integrate cultural considerations in planning and
that interventions are culturally responsive.
Options Counseling Services of Oregon participated in planning for the Fostering Hope
Initiative and provided parent education and support groups. Options contributed
Oregon Health Plan (OHP) Prevention Services and Family Support and Connections
services to project participants. Options offers quality home-based, family-centered,
outcome-focused mental health, family preservation, life skills and domestic violence
interventions to at-risk rural, urban and homeless children, adolescents, individuals and
families.
Healthy Start~Healthy Families of Marion County (HS~HF) (now Healthy Families
Oregon), during the time of the project, provided the Healthy Families America
research-based home-visiting model to reduce the incidence of child abuse and neglect
in eligible first-birth families. Trained parent educators offer parenting education,
developmental screenings, and referrals to community resources. HS~HF contributed
home visiting and parent education and support classes for first-birth families in the
research project and additional resources in donated tangible goods, such as food and
diapers.
Family Building Blocks (FBB) is located in the McKay High School catchment area (the
two Salem area neighborhoods are a part of that high school catchment area) and
provides children’s therapeutic classes, parent education, home visits, and other
services for families to keep children safe and families together. CCS has worked with
FBB related to early childhood initiatives and served with them on Great Beginnings, the
group sponsored by the Marion County Children and Families Commission to address
early childhood needs.
DHS District 3’s Children, Adults and Families (CAF) Division is responsible for foster care,
protective services, and other child welfare activities in Marion, Polk, and Yamhill
counties. The District 3 manager has been integrally involved in planning for the
Fostering Hope Initiative. She strongly feels that the work of Fostering Hope is in close
alignment with her own department’s goals and objectives related to reducing child
maltreatment and safely reducing the need for foster care. CCS has worked with District
3 over the years related to treatment foster care, Community Homes for Children
needing long-term foster care, and other services for vulnerable families.
Yamhill County Health Department (YCHD). Staff members from YCHD participated in
the planning for FHI in Yamhill County. At the start of the project, YCHD operated
Healthy Start in Yamhill County, with a subcontract from CCS to expand the services to
families meeting the eligibility for the QIC-EC project. However, partway through the
project, CCS no longer contracted with YCHD and the Healthy Start family support
worker became an employee of CCS.
Catholic Community Services Foundation (CCSF). Formed in 1985 to financially support
the programs and projects of CCS, CCSF committed to providing matching funding for
the QIC-EC project, particularly related to wrap around services.
Pacific Research and Evaluation is a new partner to FHI that was added after receiving
the QIC-EC RFP to bring to the group needed expertise on research design and
74
evaluation for the project proposal, and to conduct the local evaluation for the project.
 How the Collaborative Partnership has Evolved or Changed over the Course of the
Project
At the beginning of the project, CCS established a Participatory Evaluation and Planning
meeting that was attended by both Marion and Yamhill County partners. However, the distance
and time required for Yamhill County partners to attend the meetings in Salem was difficult.
Therefore, generally only the county Health Department representative and Family Support
Worker attended. A survey assessing the collaborative partnership across all partners indicated
that the Yamhill County partners were not satisfied with their primary connection to FHI being
through a meeting in Salem. Therefore, CCS changed its approach to attending existing
meetings in Yamhill County which included FHI partners and others. Thus, CCS now attends the
Yamhill County Early Childhood Coordinating Council and a subcommittee of that council that
designed and prepared the application to the state to become the Early Learning Hub for
Yamhill County. FHI’s Collective Impact Coordinator provided facilitation services, technical
assistance and backbone support to that committee as it prepared its application.
In the spring of 2013, CCS changed how it addresses Participatory Evaluation and Planning
in Marion County. After the site visit by the QIC-EC team in April, and the FHI Planning meeting
in June, CCS ended the existing Marion County Participatory Evaluation and Planning Team.
That team primarily was composed of mid-level managers of partner organizations. Instead,
over the summer, CCS established a Marion County FHI Executive Council, made up of partner
executive directors—some of which also provide services in Polk and Yamhill counties. The
council took over responsibility for Participatory Evaluation and Planning. This shift put each
organization’s decision-maker into the active leadership of FHI.
 New Partners that Emerged Since the Original Application
As CCS approached the end of QIC-EC funding, it was necessary to develop a strategy for
continuing FHI across the two counties. In the spring of 2013, CCS developed and submitted a
proposal to the United Way of the Mid-Willamette Valley which included new partnerships for
FHI. Although they did not officially join FHI until the United Way contract was signed at the
end of June, new partners are: Lutheran Community Services Northwest (now the Healthy
Families Oregon provider for Yamhill County); Yamhill County Head Start; Salem Keizer Coalition
for Equality (a multi-cultural, multi-racial organization that supports equality and justice in
education); Willamette Education Service District (which provides Early Intervention/Early
Childhood Special Education in Yamhill, Polk, and Marion counties to young children with
disabilities); Center 50+ (a full-service focal point senior center in Salem in Marion County); and
Oregon Child Development Coalition (a provider of Migrant Head Start in Polk and Marion
counties). In addition, a representative of It Takes a Neighborhood—a Kaiser Permanente
project in cooperation with Northwest Human Services—has now joined the Executive Council
and is providing invaluable support in both building connections with the health care industry
and in bringing a health care perspective to the Executive Council. These all joined FHI after the
end of direct service delivery for the QIC-EC project, March 31, indicating the ongoing success
of FHI in terms of sustainability and partner commitment.
75
The representative of “It Takes a Neighborhood” fills a gap in the FHI partnership identified
in the Fall 2011 Fostering Hope Partner Survey conducted by InSites: “Expertise in providing
medical care to young children.” It Takes a Neighborhood is a project of the Oregon Primary
Care Association funded by Kaiser Permanente Northwest. It Takes a Neighborhood’s Health
Instigator has joined the FHI Executive Council and is working with FHI’s Collective Impact
Coordinator on defining how health care and FHI will work together.
 Partners Who Left the Partnership
At the start of the project, Yamhill County Health Department was the Healthy
Start~Healthy Families provider in Yamhill County and a subcontractor from FHI for providing
home visiting in that county. During the project, however, CCS took over providing the home
visiting services, hiring the Yamhill County Healthy Start~Healthy Families family support
worker. Despite this change, Yamhill County Health Department continued to work with FHI in
local meetings.
 The Implementation Roles/Responsibilities of Partners and How They May Have
Changed as a Result of Working Together
In June, 2013, well after the end of the direct service delivery phase of the QIC-EC project,
CCS decided it would no longer compete to provide Healthy Start~Healthy Families services but
rather focus on Collective Impact backbone organization responsibilities. Therefore, CCS
supported Family Building Blocks, an active FHI partner, to provide all Healthy Families services
in both Polk and Marion Counties. Lutheran Community Services provides these services in
Yamhill County.
 The Collaborative Partners’ Linkages with Child Welfare, CBCAP, ECCS Leaders, Parent
Organizations, Community Organizations
CCS and its community partners have longstanding ties to many state and community
organizations. These include connections with Oregon’s Community-Based Child Abuse
Prevention Program (CBCAP)—through the DHS Office of Self-Sufficiency CAF Unit; Oregon’s
Early Childhood Comprehensive Systems (ECCS) leader in the Public Health Division of DHS; and
the Oregon Children’s Trust Fund which manages Oregon’s Trust and Prevention Funds. All
three agencies were involved in formulating Oregon’s Casey Family Programs project. DHS is a
leader for FHI, and has been active in the FHI Participatory Evaluation and Planning group, and
now in the Executive Council. The DHS District 3 CAF director has participated from the start of
planning for the Fostering Hope Initiative.
The values and goals of FHI are in strong alignment with the goals of Oregon’s ECCS
program. DHS, the Oregon Commission on Children and Families (OCCF) which has now been
replaced by the state’s Early Learning Council, the Oregon Department of Education (ODE), and
Yamhill Family and Youth Programs (YFYP) were among the ECCS partners in developing their
strategic plan. While they were still operating, CCS had good connections with OCCF through
our Healthy Start~Healthy Families program. Because of the youth and family services
76
programs operated by CCS, we have connections both with YFYP, and with the Willamette
Education Service District, a subcontractor of the Oregon Department of Education.
Similarly, FHI is in alignment with the Oregon Children’s Trust Fund, with its approach of
strengthening families and protective factors, and building parent partnerships. CCS offers four
types of services that the Trust Fund finances: community outreach and education, parenting
classes, comprehensive family support, and respite care. Indeed, during the course of the QICEC project, CCS worked with the Oregon Children’s Trust Fund related to two applications for
funding.
FHI established a Parents’ Council, comprising teens and adults who have been involved in
the foster care system. The Council has been very active, and members have participated in
presentations on FHI to United Way, Catholic Charities USA, and each Fostering Hope: Closing
the Gap Summit, as well as other community functions.
FHI is currently forging a new partnership with MERIT (MicroEnterprise Resources,
Initiatives, and Training, Salem, Oregon) and Frontiers of Innovation partner All Our Kin (New
Haven, Connecticut) to address economic self-sufficiency issues as well as increased quality of
child care. MERIT helps entrepreneurs by providing training and ongoing support from prebusiness through start-up, and beyond business-launch. All Our Kin has an approach for
working with family/friend child care providers to help them both improve their knowledge of
child development, improve the quality of their service, and improve the financial outcomes
achieved by their business. Based on meetings held in October, we are developing a
partnership within FHI that is focused on improving the financial self-sufficiency of families
living in Fostering Hope neighborhoods.
2. Required to Support and Sustain the Collaborative Partnership
 Opportunities and Strengths Provided by the Collaborative Partnership
FHI partners bring diverse but complementary skills, knowledge, and relationships to the
project. Each organization has been responsible for a specified component of the project (e.g.,
neighborhood outreach, home visiting, parent education and support groups) and was selected
to carry out that component due to their unique skills, knowledge, and resources. The FHI
partnership has included the right mix of people to do this unique project. Implementing a
neighborhood-focused approach required the collaboration of many partners that provide
services within the target neighborhoods. For example, FHI benefited from Salem Leadership
Foundation’s strong relationship with faith communities in the neighborhoods in Salem when
Holy Cross Lutheran Church offered a small house on the edge of the Washington
neighborhood for use by FHI. “La Casita” has become a community center, offering, for
example, a lending library, coffee club, garden club, counseling, and parenting support to
Washington residents.
 Challenges Resulting from the Collaborative Partnership
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One challenge of working within a collaborative partnership is ensuring that decisions made
on behalf of the partnership are made with full awareness and input from partners, and made
in a timely fashion. Far too often, CCS made decisions for FHI—such as which funding
opportunities to go after, how to design a submission—and informed partners after the
decision was made. This was especially true of grant proposals, since the monthly Participatory
Evaluation and Planning meeting did not always sync well with upcoming grant deadlines.
The challenge around proposals being submitted for FHI is an example of a larger
communication challenge. Because most of the participants in the Participatory Evaluation and
Planning meetings were largely mid-level managers, there wasn’t a regular communication
meeting with executive directors, i.e., partner decision-makers. Shifting to an Executive Council
has alleviated that issue and increased the ability of the partnership to make definitive
decisions that are supported by the partners’ top executives.
 Unexpected Events that Developed in the Collaborative
Two unexpected events developed during the project:
1. Legislation that passed in the 2013 Oregon legislative session abolished the State
Children and Families Commission and established, through the Department of Education, the
Early Learning Council as well as the Youth Development Council. The Early Learning Council’s
mandate is to create a unified system of early learning services that significantly increased the
number of children who arrive at kindergarten healthy and ready to learn. This legislation, while
supported by FHI partners, has temporarily destabilized an already fragile early childhood
development system of care.
2. Because the Fostering Hope Initiative during the QIC-EC project focused on early
childhood, we did not expect to enlist a partner focused on serving seniors. However, Center
50+ asked to become a partner both as a resource to provide volunteer support in the two
Salem neighborhoods and also to participate in meetings and Community Cafés to focus on
how to involve seniors as part of the neighborhood mobilization process and increase their
social connections. Center 50+ is well-connected with the senior community: more than 700
seniors use the Center daily and more than 500 senior citizens annually use the health
screening clinics at the Center. Center 50+ is accredited by the National Institute of Senior
Centers. Of more than 15,000 senior centers across the country, only 120 are accredited.
Center 50+ is the first senior center in the state of Oregon to receive this recognition.
 Resources Needed to Support the Partnership
CCS has assumed the role of a backbone organization for FHI’s Collective Impact Initiative.
In addition to service funds from state/federal funders—which with the end of the QIC-EC
project, now come from service contracts held by partners—CCS has sought funding to support
the collaboration. For example, small organizations have fewer resources and less flexibility for
attending the necessary meetings with partners to maintain and improve the collaborative.
Therefore, CCS found a donor to provide funds to help smaller organizations be able to
participate in collaboration meetings—$5000 per organization per year.
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In November, 2012, CCS obtained funding from the Meyer Memorial Trust for a full-time
Collective Impact Coordinator to expand and deepen partner relationships, as well as to
improve the systems that support collective impact. This position, with its focus, has had a
tremendous impact on improving the quality of the relationships in FHI, attracting new
partners, improving communication with partners, and designing improved systems for
collaborative work.
CCS has funded a part-time grant-writer whose primary responsibility has been to write
proposals to support the FHI collaboration. This effort has led to funding for FHI from The Ford
Family Foundation (rural FHI), the Oregon Community Foundation (parenting education),
United Way of the Mid-Willamette Valley (costs of collaboration), and the Kaiser Permanente
Community Fund of the Northwest Health Foundation, as well as from the Meyer Memorial
Trust.
3. Roles of Parents as Partners in the Collaboration
 How Parents were Recruited and Supported in their Work
FHI used several strategies to recruit parents to participate with the project. Home Visitors
and Neighbor Connectors recruited parents willing to take on a leadership role in Community
Cafés. Training and ongoing facilitation support were provided for organizing and leading the
Cafés. Also, partners identified prospective parents from their respective service networks. At
each event, parent volunteers are solicited to take on responsibilities for upcoming activities.
Meeting arrangements, notes, flyers, etc. are provided by the backbone organization with help
from FHI partners. Salem-Keizer Coalition for Equality, an FHI partner, recruits, trains, and
supports parent leaders to provide the parent education classes.
The CCS Executive Director recruited participants for the Parents and Youth Councils. Both
councils primarily include persons who have been involved with the foster care system, either
as a child or as a parent. Individuals were recruited from youth and adults who were former
residents of CCS foster care homes, and through personal networks.
 Specific Contributions that were Made by Parents
Parent involvement in the Initiative took place in several ways, including in Parents’ Council
meetings facilitated by the CCS Executive Director. The Council is a team of parent leaders that
advocates for policy and funding to build neighborhood-based systems of support for children
and families that will reduce child abuse and neglect. Members include individuals who have
been involved with the foster care system, either as a child or parent. The Council provided
input for the project during the planning stages and continued in an advisory role throughout
the implementation period. The Council has been very active, and members have participated
in presentations on FHI to United Way, Catholic Charities USA, and the Fostering Hope: Closing
the Gap Summits, as well as other community functions.
In addition to the Parents Council:
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•
•
•
Parents from the neighborhoods have been involved in leading Community Café
meetings and events held at La Casita, the Washington Neighborhood FHI community
center.
CCS partnered with the Salem Keizer Coalition for Equality and Mano a Mano Family
Center for outreach to Latino parents and for participation in various meetings, classes
and other activities involving Latino parents.
At key time points during project implementation an FHI newsletter was distributed
within the target communities, summarizing current results and inviting comment and
additional participation from community members
 Challenges, Opportunities, And Lessons Learned Regarding Building and Sustaining
Strong Partnerships with Parents as Part of the Collaborative Effort
The parent perspective is vital to a project such as the Fostering Hope Initiative. Their
engagement will support sustainability of project activities—particularly those associated with
neighborhood mobilization. However, getting their active and ongoing participation requires
the project to accommodate their needs. Many of these families have very complicated lives.
For example, providing stipends or bus passes for transportation, offering child care at events,
occasionally giving incentives for attendance (e.g., goods such as diapers), providing a safe
environment to meet, and using trained interpreters when necessary are all strategies that may
help support parent participation. Project staff also must show empathy, be consistent, live up
to promises, listen to both the words and hidden messages, and be flexible when working with
parents and families to develop trust.
When working with parents of different cultures, it is important to be alert for and
understand their family’s norms, values and individual roles within the family. For example, the
location from which they emigrated to come to the U.S. affects which person the family may
view a as “head of household”—for some, it will be the father, for others, it may be the
grandmother or even oldest child. Home visitors must observe family dynamics to know which
family member will be open to receiving information. These cultural differences exist from
country to country—e.g., cultural and language differences between people from Peru and
those from Mexico, and even larger differences between people from these countries and
those from Pacific Islands. However, there also are regional cultural and language differences
within a country of origin.
Parent relationships, whether from the perspective of a family receiving services or in a role
as a project leader requires that staff be respectful of parents’ multiple priorities and followthrough on all promises. Project staff needs to “step aside” at times to allow space for parents
to engage in leadership roles. Key parent leaders in the community can be very helpful to a
project by initiating contacts with other families and helping to disseminate project
information.
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In Yamhill County, as part of the new United Way project, CCS pursued the opportunity to
hire a current Head Start parent to serve as the Neighbor Connector. This parent has received
leadership training from Head Start and served as the chair of their policy committee. She
brings a unique skill set to the role. In the Washington neighborhood in Woodburn, the
Neighbor Connector is a bilingual/bicultural former resident of the neighborhood who recently
graduated from Western Oregon University and is wanting to give back to her community. Her
parents still live in the neighborhood and are monolingual Spanish speakers. She is a far more
effective than the previous connector who did not reside in the community, and was not
bilingual.
4. The Partnership’s Role in Impacting Larger Systems Issues (Program and/or
Policy), Including Changes in Practices that have been or may be Adopted by the
Larger Systems in the Region or State.
FHI carried out an advocacy campaign to inform the legislature of the effect of the then
current policy of the Healthy Start~Healthy Families program to limit eligible families to only
those having their “first birth.” However, the experience of partners was that many families
face increased stress with subsequent births, having to balance caring for an infant with their
existing child care needs, as well as dealing with the additional costs associated with having
another child. The advocacy effort was successful: in the 2013 legislative session, the policy
was changed for the “Healthy Families Oregon” program so that any family with an infant three
months of age or younger, including prenatal, that has qualifying risk factors could be served.
In 2010, CCS, a local business advocate and the Department of Human Services worked with
the Senate President to craft and pass Senate Bill 991 to make Safe Families for Children
possible. This bill removed regulatory barriers that prevented private organizations from
providing voluntary respite care for children. The bill was lauded as a successful bipartisan
effort with the proposed legislation winning unanimous support.
In addition to these formal legislative changes, FHI partners have adopted the
Strengthening Families Protective Factors Framework, and some of them have built the
framework into their organizational policies.
D. Overview of the Project Model
1. Theoretical Foundation and Guiding Principles of the Project
The overarching goal of the FHI partnership is to build an enduring system of neighborhoodbased supports for fragile families at high-risk for child maltreatment—a system robust enough
to reduce child abuse and neglect and safely reduce the need for foster care in Marion and
Yamhill counties by 50% by 2020. In alignment with research findings recommending focus on
risk and protective factors, the FHI collaborative provides services that enhance family and
community well-being among high-risk families in the targeted neighborhoods. This includes
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neighborhood outreach and coordination; ongoing developmentally-specific neighborhoodbased parent education and support groups; and home visiting with wraparound services.
FHI works at all four levels of the social ecology. The project: 1) provides services such as
home visiting, parent education/support, and volunteer respite care to mitigate sources of toxic
stress and teach parents to be more resilient in the face of stress, 2) mobilizes neighborhood
residents to promote family protective factors and thereby make their neighborhood a better
place to raise children, 3) uses collective impact strategies to improve collaboration, quality and
accountability across partners, and 4) advocates for family-friendly public policy, including
policy that pays for outcomes rather than units of service and supports collaboration. CCS, as
the “backbone organization,” supports collaboration across sectors for collective impact.
Principles guiding the project include:
• Services must be family-centered, strength-based, individualized, culturally competent,
developmentally appropriate, and outcome driven.
• The project must address the neighborhood around families, through community
outreach, neighborhood mobilization, and activities that bring families together.
• The project must be founded on principles of quality management, including a focus on
the customer, teamwork, and a scientific approach to data collection and analysis for
program improvement.
Several key assumptions, based on scientific research, underlie FHI’s Theory of Change:
• Safe, stable nurturing relationships are the key social determinant of optimum child
development.
• “Toxic stress” disrupts safe, stable nurturing relationships by interfering with the brain
“executive function” (problem-solving, self-regulation, the ability to delay gratification)
and triggering fight-flight responses.
• Acute and/or chronic adversity in childhood leads to hypersensitivity to stress. Traumainformed approaches to service delivery are, therefore, often necessary.
• Toxic stress can be reduced and access to executive function developed by providing
support and services which address the sources of stress; by teaching knowledge, skills
and personal attributes to help parents become more resilient in the face of stress; and
by promoting Strengthening Families Protective Factors at home and in the
neighborhood.
• Early childhood investment will benefit both a child’s capacity to learn and the child’s
prospects for lifelong health.
• Living in a safe neighborhood where neighbors know and care about one another
strengthens families and promotes and protects optimum child development.
• The intentional pursuit of quality and accountability—i.e., grounding service design in
credible science, evaluating service delivery to ensure fidelity to service design,
evaluating results, and using the data to continually improve decision-making—is vital to
achieving the desired results.
• Collaboration is vital for solving complex social problems and creating collective impact.
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•
Public policy can strengthen families and promote/protect optimum child/youth
development, or it can undermine families and child/youth development.
2. The Project’s Specific Goals and Objectives, Activities/Interventions, and
Outcomes being Measured at Each Domain of the Social Ecology
Tables 92 and 93 display the outcome and process goals and objectives guiding FHI
implementation and evaluation. The tables also include activities/interventions and measures
associated with each goal.
Table 92
Project-specific Goals and Objectives, Activities/Interventions and Outcomes Being Measured at
each Domain of the Social Ecology
Goal(s)
Parents are
satisfied with FHI
Activities/
Interventions
Individual/Parent/Caregiver Domain
80% of parents will report
Home visiting and
neighborhood-based
satisfaction
services
Objective(s)
Promote parent
involvement in
service planning,
delivery, and
decision-making
80% of parents will report a
satisfactory level of
involvement in decisionmaking and service delivery
planning
Home visiting
Referrals are
utilized
50% of referrals made by
FHI staff will be utilized
Resource/referral to
home visiting recipients
Decrease child
maltreatment
risk
Maltreatment risk will
decrease significantly
among program participants
Home visiting and
neighborhood-based
services
Increase child
well-being
Decreases in maltreatment
risk among program
participants will be
significantly greater than
among comparison group
participants
A significantly smaller
proportion of child program
participants will test as
delayed than children in the
comparison group
Home visiting and
neighborhood-based
services
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Outcome Measures
Satisfaction with FHI
staff and services
(Caregiver’s Repeated
Measures Survey)
Perceptions of
involvement in decisionmaking and service
delivery planning
(Caregiver’s Repeated
Measures Survey)
Referrals resulting in
services received
(Resource/referral
tracking)
Risk for child abuse and
neglect (APPI)
Developmental status
and social-emotional
functioning (ASQ:3 and
ASQ-SE)
Goal(s)
Ensure home
safety
Decrease parent
stress
Decrease family
conflict
Increase
protective
factors
Increase social
capital
Objective(s)
Indicators of home safety
will increase significantly
among program participants
Increases in home safety
indicators among program
participants will be
significantly greater than
among comparison group
participants
Parent stress will decrease
significantly among program
participants
Decreases in parent stress
among program participants
will be significantly greater
than among comparison
group participants
Family functioning will
improve significantly among
program participants
Family functioning
improvements among
program participants will be
significantly greater than
among comparison group
participants
Protective factors will
increase significantly among
program participants
Increases in protective
factors among program
participants will be
significantly greater than
among comparison group
participants
Activities/
Interventions
Home visiting and
neighborhood-based
services
Outcome Measures
Home safety indicators
(Items adapted from the
Family and Child
Experiences Scale,
FACES)
Home visiting and
neighborhood-based
services
Parent stress (PSI)
Home visiting and
neighborhood-based
services
Family functioning (SRFI)
Home visiting and
neighborhood-based
services
Protective factors
(CAPF)
Relationship Domain
Social capital will increase
Home visiting and
significantly among program neighborhood-based
participants
services
Increases in social capital
among program participants
will be significantly greater
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Social support (SNM,
Social Connections CAPF
subscale, Isolation PSI
subscale)
Goal(s)
Activities/
Interventions
Objective(s)
Outcome Measures
than among comparison
group participants
Reduce child
maltreatment
Community Domain
Child maltreatment rates
Home visiting and
will decrease by at least 20% neighborhood-based
in target neighborhoods
services
Department of Human
Services (DHS)
maltreatment data
Reductions in child
maltreatment rates in the
targeted neighborhoods will
be significantly greater than
in comparison
neighborhoods
Ensure effective
collaborative
functioning
The collaborative will
demonstrate characteristics
of effective functioning
CCS serves as backbone
organization and
provides administrative
support to FHI as a
collective impact
initiative
Collaboration survey
Table 93
Process Goals and Objectives
Goal(s)
Collect background
information from
participants
Recruit the targeted
number of
participants
Maintain acceptable
retention rates
Objective(s)
Activities/
Interventions
Individual/Parent/Caregiver Domain
Generate a description of the
program and comparison
participants targeted by the
program and the evaluation
Recruit 100 program and 100
comparison participants
70% of enrolled families will
complete at least one year of
service.
85
Process
Measures
Collect evaluation data
on enrolled participants
Demographic
data (BIF)
Participant recruitment
activities in the
neighborhoods
Healthy Families
America creative
outreach activities
Enrollment data
− Retention data
− Parent phone
interviews
− Home visitor
focus group data
Goal(s)
Objective(s)
Maintain acceptable
participation rates
Caregivers will receive the
number of home visits
identified in their service plan
Facilitate parent
involvement
Parents will participate in the
Parents’ Council
Refer clients to
support services
Address caregiver needs.
Document
Implementation Team
meeting frequency
and attendance rates
Activities/
Interventions
Home visiting
Process
Measures
Home visitor
service tracking
data
Invite parent
attendance
Parents’ Council
attendee tracking
Referrals made as
needed
Community Domain (Service Providers)
Support collaborative
Monthly
Implementation Team
functioning
meetings
Resource/
referral data
Meeting
attendance
3. How the Project Supports Building Protective Factors
FHI includes several strategies for building protective factors and addressing risk factors in
families. These strategies are summarized in Table 94.
Table 94
FHI Components Addressing Protective and Risk Factors
Protective Factors
Parental Resilience
Social Connections
Knowledge of
Parenting and Child
Development
Concrete Support in
Times of Need
Nurturing Children’s
Social and Emotional
Competence
FHI Component
Home visiting
Parent education and support groups
Home visiting
Parent education and support groups
Activities and connections resulting from Neighborhood mobilization,
including Community Cafés, Community Dinners, etc.
Home visiting
Parent education and support groups
Use of evidence-based curricula such as Parents as Teachers © and Abriendo
Puertas
Tangible goods and incentives for participation provided during home visiting
and/or parent education and support groups
Other supports/referrals identified through home visiting
Home visiting
Other supports identified through home visiting
Parent education and support classes
Parent/child activities e.g., play groups
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Protective Factors
Risk Factors
E.g., Substanceabusing or HIV/ AIDS
affected caregivers;
Lack of social
cohesion
FHI Component
Home visiting
Parent education and support groups
Activities and connections resulting from Neighborhood mobilization,
including Community Cafés, community dinners, and literacy activities.
FHI components focus most directly on protective factors. However, other
needed supports were identified through home visiting. FHI has included
funding support for mental health and substance abuse treatment for those
who are not eligible for existing funded programs such as Oregon Health Plan
services. In addition, home visitors provide referrals to other programs and
follow-up on referrals to ensure families have made connections with those
programs.
FHI includes strategies for building protective factors within activities related to each
domain of the social ecology:
Individual /Family/Caregiver Domain: FHI’s services have focused on infants and children
up to age 2 at the start of service and their primary caregivers. FHI includes a variety of
services—home visits, resource and referral, parent education classes and support groups—
each of which is designed to increase protective factors and decrease risk factors associated
with child maltreatment. Parent education classes use developmentally-appropriate evidencebased curricula. and parent support groups use the Community Café approach
(http://www.thecommunitycafe.com/), to ensure effectiveness. Together, these services
address each of the protective factors over time. The experience of home visitors suggests that
families first need support with addressing concrete needs as they develop trust in the home
visitor. As the first several months go by, and the home visitor has been a consistent source of
support to them, caregivers are more willing to be open to sharing other needs and receiving
other types of support.
Relationship (Neighborhood) Domain. In addition to working with the primary caregiver,
the home visitors also worked with secondary caregivers (e.g., fathers, grandparents, other
relatives, friends) who most closely surround and are involved with families and young children
to offer support and education focused on maltreatment prevention. The parent education
classes and support groups also address this level of the social ecology, working to build a
community of neighbors. The groups are structured to bring parents together as a source of
social support for each other (e.g., Transmit cultural values and engender feelings of
connectedness and security), as well as to provide training on child development and parenting
from evidence-based curricula. Both the parent education classes and Community Café
meetings are open to any caregiver from the neighborhood, in order to eliminate any stigma
that might be attached with attending these meetings, and to support developing relationships
with other neighborhood residents. The Community Café has had a high level of participation
and interest. Indeed, CCS offered a training session in October, 2013, which was attended by
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individuals from each of the three counties. In addition, the neighborhood outreach workers
and Neighbor Connectors, much like community organizers, assist in local projects to address
neighborhood issues. For example, staff members from Mano a Mano and Salem Leadership
Foundation have supported a variety of activities available at La Casita—FHI’s neighborhood
center in Salem’s Washington neighborhood—including a lending library, garden club, literacy
activities, a coffee club, and play groups. Thus, each of the protective factors may be addressed
within these neighborhood mobilization activities.
Community (Service System) Domain: FHI has focused on improving its systems to support
collective impact. FHI collaborators share a common vision, support a common set of strategies
and measures, communicate with each other about their activities and outcomes, and benefit
from the support of a backbone agency (CCS.) The collaboration is committed to continuously
improving quality and accountability. All partners regularly discuss the protective factors. Some
have adjusted their policies and procedures to embed their important role in building
protective factors. Because of the FHI collaborative, more service agencies have become aware
of the importance of helping families to build protective factors, and it has become a common
objective of their work.
Systems (Policy) Domain: While the project funded by the QIC-EC did not address the
systems level, FHI has been very active at the policy level related to protective factors, as well.
• FHI was a component of Marion County’s Casey Family Programs project to reduce child
maltreatment and foster care. That project had a goal of influencing policy at the
systems level, and FHI worked closely with that project to achieve change.
• By offering parenting education and support groups to a critical mass of child caregivers
and neighbors in the targeted neighborhoods, the project tried to shift social norms and
attitudes within neighborhoods related to the appropriate treatment of young children.
• The research findings from FHI have been used as evidence to influence child
maltreatment policy. Relevant findings have been disseminated to key policy makers,
leaders, and state and federal agencies.
• CCS and its partners have been active in advocating for policy change at the state level,
working to achieve changes so that policies are more family-friendly, support
collaboration across providers, fund prevention activities at both a family and
neighborhood level, and invest savings from reductions in foster care and a reduced
need for residential treatment facilities—and concomitant savings in other state
systems such as juvenile justice, behavioral health—into effective programs such as
Fostering Hope. Thus, these policy changes would support increased focus and activities
within the first three domains of the social ecology.
4. The Project’s Final Logic Model
After being selected to participate in Harvard University’s Frontiers of Innovation (FOI)
project, FOI staff provided substantial assistance to CCS to improve the logic model for FHI. The
current version of the FHI Theory of Change (available
at: http://fosteringhopeinitiative.org/images/Theory%20of%20Change.pdf ) includes
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additional assumptions, based in science, and clarifies the target population. CCS is currently
working with Harvard’s FOI on a theory of change logic model specific to incorporating financial
self-sufficiency into FHI’s Theory of Change.
E. Overview of the Local Evaluation
1. The evaluation (research) design, data collection procedures, and the data
analysis plan
The evaluation was primarily guided by the overarching research question generated by the
QIC-EC:
How and to what extent do collaborations that increase protective factors and decrease
risk factors in core areas of the social ecology result in optimal child development,
increased family strengths, and decreased likelihood of child maltreatment, within
families of young children at high-risk for child maltreatment?
The study employed multiple methods to assess the implementation of and outcomes
associated with the Initiative. Evaluation methods associated with project implementation and
outcomes are addressed below.
Implementation Research Questions
•
•
•
•
•
•
To what extent is the collaborative marked by indicators of high-level collaborative
development?
What are the background characteristics of the target and comparison populations/
neighborhoods?
Are the targeted number of children and families attending or using the various FHI
events and services?
Does FHI maintain acceptable retention rates?
What does the Initiative cost per program recipient?
What type(s)/how many referrals are made for participating children/families?
Implementation Measures
Service tracking data. FHI includes numerous program components and services provided
by CCS and its collaborative partners. Home visitors tracked home visits and referrals. Home
visiting participants’ utilization of parenting education, community cafes, community dinners,
and partner agency services was captured with a follow-up survey. Attendance forms were
used to track parent support groups, Parents’ Council meetings, community dinners and
Community Cafés.
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Process data. Program staff and recipients assisted in the process evaluation by offering
feedback and recommendations about the program during the first six months of the
implementation period. Staff focus groups were conducted with the home visitors/parent
educators and addressed client enrollment, retention, and participation in home visiting and
parenting education classes. Client outcomes and staff support also were discussed. Parent
telephone interviews were carried out with a sample of primary caregivers and queried
neighborhood characteristics, enrollment/retention/participation issues, perceptions about
their involvement in program processes and decision-making, social supports, and perceptions
of program successes and challenges. The Year 1 Process Evaluation Report is provided in
Appendix A.
Table 95 presents the implementation measures employed in the evaluation with their
purpose and associated data collection schedule.
Table 95
Implementation Measures
Performance Measure
Parents’ Council
Attendance Record
Community Café
Attendance Record
Purpose
Document Parents’ Council attendance
Document attendance at Community Cafés
Schedule
All Parents’ Council
meetings
All Community Cafés
Home Visit Monthly
Service Log
Document all FHHV home visits
Monthly
Referral Tracking Form
Track number and type of referrals
Treatment Follow Up
Survey
Track participation in parenting education,
Community Cafés, community dinners, and partner
agency services
Collect background information
All referrals made by FHI
staff
Discharge
QIC-EC Background
Information Form (BIF)
Staff Focus Groups
Parent Telephone
Interviews
Address outreach, enrollment, and retention
Assess parent participation in services
Assess parent involvement in treatment planning
Assess caregivers' response to offers of social
support and resulting change
Reflect on program successes and challenges
Address retention/ participation
Assess perceptions of involvement
Reflect on program successes and challenges
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Intake and every 6 mos.
thereafter
Year 1
Year 1
Outcome Research Questions
•
•
•
•
•
•
•
•
How effectively does the collaborative function?
To what extent are parents satisfied with their level of involvement in programmatic
decision-making and service delivery planning?
To what extent are parents satisfied with Initiative programs and services?
What percentage of referrals is used?
To what extent does the FHI influence social connections among service recipients in the
targeted neighborhoods?
How does participant ethnicity influence program outcomes?
How do county differences influence program outcomes?
How and to what extent does the set of services and supports offered by FHI increase
protective factors and decrease risk factors among families in the targeted
neighborhoods, resulting in optimal child development, increased family strengths, and
decreased likelihood of child maltreatment?
Outcome Measures
Collaborative functioning. The functioning of the partnership was assessed with a survey
completed in the summer of 2011. Survey items addressed both the individual and
organizational levels of involvement and satisfaction at the planning stage and at the time of
the survey. Additional survey items were taken from Borden and Perkin’s (1999) Collaboration
Rubric. 3
Client level outcome data. The majority of program outcome measures were collected
from/about primary caregivers and children receiving home visits. Outcome data were
collected at baseline (i.e., intake) and at six month intervals to assess the extent to which
program participants would demonstrate statistically significant improvements, both
independently and as compared to children/families in comparison neighborhoods. Table 96
contains a list of outcome measures, their purpose, and the schedule according to which the
data were collected. Those required for the cross-site evaluation are indicated with “QIC-EC” in
parentheses following the name of the measure. 4 The table reflects an expectation that DHS
will provide neighborhood-level child maltreatment data at baseline and annually thereafter. 5
3
A copy of the Year 1 Collaboration Survey Report is contained in Appendix A
4
Copies of program-specific outcome measures developed for the evaluation are contained in Appendix C: Referral
Tracking Form, Collaboration Survey, and Caregiver Repeated Measures Survey.
5
In May, 2013 Pacific Research and Evaluation received notification from DHS informing us that errors related to
children and their founded allegations were identified in the DHS (NCANDS) data file for fiscal year 2012. While
DHS is unable to determine if the errors were specific to the children in our study neighborhoods, we have been
advised to disregard the data file and await a corrected copy. DHS has been unable to provide an estimate as to
when we will receive a replacement file. Once a corrected file for the 2012 fiscal year (date TBD) and the
91
Table 96
Client Level Outcome Measures
Performance Measure
FHI Referral Tracking Form
Purpose
Track referral resolution turnaround time
Track outcome of referrals
Assess collaborative functioning
Implementation Team
Collaborative Functioning Survey
Background Information Form
Measure change in child health
(QIC-EC)
indicators
Measure change in home
maintenance and safety
Measure neighborhood context
Measure income, housing
stability, and food security
FHI Caregiver Repeated
Measure change in service use
Measures Survey
Assess satisfaction with the FHI
Assess level of involvement in
decision-making and service
delivery planning
Ages and Stages Questionnaire 3 Assess/measure change in child
and Ages and Stages Socialwell-being (education/cognitive
Emotional
and social-emotional)
Parenting Stress Index (QIC-EC)
Measure change in parenting
stress
Adult-Adolescent Parenting
Measure change in parenting
Inventory (QIC-EC)
and child-rearing attitudes, risk
for child abuse and neglect
Self-Report Family Inventory
Measure change in family
(QIC-EC)
functioning and family cohesion
Social Network Map (QIC-EC)
Measure change in perceived
social support
Caregivers' Assessment of
Measure change in protective
Protective Factors (QIC-EC)
factors
DHS maltreatment data
Measure change in child
maltreatment rates
Schedule
All referrals made by
FHI staff
Year 1
Intake and every 6
mos. thereafter
Intake and every 6
mos. thereafter
Every 6 mos. after
intake
Intake and every 6
mos. thereafter
Intake and every 6
mos. thereafter
Intake and every 6
mos. thereafter
Intake and every 6
mos. thereafter
Intake and every 6
mos. thereafter
Intake and every 6
mos. thereafter
Baseline and end of
Y1, Y2, Y3
subsequent data file for the 2013 fiscal year (anticipated receipt date of June, 2014) are both received, we will
assess change over the entire study period for each of the six study neighborhoods.
92
The target for the home visit study population and comparison group (from whom the client
level outcome measures were collected) was 100 treatment and 100 comparison participants,
distributed among the neighborhoods as shown in Figure 2.
Figure 2. Sample distribution by county and neighborhood.
Data Collection and Management
Following completion of informed consent procedures approved by Western IRB
(www.wirb.com), client level data were collected by a bilingual Research Assistant (BIF, PSI,
AAPI, SRFI, SNM, ASQ-3, ASQ SE) and home visitors (SNM, ASQ-3, ASQ SE) at intake and 6month intervals thereafter. Data were collected in the caregiver’s primary language (English or
Spanish).
Data Analysis and Data Monitoring
Qualitative data from the focus groups and interviews were compiled, synthesized, and
analyzed to discern key findings. Quantitative data collected from the service tracking tools,
surveys, and outcome measures were cleaned and the responses were entered and checked for
accuracy. All quantitative data were analyzed using descriptive statistics such as frequencies,
and when applicable, means.
93
The primary analysis for comparing treatment and comparison neighborhoods was analysis
of covariance, using data collected on each outcome measure at intake as the covariate, and
data collected 12 months post-intake as the dependent variable.
Effect size estimates were also calculated when appropriate. Effect size (ES) is a name given
to a family of indices that measure the magnitude of a treatment effect. Whereas statistical
tests of significance tell us that the likelihood that experimental results differ from chance
expectations, effect-size measurements tell us the relative magnitude of the experimental
treatment.
Sample Size(s) and Estimated Power to Detect Impacts
During the design phase it was anticipated that final enrollment in the program (and by
proxy, the evaluation) would include at least 100 treatment and 100 comparison families over
the three-year implementation period. In order to estimate the effect size of the Fostering
Hope Initiative, a literature search was conducted to identify similar interventions, and several
relevant studies of home visiting programs were found. All effect sizes noted below were
measured using Cohen’s d.
In a randomized, control group study of the effects of the Early Start home visiting program,
Ferguson (2006) obtained effect sizes of 0.26 on severe physical abuse, and 0.22 on punitive
parenting. Armstrong (1999) conducted a randomized, controlled trial of a nurse home visiting
program for at-risk families, and obtained effect sizes of 0.77 on establishing a positive and
healthy home environment, 0.53 on parent responsivity, and 0.44 on symptoms of parental
depression. Olds (2002) also studied a nurse home visiting program and found effect sizes of
0.37 on establishing a positive and healthy home environment, and 0.31 on cognitive
development in children.
Several studies of the effects of home visiting programs on parent outcomes found smaller
effect sizes. These include effects of 0.16 on parent supportiveness during play (Love, 2005),
0.14 on parenting stress (U.S. Department of Health and Human Services, 2002), and 0.18 on
maternal sensitivity (Olds, 2004).
Two studies of the Family Connections Program are also relevant to the Fostering Hope
Initiative. The Family Connections Program is a multifaceted, community-based service
program that works with families to help them meet the basic needs of their children and
reduce the risk of child neglect. Parker (2008) studied the effects of Family Connections on selfsufficiency, and found effect sizes of 0.34 for economic self-sufficiency, 0.17 for social
emotional self-sufficiency, and 0.31 for total self-sufficiency. Another study of the Family
Connections program conducted by Girvin, DePanfilis, and Daining (2007) focused on various
aspects of the quality of the helping relationship between parents and home visitors. Effect
sizes in this study ranged from 0.89 to 1.11, indicating an extremely large effect.
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Based on caseloads for the five home visitors contributing to the project, a sample size of
100 treatment participants was projected. Adding a matching comparison group of equal size,
we anticipated a total sample size of 200.6
All power analysis calculations described below were conducted using G*Power 3.0 (Faul,
Erdfelder, Lang, and Buchner, 2009). It is suggested by Cohen (1992) that studies should
attempt to obtain a power of at least .80. Because of its similarity to the Family Connections
intervention, the researchers anticipated that the Fostering Hope Initiative would achieve at
least moderate effect sizes (i.e., d = 0.50). Electing to make conservative estimates, however, a
small effect size of 0.25 was projected for the study. Using the parameters detailed above,
calculations indicated that the required total sample size (treatment and comparison groups
combined) was 108. Additional power analyses indicated that a sample size of 108 would also
be adequate for conducting non-parametric analysis of categorical data (e.g., reports of child
abuse or neglect). Using the same parameters discussed above (power = .80, alpha = .05), the
required sample size for detecting an effect size of 0.25 using non-parametric statistical tests
was 155, well below our estimated sample size of 200.
Table 97 below displays the goal and final enrollment in the home visiting component for
each study neighborhood. The final sample (n=135) was sufficiently large to achieve statistical
power for the primary proposed analysis (ANCOVA). The sample fell short, however, for
administration of nonparametric tests.
Table 97
Final Study Enrollment
Neighborhood
Swegle
Washington
Sue Buel
Treatment totals
Hallman
Hoover
Edwards
Comparison totals
TOTAL:
Study
Goal
Final
Study
Total
Hispanic Study
Participant
Total
% Hispanic
Study
Participants
Hispanic % Neighborhood
Overall
40
40
20
100
40
40
20
100
200
28
27
15
70
28
20
17
65
135
19
17
13
49
25
18
10
53
102
67.86%
62.96%
86.67%
70.00%
89.29%
90.00%
58.82%
81.54%
75.56%
43.80%
58.60%
29.10%
N/A
73.00%
74.70%
37.90%
N/A
N/A
2. Problems Encountered in the Implementation of the Evaluation Plan
A total sample of 220 was initially projected for the study. It was determined shortly after the study period
began, however, that the projected sample should be reduced to 200 to accommodate the distribution of home
visitors across the two counties.
6
95
Recruiting was slow during program startup. It also waned during the summer months and
the holiday season. Enrollment was monitored closely and numerous strategies were employed
to increase enrollment, including team canvassing, recruitment from large community events,
and “friend and family” referrals in which the family member making the referral received a $20
gift card for every participant enrolled. Ultimately, however, the study targets were not met.
Additionally, within each study neighborhood, Hispanic representation was expected to
match that of the targeted elementary school. However, most FHI outreach workers and home
visitors responsible for recruiting and enrolling participants were Hispanic, which resulted in
over-enrollment of Latinos in the early months of the project. After adjusting the targets (with
QIC-EC approval) to increase the proportion of Hispanic participants (60% Hispanic, 40% nonHispanic English speakers), Hispanics continued to be overrepresented in the neighborhoods.
The right-most column in Table 97 above displays Hispanic representation in the study
neighborhoods.7 As shown in the table, Hispanic study participant enrollment exceeded that of
all six study neighborhoods. The discrepancy was greatest in the Sue Buel neighborhood. While
this overrepresentation of Hispanic/Latino families was a problem from a research perspective,
it also was a benefit. Since Hispanic/Latino children have lower achievement scores once they
reach school, overrepresentation of those families allowed FHI to learn more about working
with this group.
Data acquisition and sharing also was a challenge. The FHI is a neighborhood-based
intervention and service areas are defined by elementary school boundary lines. Few agencies
collect data at the neighborhood level, FHI collaborative partners included. This made data
sharing and documentation of results more challenging. Specifically, it was not possible to
collect service data from the partners at the neighborhood level, and as such, all results
contained within this report focus on study participants receiving home visiting services whose
data were collected by evaluation research staff and the FHI home visitors, who were all
employed by CCS by the end of the study. Exceptions include service monitoring data collected
for Community Cafes, community dinners, and Parents’ Council meetings.
Obtaining child maltreatment data from the Department of Human Services (DHS) also
proved to be a challenge. At the start of the study an agreement was established with the
Department in which DHS agreed to provide child maltreatment data for each of the six study
neighborhoods. During the study period the Department transitioned to a new data system
(OR-Kids), delaying submission of the requested data. Ultimately the study team received
notice that the transition to the new system had caused errors related to children and their
founded allegations and that DHS would be unable to provide the requested data for an
indeterminate amount of time. The most recent communication from the Department, received
on October 7, 2013, indicated that the requested data for fiscal years 2012 and 2013 were still
unavailable, and that we could expect to receive the files in 2014.
7
Marion County and Edwards Elementary data drawn from http://www.schoolmatters.com/schools on April 25,
2010. Sue Buel data drawn from http://www.msd.k12.or.us/district/fast-facts on April 25, 2010.
96
3. Changes in the Evaluation Plan
The study population shifted to include greater representation of Hispanic families, as
described in previous sections. The distribution of families across the study neighborhoods also
changed. Initially the researchers believed distribution would be equal, but assignment of home
visitors varied in that just one visitor worked in the Sue Buel neighborhood. As such, 40
caregivers were slated for recruitment in the Marion County neighborhoods (Swegle,
Washington, Hallman, and Hoover) whereas 20 caregivers were targeted for inclusion from Sue
Buel and Edwards.
The data collection plan for the site-specific collaboration survey also changed. It was
expected that the collaboration survey of partner agency leadership and staff would be
administered at two time-points during the study. The cross-site team administered a separate
survey collecting similar data (PARTNER survey), and it was determined that the site-specific
collaboration survey constituted duplication of effort and was not re-administered as planned.
Finally, staff focus groups and parent interviews were expected to occur each year of the
study. The evaluation budget became constrained, however, so these activities were only
facilitated by the research team during Year 1. For similar reasons, community safety, housing
quality, and crime rate data were not collected.
F. Cross-Site Evaluation
In addition to the program-level evaluation, the Initiative contributed to the national crosssite evaluation conducted by InSites on behalf of the QIC-EC. Quantitative participant data for
the cross-site evaluation included the following measures: Background Information Form (BIF),
Caregivers’ Assessment of Protective Factors (CAPF), Adult-Adolescent Parenting Inventory
(APPI), Parenting Stress Index (PSI), Self-Report Family Inventory (SRFI), and Social Network Map
(SNM). Data were collected from home visiting participants on the agreed-upon schedule
(intake and subsequent 6-month intervals) and submitted for entry as the forms were
completed. Collaboration partner members also completed the requested PARTNER survey at
two time points.
In addition to the quantitative measures, the evaluation team and key members of the FHI
project staff participated in monthly calls with the InSites cross-site evaluation team members,
describing progress to date toward achieving project milestones.
Each year the cross-site team and representatives from the QIC-EC conducted a two to
three day site visit. All site visit activities were coordinated by the FHI project team. FHI
arranged the site visit agendas to include activities and timelines requested by the cross-site
visitors. Specific agendas varied by year, but included meetings with the then-Chief Justice of
the Oregon Supreme Court, and separately with Yamhill and Marion County partners. In
addition, site visits included meetings with the CCS project team and evaluation team. The final
site visit in April, 2013, included a focus group with caregivers who had received home visiting
97
services, participation at the Community Dinner in the Swegle Neighborhood, and attendance
at a parenting education class.
98
III.
Project Implementation/Program Strategies
A. Project Eligibility, Recruitment, Screening, Intake, Retention, and Termination
Inclusion Criteria
In addition to the enrollment criteria stated previously (children had to be under 24 months
of age at intake and without a substantiated report of abuse/neglect), participants also needed
to be willing to participate in the program and/or evaluation and be characterized as “high-risk”
for abuse/neglect. Because the home visitation component employed the Healthy Start/Healthy
Families America (HS/HF) research-based home visiting model, the New Baby Questionnaire
(NBQ), the tool used by HS/HF, was used to identify high-risk families during the screening
process. Families were identified as high-risk if NBQ responses to items 1, 2, or 3 were present:
1. They report depression
2. They report drinking/drug use issues
3. They have any two or more risk factors in the bulleted list below:
• Mother is 17 years old or younger (teen parent)
• The primary caregiver is unmarried
• Prenatal care began more than 12 weeks into the pregnancy
• Lack of comprehensive prenatal care (less than 5 times)
• Education of the primary caregiver is less than a high school diploma
• Primary caregiver and spouse/partner are unemployed or seasonally employed
• Family experiences trouble paying for basic expenses “some” or “most of” the time
• “Some” or “serious” problems in marital/family relationships
The results of the NBQ screening process are summarized in Table 98 below for all study
participants included in the outcome analyses presented in subsequent sections of this report.
As shown, treatment group participants were more likely to report feeling down, depressed, or
hopeless (87.1%), to be a teen parent (17.4%), for the first prenatal visit to have taken place
after 12 weeks of pregnancy (44.1%), to have difficulty paying for basic expenses “some” or
“most of” the time (98.6%), and to report “some” or “serious” problems in family relationships
(55.7%).
99
Table 98
New Baby Questionnaire Maltreatment Risk Criteria
New Baby Questionnaire
Feeling down, depressed, or hopeless in the past month
Caregiver or partner feel a need to cut down on drinking or drugs
Teen parent
Primary caregiver is unmarried
First prenatal visit after 12 weeks
Less than 5 prenatal visits
Primary caregiver has less than a high school diploma
Primary caregiver and spouse/partner are unemployed or seasonally
employed
Difficulty paying for basic expenses "some" or "most of" the time
"Some" or "serious" problems in family relationships
Treatment
Comparison
(n=70)
87.1%
(n=69)
1.4%
(n=69)
17.4%
(n=70)
48.6%
(n=68)
44.1%
(n=67)
3.0%
(n=69)
55.0%
(n=70)
35.7%
(n=70)
98.6%
(n=70)
55.7%
(n=63)
39.7%
(n=64)
0.0%
(n=65)
3.1%
(n=64)
50.0%
(n=64)
26.6%
(n=64)
9.0%
(n=64)
64.1%
(n=65)
46.2%
(n=64)
90.6%
(n=64)
20.4%
Children for whom there had been a substantiated case of abuse/neglect and children over
24 months of age at intake were excluded from the study per the QIC-EC program expectations.
DHS provided substantiation information for all study participants and those who had an active
case with DHS were not enrolled in the study. Inclusion/exclusion criteria are summarized
below:
Inclusion:
• Child between the ages of birth and 24 months at the time of enrollment
• No substantiated case of child maltreatment on the targeted child for the
program/study
• Screened as “high risk” for abuse/neglect according to HS/HF NBQ criteria
• Willingness to participate in the program/study
• Provision of consent
• English/Spanish language speakers
100
Method of Subject Identification and Recruitment
Recruitment from the treatment and comparison neighborhoods was conducted by the FHI
Program Director, outreach workers, and home visitors. The Program Director facilitated flyer
distribution through the Department of Human Services (to TANF families), collaborative
partner agencies, hospitals, and the elementary schools. Outreach workers identified families
by contacting pregnancy and family resource centers, childcare providers, preschools, and
churches, as well as by posting flyers at high-traffic areas in the targeted neighborhoods (e.g.,
local markets and laundromats). The home visitors recruited program families from the parent
education and support groups they led, in addition to assisting the outreach workers with
neighborhood canvassing and other outreach efforts. FHI staff responsible for recruitment also
made presentations about the Initiative at relevant organizations and service provider
locations, during which FHI staff asked them to inform families about the FHI/research study.
Flyers, information cards and coupons describing the program/study and incentives were
distributed during all of the above activities.
These efforts, as well as other outreach activities to raise awareness of the Initiative in the
neighborhoods, are summarized in the Outreach Data Report developed in September, 2011
that documents all outreach conducted in the first nine months of the project. A copy of the
Fostering Hope Initiative Outreach Data Report is provided in Appendix A.
Study Screening and Intake Data Collection
Families interested in participating in the study were screened in person and by telephone.
The screening process began with administration of the NBQ by a home visitor (treatment
neighborhoods) or a PRE Research Assistant (comparison neighborhoods). In addition to the
NBQ, potential participants were asked to indicate whether they met the additional QIC-EC
criteria (home address within a study neighborhood and parenting a child under 24 months of
age). The researchers and program staff also relied on parent self-report to initially determine
whether a substantiated claim of child abuse/neglect existed for the child; these data were
confirmed by DHS subsequent to enrollment. Those who met the study criteria were enrolled in
FHI (treatment neighborhoods only) and invited to participate in the evaluation (treatment and
comparison neighborhoods). During the in-person intake process that followed, each family
completed IRB-approved consent forms, in addition to participating in collection of all baseline
outcome measures. All data were managed in compliance with HIPAA regulations. Participant
needs were assessed during the first home visit conducted by the participants’ assigned home
visitor with the referral form. The form queried a variety of services and community linkages,
determining which resources the caregiver was already linked to and those that were needed.
Incentives and Retention
Study participants from the comparison neighborhoods received a gift card following each
completed interview ($25, $50, and $75 for the intake, 6-month, and 12-month interviews,
respectively). Study participants who received home visiting services received tangible goods
101
such as books, clothing, and diapers to incentivize their participation. Retention strategies also
included “creative outreach”, the structured retention process defined by the Healthy Families
America evidence-based model (treatment families), and ongoing contact through telephone
and visits to the home, and through distribution of reminder items such as flyers and
refrigerator magnets with study information and incentive reminders (comparison families).
Final retention rates for the study are shown in Table 99.
Table 99
Study Enrollment and Retention Rates
Neighborhood
Goal
Final Enrollment
Final Total with
Attrition
Retention Rate
Swegle
Washington
Sue Buel
Treatment totals
40
40
20
100
40
40
20
100
200
41
39
29
109
33
25
20
78
187
28
27
15
70
28
20
17
65
135
68.3%
69.2%
51.7%
64.2%
84.8%
80.0%
85.0%
83.3%
72.2%
Hallman
Hoover
Edwards
Comparison totals
TOTAL:
 The Referral Process for the Program
FHI has strong connections with many service programs and other potential referral sources
in Marion and Yamhill Counties. In addition, FHI staff met with caseworkers from other
organizations to ensure they were familiar with FHI and how to refer someone for FHI support.
These included: Healthy Start, Exchange Club Parenting Center, Options Counseling, DHS
District 3, neighborhood schools, pregnancy and family resource centers, child care providers,
preschools, and the faith community. To avoid issues with confidentiality, some organizations
gave families information on FHI and asked them to contact FHI directly, i.e., self-refer.
 How Families Who were Eligible for Services Learned about the Program
Families learned about FHI in different ways. These included:
• Flyers that were posted in community locations frequented by families in poverty with
young children, e.g., grocery stores, laundromats, food banks, churches.
• Door-to-door campaigns, in which FHI staff in pairs walked through the neighborhood,
knocking on doors and handing out information. During these campaigns, staff also
interacted with any mothers with infants or very young children whom they met on the
street.
• Caregivers who attended parenting education classes or Community Cafés received
information on the larger FHI project.
• Informational tables on FHI, with FHI staff, at school and neighborhood events.
• Information provided by a case worker from another agency.
102
•
•
By word of mouth from their friends and neighbors.
By attending an event at La Casita, the FHI neighborhood center in the Washington
neighborhood.
The Procedure for Determining Which Protective Factors Were of Priority for Each
Family/Caregiver.
According to the home visitors, attending to families’ basic needs (food, housing, etc.) or
providing “crisis services” (mental health, domestic violence) typically comes first, and as a
result families gain trust in the home visitors and see them as a source of concrete and social
support. Once crisis services and basic needs have been addressed, home visitors reported that
they work with all of the protective factors to some degree, catering services to families’
individualized needs. In both home visiting and parent education, special emphasis is placed on
the “Nurturing and Attachment” protective factor.
 The Process of Seeking, Obtaining, and Using Caregiver or Community Input Regarding
Recruitment and Retention
During the Year 1 telephone interviews, caregivers who received home visits were queried
about study recruitment and retention. When asked how they heard about Fostering Hope,
parent interview respondents were most likely to indicate that they heard about the program
through their child’s school. Parents also learned about the program from a variety of other
sources, listed below.
• Catholic Community Services staff member
• Local health clinic
• Healthy Start
• Department of Human Services
• Church event
• Letter in the mail
• Parenting class
Complete results of the Year 1 parent interviews are contained in the Year 1 Process
Evaluation Report, presented in Appendix A.
When asked to suggest ways to increase awareness of the program in the targeted
communities or increase program enrollment, fliers and mailings were mentioned most often-recruitment strategies already in place. One parent raised a concern over how the program is
presented in the community. She stated, “Honestly I wasn’t even going to go with the program.
One of the volunteers passing out fliers said the purpose of the program was to keep my kids
out of foster care. This really turned me off and I at first said that I was not interested. Then
another lady saw how I was offended so she told me, ‘Let our director call you and she’ll explain
more.’” Other recommendations to increase awareness/enrollment are listed below.
• Face-to-face (neighborhood canvassing, informative meetings, school visits)
• Rely on word-of-mouth/ask parents to tell their friends
103
•
Explain that the program can help people suffering from depression
The majority of parents who accepted services did so to gain information about parenting.
One parent stated, “I was pregnant at the time and I had other children as well, so I wanted to
learn about how to treat the children, how to educate them and how to help them get along
with each other better.” Another shared, “It seemed like a good program to help people
become better mothers.” Other reasons for deciding to participate included:
• General help/help attaining resources
• Depression
When queried about persistence, parents cited the information and assistance provided by
the home visitors most often as their reasons for continuing with the program over time.
Moving out of the neighborhood was mentioned most often as the reason for discontinuing
services. Additionally, one parent who dropped from the program stated, “What happened is
that I simply don’t have time to go to all of the appointments and meetings that they were
scheduling because I have many children and many other things that I have to do. It wasn’t a
problem with the program; I just don’t have enough time.” Parents who missed appointments
or events while enrolled offered the following reasons:
• Work hours
• Lack of transportation
• Illness
• Had a baby
• School
Among those who missed FHI events or appointments, parents suggested holding events at
various times (e.g., during the day, evening, and on the weekend) and providing transportation
assistance to increase access.
In addition to qualitative data collected during the parent interviews, caregivers also
completed a local measure, the Caregivers Repeated Measures Survey, which queried general
satisfaction with the Fostering Hope Initiative home visiting services they had received. At the
six-month and one-year time-points, caregivers were asked to rate a series of items on a 5point scale from one or “strongly disagree” to five or “strongly agree”. Results are presented in
Table 100 below and demonstrate that caregivers were generally satisfied with the services
they received. Mean ratings for all but one item were between agree and strongly agree.
Exceptions included the two items addressing caregivers’ involvement in planning Fostering
Hope services for the future, indicating a desire to be more involved in these activities.
104
Table 100
Caregiver Repeated Measures Survey – Satisfaction
Mean Response
Statement
Six Months
(n=54)
One Year
(n=62)
Fostering Hope staff have the time to see me.
Fostering Hope staff ask for my opinions about my problems and how
to solve them.
Fostering Hope staff are sensitive to my cultural background.
Fostering Hope staff are prepared and organized.
Fostering Hope staff are knowledgeable.
Fostering Hope staff present information in a way that is easy to
understand.
I have used the information presented in Fostering Hope.
My parenting skills have improved because of Fostering Hope.
Fostering Hope is helpful.
I would recommend Fostering Hope to others.
I am involved in planning Fostering Hope programs and services for the
future.
I would like to be more involved in planning Fostering Hope programs
and services for the future.
4.33
4.34
4.31
4.23
4.41
4.37
4.31
4.42
4.31
4.42
4.44
4.47
4.22
4.20
4.43
4.48
4.34
4.19
4.47
4.50
3.24
4.39
3.80
3.81
Data about recruitment and retention also were gathered from home visiting staff and
parent educators during a focus group conducted in year 1. According to respondents, face-toface contact was more successful than flyer/literature distribution for recruitment. With her
office located in the Public Health Department, the home visitor assigned to Yamhill County
recruited numerous Department walk-ins for home visiting. She reported that referrals through
the school often did not qualify for services, and that efforts to obtain referrals from other
agencies such as Head Start or the county mental health center were not successful either.
In Marion County, team canvassing in the targeted neighborhoods met with mixed results.
Apartments generated more screenings than canvassing single or multi-family homes. The
home visiting team also attended large community events such as International Night and the
No Child Left Behind Literacy Conference. Both canvassing and event attendance efforts sought
to access a large number of families in a small area over a short time. When conducting
outreach, home visitors made an effort to bring activities rather than make presentations about
Fostering Hope, which they found to be more effective when engaging potential participants or
partner agencies. Additionally, Marion County established a relationship with the Head Start
Outreach Coordinator who “hand-picked” families for FHI home visiting, a memorandum of
agreement was established with the hospital to screen new births, and mothers were recruited
for services from teen parent programs in the area.
105
According to program staff, challenges that caused clients to drop from the program or miss
out on events or services included transience/moving out of the service area, lack of
transportation (primarily an issue for parent education attendees), and domestic violence and
addictions issues.
 Challenges in Recruiting, Intake, and Maintaining Families in the Project and
Responses to the Challenges
Recruitment was closely monitored throughout the study period and program staff and
project leadership received monthly updates during Participatory Evaluation and Planning (PEP)
meetings. PEP is a real-time, issue-focused data sharing partnership that supports
implementation and facilitates outcome achievement. PEP combines participatory, utilizationfocused evaluation methods with the Shewhart Cycle, a process for continuous quality
improvement, to monitor implementation and progress toward program outcomes. An
example of a graph developed to monitor enrollment is presented in Figure 3. As shown in the
graph, in May of 2011, projected enrollment generated from an average of enrollment from
previous months indicated that the study would not achieve its enrollment target for the
neighborhood shown. Similar graphs were created for each neighborhood and the
Implementation Team brainstormed strategies to improve enrollment rates. At subsequent
meetings, the results of the strategies employed were discussed and new ideas generated. The
process produced gains in enrollment rates, in addition to providing staff with regular
opportunities to collectively discuss project data.
40
36.
60
Number of participants
35
30
28.20
23.80
25
Target, accounting for
attrition (30% added)
Target, simple value
20
15
10
13
Actual, enrolled and
maintained
Projected, enrolled and
maintained
5
0
Figure 3. Study enrollment/retention monitoring example from the Washington neighborhood.
106
 The Process for Termination of Services to Project Participants and Providing Them
with Linkages to Community Resources at Termination
FHI home visitors did not terminate any project participants who had an interest in
continuing with the program, except at the end of project funding, in March 2013. While the
frequency and intensity of services decreased over time with families, as they built protective
factors and exhibited greater skills at managing parenting, families were not asked to leave the
program. Most terminations were due to the family leaving—moving out of the neighborhood
or deciding to end their participation. However, in March, 2013, with the end of project funding
for direct services, home visitors took several steps to smooth the transition for families served
by FHI:
• Gave families information at least several weeks prior to the end of service that the
project was ending and that they would no longer receive home visits after the end of
March.
• Reminded families that they had been told from the beginning that the program would
be time-limited.
• Connected families with other resources to ensure that they had other strategies and
supports available to help them.
• Distributed the remaining “tangible goods” (e.g., diapers, books) to families.
• Invited families to participate in a focus group with the cross-site evaluation team as a
way of debriefing their involvement with the project.
• Held a formal “graduation ceremony” to celebrate the accomplishments of the families
during their participation with FHI.
B. Major Strategies Implemented/Services Provided as Part of the Intervention
A total of 70 caregivers received at least 12 months of home visiting services under the
auspices of the initiative. Table 101 summarizes the number of home visits that participants
received. Specifically, the table presents the minimum, maximum, and average (mean) number
of home visits that participants received during the first six months of service, the second six
months of service, and for the first year. The right-most column displays the average number of
home visits received monthly. According to the Healthy Families America model, participants
typically receive weekly home visits during the first six months of service and bi-monthly visits
during the second six months of service. As shown, visitors were not successful in scheduling 4
visits per month during the first six months of service, averaging 2.65 visits per month. Home
visits decreased during the second six months of service (in accordance with the model). On
average, participants received two visits per month during the second six months of service.
Collectively, the 70 treatment neighborhood participants who completed at least 12 months of
service received 582 home visits during their first year of participation in the Initiative.
Table 101
Home Visit Summary
Time
1-6 Months
Minimum
Maximum
Mean
Monthly Average
5
24
15.89
2.65
107
7-12 Months
Year 1
5
12
19
40
12.44
28.33
2.07
2.36
Caregivers receiving home visiting from a Fostering Hope Initiative home visitor were
encouraged to participate in other services provided in their neighborhoods. With a follow-up
survey, caregivers in the treatment group were asked to report on the programs and services in
which they had participated. As shown in Table 102, among the 49 caregivers who responded,
most indicated that they had not attended a parenting education class while enrolled in home
visiting (65.3%). Additionally, one participant reported receiving home visiting services and
another received therapeutic classroom services for his/her child through Family Building
Blocks (FBB), a Fostering Hope partner (data not tabled).
Table 102
Participation in Parenting Classes
Parenting Class
% Yes (n=49)
Make Parenting a Pleasure
24.5%
Parenting with Love and Logic
8.2%
Incredible Years
10.2%
Strengthening Families
4.1%
None
65.3%
In addition to the caregivers
receiving home visiting, Parent Council
meetings, Community Cafes, and
community dinners also were tracked.
Data for these parent involvement and
neighborhood engagement strategies
are summarized in Table 103 Results
display the number of meetings or events and the overall attendance for the study period
running from October, 2010-March, 2013.
It should be noted that 12 home visiting recipients indicated that they had attended at least
one Community Café in their neighborhood. Specifically, respondents reported attending
between two and 15 cafes, with an average of seven cafes attended by the respondents who
were able to recall this information. In addition, 13 home visiting recipients attended at least
one community dinner. Caregivers who attended the dinners reported attending six dinners, on
average.
Table 103
Activity Summary Data
Activity
Parent Council Meetings
Washington Neighborhood Community Cafes
Swegle Neighborhood Community Cafes
Swegle Neighborhood Community Dinners
Number of
Meetings
Number Attending
(Duplicated Count)
20
28
22
63
102
151
237
12,856
Fostering Hope Initiative used a variety of service strategies (See Table 104). Basic to each
treatment neighborhood were home visiting, parenting education, and Community Cafés.
Additional strategies, such as a community dinner (Swegle), an FHI Neighborhood Center (La
108
Casita, in Washington), emerged in individual neighborhoods and then were supported by FHI
partners. None of these services were provided by the Fostering Hope Initiative in the
comparison neighborhoods. However, other programs, such as Healthy Start~Healthy Families
and Family Support and Connections held contracts that funded services provided throughout
each county, and therefore could have included services within the comparison neighborhoods.
No FHI-sponsored neighborhood mobilization activities occurred in the comparison
neighborhoods.
Table 104
Summary of FHI Service Strategies
Strategy and
Leaders
Home
Visiting:
Healthy Starttrained home
visitors
Dosage/
Duration
1 Hour visits
based on skill
level:
Level 1: Weekly
Level 2: Twice
monthly
Level 3: Monthly
Parenting
Education
Classes:
Certified
parent
educators
Community
Cafés: Parent
educators
and
neighborhood
residents
Approx. 1.5
hours/class;
8-12 weeks
varied with
curriculum
La Casita—
the FHI
Neighborhood
Centera:
Salem
Once monthly
for about 2
hours
“La Casita”
emerged in one
neighborhood
out of local
relationships.
Open for use
Challenges/Barriers
− Fears due to immigration
status
− Partner resistance
− Mobility of families
− Difficulty contacting families
− Gaining family trust
− Finding and enrolling eligible
families
− Families finding time in their
busy schedules
− Inconsistent attendance
− Recruiting other families who
were not receiving home
visiting service
− Recruiting ongoing parent
leaders for Cafés
− Parent educators needing to
fill gaps when parent leaders
can’t do it
− Deciding to stay together or
split when a group gets large
− Parent educators “stepping
back” as leaders emerge from
the group
− Coordinating the various
events and organizations
using the house
− Ensuring that maintenance is
shared
− Providing volunteer support
109
Lessons Learned
− Address concrete needs first
− Address the issues the
caregiver presents
− Be a consistent nonjudgmental listener and
supporter
− Be patient waiting for trust to
develop
− Classes held after a weekly
Community Dinner
encouraged participation
− Use tangible goods incentives
− Provide on-site child care
− Recruit through classes and
home visiting
− Use as a way to help groups
stay together after the end of
a parenting class
− Serve food
− Provide resource lists for
tangible goods and/or
distribute goods at meetings
− Plan dates and topics 2-3
months in advance to allow
families to plan ahead
− Provide on-site child care
− Use a single coordinator for
scheduling
− Post the monthly schedule in
the house
− Hold regular “management”
meetings of leaders to ensure
Strategy and
Leaders
Leadership
Foundation &
Mano a
Mano
Dosage/
Duration
most days,
some evenings.
Community
Dinnersa:
Salem
Leadership
Foundation,
Christian
Center of
Salem, and
Marion/Polk
Food Share
Weekly dinners
during fall,
winter and
spring, except
for holiday
times
Neighbor
Connectorsa:
CCS
(Funded
through
other
sources)
Neighbor
Connectors get
to know the
neighborhood
and its residents
and help to
connect them
with other
neighbors and
needed
resources
a
Challenges/Barriers
Lessons Learned
to keep house open and
available to neighbors
− Obtaining needed resources,
e.g., internet connection and
computer for family use,
books for lending library
activities and plans are
coordinated
− Encourage neighborhood
ownership at all levels,
including picking up and
cleaning after use of the house
− Invite community groups to
offer events or services there
− Sponsor “clubs”
− Hold coffee clubs the morning
after a community event (e.g.,
after Parent-Teacher
meetings)
− Invite community schools to
help furnish, paint, decorate,
or make signage for house
− Look for cooperative
opportunities with neighbors
− Listen to what the children
and parents say they want to
do
− Community dinners emerged
from one neighborhood’s
interest and would not be
appropriate to “force” if there
is not sufficient interest and
major players (site,
coordinator, chef, food share)
willing to invest in it
− Finding a chef who will
volunteer time to plan and
cook the meals
− Developing menus based on
what is available from the
Food Share
− Having sufficient volunteers
to help with serving and
clean-up
− Coordinating the various
players
− Finding people who get to
− May need a strategy for hiring
know people easily
individuals from
neighborhoods who may not
− Finding people who live in the
meet the typical profile for
neighborhood and already
hiring (e.g., drug use, criminal
know many neighborhood
record)
residents
− Use multiple methods to find
− Finding people who meet
potential candidates, including
other requirements and also
radio commercials, and
are bilingual
recruitment in the Latino
(Spanish/English)
newspaper
Strategy was new or changed during the course of the project
110
C. Approach to Program (Model) Fidelity
FHI used the evidence-based model, Healthy Families America, for home visiting, with two
modifications: the infant or pregnancy did not have to be the first-birth for the family, and the
target child could be as old as 24 months at the start of service (HFA requires service begin
within 3 months of birth). The home visitors also used the Parents as Teachers evidence-based
curriculum during their home visits. FHI Home Visitors received supervision from a qualified
HFA supervisor, for the required amount of time each week (i.e., 1.5-2 hours of reflective
supervision each week for staff working 20 hours or more per week; 1 hour per week for staff
working less than 20 hours per week). In these sessions, the supervisor reviewed progress on
cases, case plans, issues and next steps at each meeting—coaching and providing feedback on
strength-based approaches and interventions. The supervisor supported accountability by
discussing home visit completion rates, as well as family retention, and attrition.
In addition, the supervisor accompanied the FHI Home Visitor on selected home visits, to
check fidelity and to ensure that the supervisor was known to the family, in the event the
supervisor needed to fill in for the home visitor due to sickness, or other reason for absence.
For additional information on supervision in Healthy Start~Healthy Families, go to:
umchsresources/administration/pandp/Healthy_Start/HS4_Healthy%20Start%20for%20Supervi
sors%20&20Managers/Oregons_Healthy_Start_PM_Sup_Reference_Guide.pdf. This UmatillaMorrow county site has excellent information related to the model.
The parenting education classes used evidence-based curricula. Some of the classes were
taught with a pair of certified parent educators, who could give feedback to each other. Class
series were evaluated by participants, including whether they felt they had learned helpful
information. No other strategies to assess fidelity were used with the parenting education
classes.
Community Cafés used the facilitation process developed and disseminated by the National
Alliance of Children’s Trust and Prevention Funds (http://ctfalliance.org/initiative_parents2.htm). No assessment of fidelity was completed for Community Cafés.
Other FHI strategies emerged from the interests of families in service, other neighborhood
families and/or from the involvement of partner organizations.
C. Use of a Protective Factors Approach
Jim Seymour, CCS’ Executive Director, embraced the Strengthening Families Protective
Factors Framework™ early on in the project. As a result, at every Initiative meeting and event,
the Framework was explicitly addressed. Additionally, Dr. Charlyn Harper Browne was invited to
speak at each Fostering Hope: Closing the Gap Summit, presenting the Framework in detail. As a
result of this leadership, the partner agencies and project staff engaged directly with the
111
Protective Factors, which shaped their attitudes and practices related to improving child and
family wellbeing. The broader community engaged in the Initiative also is now well-versed in
the Framework.
112
IV.
Project Outcome Evaluation
Analysis Approach
All outcome evaluation measures were administered to study participants at baseline and at
six-months and 12-months post-baseline. Qualitative data collected from Fostering Hope home
visitors indicated that for many families participating in the Fostering Hope program,
relationship and rapport-building takes approximately six months. Hence, while data collected
at the 6-month time point was used during the course of the project for formative purposes
and to examine early outcomes, the primary analyses in the outcome evaluation involve
comparisons of outcomes for the treatment and comparison groups at the 12-month time
point.
While study participants in the treatment and comparison neighborhoods were very similar
in most respects, there were slight differences between groups on some demographic variables
(e.g., ethnicity, maltreatment risk indicators). In addition, analysis of outcome data at baseline
revealed differences between the treatment and comparison groups on several measures:
• The Parental Stress Index Total Stress Domain: t(117) = 2.51, p = .013.
• The Parental Stress Index Parent Domain: t(116) = 2.09, p = .039.
• The Self-Report Family Inventory Conflict Scale: t(134) = 2.32, p = .022.
• The Caregivers Assessment of Protective Factors Resilience 1 Scale: t(133) = 1.97, p =
.051.
To account for these differences at baseline, analysis of covariance (ANCOVA) was selected
as the primary statistical test for the outcome evaluation. Specifically, for each outcome
measure, baseline scores were entered as a covariate, with 12-month scores as the dependent
variable. Overall results are reported for each measure, as are noteworthy findings for
subgroups of interest. Effect size, partial eta squared (η2p), is presented for selected results.
A. Increased Likelihood of Optimal Child Development: Findings
Competence Subscale on the PSI
High scores on the Competence subscale may be produced by a number of factors. For
example, it is expected that young parents of an only child will earn somewhat higher scores
than multiparous parents. Parents who are lacking in practical child development knowledge or
who possess a limited range of child management skills will also earn high scores. Finally, high
scores will be found among parents who do not find the role of parent as reinforcing as they
had expected. These parents are often overwhelmed by the feeling that “this child is more than
I bargained for” and “I am not sure I would have children if I had it do over again” (Parenting
Stress Index Third Edition Professional Manual, p.10). Analysis of covariance (ANCOVA)
comparing results for all treatment and comparison participants generated a statistically
significant result (p=.035) but the effect size was not noteworthy (η2p = .038).
113
•
PSI Competence Subscale: F(1, 116) = 4.55, p = .035; η2p = .038
To further explore the data, the same analyses were conducted for Marion County
neighborhoods only:
• PSI Competence Subscale: F(1, 89) = 7.22, p = .009; η2p = .075
Results were also conducted for Hispanic participants only:
• PSI Competence Subscale: F(1, 87) = 6.52, p = .012; η2p = .070
Finally, ANCOVAs were conducted for Hispanic participants in Marion County:
• PSI Competence Subscale: F(1, 66) = 6.72, p = .012; η2p = .092
The results of these subgroup analyses indicate that the Fostering Hope Initiative may have
had a greater impact, at least in terms of caregivers’ sense of competence, in Marion County.
The FHI also appears to have been more effective among Hispanic participants, and particularly
among Hispanic participants residing in the two Marion County neighborhoods. For this latter
analysis, sample sizes were quite small (n = 31 in the treatment group and 38 in the comparison
group), but yielded somewhat noteworthy effect sizes (η2p = .070-.092).
Group mean scores at baseline and 12-months for the PSI Competence subscale are
presented in the table below. Reductions in scores over time represent an improvement in
ones’ sense of competence.
Table 105
PSI Subscale Means at Baseline and 12-months
PSI Sense of
Competence
Baseline
12-months
Overall
Marion County
Hispanic
Participants
Marion County
Hispanic
Participants
Tx.
(n=59)
Comp.
(n=60)
Tx.
(n=47)
Comp.
(n=45)
Tx.
(n=42)
Comp.
(n=48)
Tx.
(n=31)
Comp.
(n=38)
33.02
31.71
30.81
32.63
33.07
31.21
30.07
32.51
32.72
31.73
31.01
33.23
32.56
31.25
30.77
33.05
Note. Tx = Treatment; Comp. = Comparison.
Adult Adolescent Parenting Inventory (AAPI)
The AAPI measures five constructs regarding parenting and child-rearing attitudes. These
constructs provide an index of risk for behaviors related to child abuse and neglect. Results of
ANCOVAs conducted on each of these constructs are presented below. It should be noted that
AAPI raw scores were converted to STEN scores for analysis and reporting.
• Construct A - Expectations of Children: F(1, 132) = 3.93, p = .049; η2p = .029
• Construct B - Empathy Towards Children's Needs: F(1, 132) = 2.50, p = .116
• Construct C - Use of Corporal Punishment as a Means of Discipline: F(1, 132) = 0.22, p =
.643
114
• Construct D - Parent-Child Role Responsibilities: F(1, 132) = 1.03, p = .311
• Construct E - Children's Power and Independence: F(1, 132) = 0.18, p = .668
Only the ANCOVA conducted on Construct A, measuring expectations of children, yielded
statistically significant results, with the treatment group showing a slightly larger improvement
over time than the comparison group. The associated effect size of .029, however, is quite
small indicating that the effect may not be particularly meaningful.
Additional ANCOVAs conducted with subgroups (Marion County only, Hispanic participants,
Marion County Hispanic participants) yielded a virtually identical pattern of results. Specifically,
only results for Construct A reached or approached statistical significance. ANCOVAs for
Construct A are presented below for these subgroups.
• Marion County, AAPI Construct A: F(1, 101) = 3.52, p = .064; η2p = .034
• Hispanic Participants, AAPI Construct A: F(1, 99) = 4.05, p = .047; η2p = .039
• Marion County Hispanic Participants, AAPI Construct A: F(1, 75)= 3.50, p = .065; η2p = .045
Overall, analysis of data from the AAPI suggests that treatment group participants showed
improvement, relative to comparison group participants, in terms of having more appropriate
expectations of their children. This finding appears to be consistent across subgroups.
Group mean scores at baseline and 12-months for all AAPI subscales are presented in the
table below. Increases in scores over time represent improvement in parenting and childrearing attitudes.
Table 106
AAPI Scale Means at Baseline and 12-months
Overall
AAPI Construct A
Baseline
12-months
AAPI Construct B
Baseline
12-months
AAPI Construct C
Baseline
12-months
AAPI Construct D
Baseline
12-months
AAPI Construct E
Marion County
Hispanic
Participants
Marion County
Hispanic
Participants
Tx.
(n=70)
Comp.
(n=65)
Tx.
(n=55)
Comp.
(n=49)
Tx.
(n=50)
Comp.
(n=52)
Tx.
(n=36)
Comp.
(n=42)
4.96
5.79
4.60
5.06
4.82
5.69
4.53
4.94
4.74
5.78
4.37
4.94
4.53
5.67
4.36
4.88
3.50
4.24
3.06
3.51
3.33
4.27
2.63
3.33
3.30
4.14
2.50
3.04
3.03
4.14
2.31
3.07
5.24
5.04
5.20
4.92
5.15
5.05
5.18
4.80
5.14
4.98
4.90
4.62
5.00
4.97
5.00
4.67
4.66
5.31
4.25
4.72
4.36
5.05
3.86
4.53
4.64
5.14
3.73
4.31
4.22
4.72
3.67
4.36
115
Baseline
12-months
5.51
5.43
4.91
4.98
5.31
5.42
4.57
4.67
5.44
5.20
4.37
4.38
5.19
5.17
4.29
4.36
B. Increased Family Strengths: Findings
Self-Report Family Inventory
The Self-Report Family Inventory is intended to assess an individual’s perception of his/her
family’s functioning. Subscales include Health/Competence, Conflict, Cohesion, Expressiveness,
and Leadership. It was determined by QIC-EC leadership and the cross-site evaluation team
that the Leadership subscale would not be used in this evaluation. Results of ANCOVAs
conducted on each of the four remaining scales are presented below.
• SRFI Health/Competence: F(1, 133) = 0.40, p = .529
• SRFI Conflict: F(1, 133) = 0.78, p = .379
• SRFI Cohesion: F(1, 133) = 0.03, p = .867
• SRFI Expressiveness: F(1, 133) = 3.66, p = .058; η2p = .027
Only the ANCOVA conducted on the Expressiveness subscale approached statistical
significance, with the treatment group showing slightly more improvement over time than the
comparison group. The effect size of .027 for this result is quite small, however, indicating that
the effect may not be particularly meaningful.
Additional ANCOVAs conducted with subgroups of interest (Marion County only, Hispanic
participants, Marion County Hispanic participants) did not yield any results approaching
statistical significance. The results of these analyses are listed below for the Expressiveness
subscale only:
• Marion County, SRFI Expressiveness: F(1, 102) = 2.23, p = .138; η2p = .021
• Hispanic Participants, SRFI Expressiveness: F(1, 100) = 2.08, p = .152; η2p = .020
• Marion County Hispanic Participants, SRFI Expressiveness: F(1, 76) = 0.67, p = .417; η2p =
.009
Overall, results from the SRFI suggest that treatment group participants improved slightly
relative to comparison group participants on the Expressiveness subscale. The magnitude of
this group difference, as measured its effect size, is not particularly noteworthy. Scale mean
scores for the entire sample are presented in the table below. It should be noted that on the
SRFI, decreases in scores over time indicate improvement.
116
Table 107
SRFI Scale Means at Baseline and 12-months
Overall Scale Scores
Treatment
(n=70)
Comparison
(n=66)
59.44
59.11
59.97
59.91
35.77
37.20
37.53
37.33
14.77
14.83
14.61
14.74
15.84
15.61
16.53
16.42
SRFI Health/Competence (Max = 90)
Baseline
12-months
SRFI Conflict (Max = 60)
Baseline
12-months
SRFI Cohesion (Max = 25)
Baseline
12-months
SRFI Expressiveness (Max = 25)
Baseline
12-months
Background Information Form, Items 18 and 19 - Safety
Tables 108 - 125 below present data about home safety knowledge and practices, as well as
respondents’ use of emergency numbers. As shown below, responses for both the treatment
and comparison participants increased for most of the items queried. Exceptions included
receipt of CPR training, which demonstrated a small decrease from intake to one year. Similarly,
rates of emergency calls also decreased.
117
Table 108
Safety Statements – Overall - % True
Safety (% True)
Overall
Study Group
Treatment
Intake
One Year
(n=70)
(n=70)
Comparison
Intake
One Year
(n=65)
(n=65)
I have a first-aid kit at home
I have received first-aid training
I have received CPR training
I know how to do CPR on infants and young children
I have the poison control center telephone number
in my cell phone or by a phone at home
I have other emergency numbers in my cell phone or
by a phone at home
50.0%
41.4%
45.7%
38.6%
34.3%
64.3%
44.3%
44.3%
45.7%
54.3%
35.4%
40.0%
41.5%
33.8%
35.4%
63.1%
43.1%
36.9%
44.6%
60.0%
65.7%
80.0%
61.5%
72.3%
I have had to call poison control, 911 or another
emergency number in the past 12 months
18.6%
14.3%
10.8%
7.7%
Time-point
Table 109
Safety Statements – Marion County - % True
Safety (% True)
Marion County
Study Group
Treatment
Intake
One Year
(n=55)
(n=55)
Comparison
Intake
One Year
(n=49)
(n=49)
I have a first-aid kit at home
I have received first-aid training
I have received CPR training
I know how to do CPR on infants and young children
I have the poison control center telephone number
in my cell phone or by a phone at home
50.9%
40.0%
45.5%
36.4%
40.0%
63.6%
41.8%
43.6%
43.6%
50.9%
30.6%
36.7%
40.8%
32.7%
28.6%
59.2%
40.8%
36.7%
44.9%
59.2%
I have other emergency numbers in my cell phone or
by a phone at home
63.6%
81.8%
55.1%
67.3%
I have had to call poison control, 911 or another
emergency number in the past 12 months
16.4%
14.5%
10.2%
4.1%
Time-point
118
Table 110
Safety Statements – Yamhill County - % True
Safety (% True)
Yamhill County
Study Group
Time-point
I have a first-aid kit at home
I have received first-aid training
I have received CPR training
I know how to do CPR on infants and young
children
I have the poison control center telephone
number in my cell phone or by a phone at home
I have other emergency numbers in my cell phone
or by a phone at home
I have had to call poison control, 911 or another
emergency number in the past 12 months
Treatment
Intake
One Year
(n=15)
(n=15)
Comparison
Intake
One Year
(n=16)
(n=16)
46.7%
46.7%
40.0%
40.0%
66.7%
46.7%
40.0%
46.7%
50.0%
50.0%
50.0%
43.8%
75.0%
56.3%
43.8%
50.0%
20.0%
66.7%
50.0%
62.5%
73.3%
73.3%
81.3%
87.5%
20.0%
13.3%
18.8%
18.8%
Table 111
Safety Statements – Washington Treatment Neighborhood (Marion Co.) - % True
Safety (% True)
Washington
Time-point
I have a first-aid kit at home
I have received first-aid training
I have received CPR training
I know how to do CPR on infants and young children
I have the poison control center telephone number in my cell phone or by a
phone at home
I have other emergency numbers in my cell phone or by a phone at home
I have had to call poison control, 911 or another emergency number in the
past 12 months
119
Intake
(n=27)
One Year
(n=27)
51.9%
48.1%
59.3%
55.6%
44.4%
70.4%
51.9%
51.9%
48.1%
51.9%
70.4%
92.6%
18.5%
7.4%
Table 112
Safety Statements – Swegle Treatment Neighborhood (Marion Co.) - % True
Safety (% True)
Swegle
Intake
(n=28)
One Year
(n=28)
I have a first-aid kit at home
I have received first-aid training
I have received CPR training
I know how to do CPR on infants and young children
I have the poison control center telephone number in my cell phone or by a
phone at home
50.0%
32.1%
32.1%
17.9%
35.7%
57.1%
32.1%
35.7%
39.3%
50.0%
I have other emergency numbers in my cell phone or by a phone at home
57.1%
71.4%
I have had to call poison control, 911 or another emergency number in the
past 12 months
14.3%
21.4%
Time-point
Table 113
Safety Statements – Hallman Comparison Neighborhood (Marion Co.) - % True
Safety (% True)
Hallman
Time-point
I have a first-aid kit at home
I have received first-aid training
I have received CPR training
I know how to do CPR on infants and young children
I have the poison control center telephone number in my cell phone or by a
phone at home
I have other emergency numbers in my cell phone or by a phone at home
I have had to call poison control, 911 or another emergency number in the
past 12 months
Intake
(n=29)
One Year
(n=29)
37.9%
44.8%
48.3%
37.9%
27.6%
58.6%
44.8%
37.9%
48.3%
58.6%
58.6%
13.8%
69.0%
3.4%
Table 114
Safety Statements – Hoover Comparison Neighborhood (Marion Co.) - % True
Safety (% True)
Hoover
Time-point
I have a first-aid kit at home
I have received first-aid training
I have received CPR training
I know how to do CPR on infants and young children
I have the poison control center telephone number in my cell phone or by a
phone at home
120
Intake
(n=20)
One Year
(n=20)
20.0%
25.0%
30.0%
25.0%
30.0%
60.0%
35.0%
35.0%
40.0%
60.0%
I have other emergency numbers in my cell phone or by a phone at home
I have had to call poison control, 911 or another emergency number in the
past 12 months
50.0%
65.0%
5.0%
5.0%
Table 115
Safety Statements – Sue Buel Treatment Neighborhood (Yamhill Co.) - % True
Safety (% True)
Sue Buel
Time-point
I have a first-aid kit at home
I have received first-aid training
I have received CPR training
I know how to do CPR on infants and young children
I have the poison control center telephone number in my cell phone or by a
phone at home
I have other emergency numbers in my cell phone or by a phone at home
I have had to call poison control, 911 or another emergency number in the
past 12 months
Intake
(n=15)
One Year
(n=15)
46.7%
46.7%
40.0%
40.0%
20.0%
66.7%
46.7%
40.0%
46.7%
66.7%
73.3%
20.0%
73.3%
13.3%
Table 116
Safety Statements – Edwards Comparison Neighborhood (Yamhill Co.) - % True
Safety (% True)
Edwards
Time-point
I have a first-aid kit at home
I have received first-aid training
I have received CPR training
I know how to do CPR on infants and young children
I have the poison control center telephone number in my cell phone or by a
phone at home
I have other emergency numbers in my cell phone or by a phone at home
I have had to call poison control, 911 or another emergency number in the
past 12 months
121
Intake
(n=16)
One Year
(n=16)
50.0%
50.0%
50.0%
43.8%
50.0%
75.0%
56.3%
43.8%
50.0%
62.5%
81.3%
18.8%
87.5%
18.8%
Table 117
Child Safety Statements – Overall – Mean Response (1=All of the time; 2=Most of the time;
3=Some of the time; 4=None of the time)
Child Safety (Mean Response)
Overall
Study Group
Treatment
Intake
One Year
(n=68-70)
(n=70)
Time-point
Comparison
Intake One Year
(n=65)
(n=65)
I use a safety seat or seat belt for my child when
riding in the car
1.04
1.01
1.00
1.02
I keep medicines in childproof bottles
I keep medicines out of children's reach
1.14
1.11
1.11
1.04
1.23
1.06
1.08
1.08
I have at least one working smoke detector in my
house
1.29
1.04
1.12
1.00
I regularly change the battery in my smoke detector
I keep cleaning materials out of reach of my child
I keep cleaning materials in locked cabinets
1.56
1.41
1.48
1.23
1.29
2.37
1.16
1.93
1.20
1.77
1.11
1.63
I keep matches and cigarette lighters out of my
child's reach
1.09
1.13
1.02
1.08
I supervise my child when he or she is in the bathtub
1.09
1.04
1.02
1.00
122
Caregivers also reported on their rates of employing various child safety practices on a
4-point Likert scale ranging from 1, or “all of the time”, to 4, or “none of the time”. Mean
responses are displayed in the tables below. For all the safety practices addressed in this
portion of the survey, respondents in the treatment and comparison neighborhoods indicated
employing the behaviors “all of the time”, on average. The only exception was with regard to
keeping cleaning materials in locked cabinets. Both groups were most apt to indicate doing so
“most of the time” 8.
Table 118
Child Safety Statements – Marion County - Mean Response (1=All of the time; 2=Most of the
time; 3=Some of the time; 4=None of the time)
Child Safety (Mean Response)
Marion County
Study Group
Treatment
Comparison
Intake
(n=53-55)
One Year
(n=55)
Intake
(n=49)
One Year
(n=49)
I use a safety seat or seat belt for my child when
riding in the car
1.06
1.02
1.00
1.02
I keep medicines in childproof bottles
I keep medicines out of children's reach
1.16
1.07
1.31
1.13
1.05
1.04
1.29
1.06
1.10
1.10
1.08
1.00
1.60
1.27
1.44
1.09
1.49
1.20
1.20
1.12
I keep cleaning materials in locked cabinets
I keep matches and cigarette lighters out of my
child's reach
2.44
1.06
1.84
1.11
1.94
1.02
1.80
1.06
I supervise my child when he or she is in the bathtub
1.11
1.00
1.02
1.00
Time-point
I have at least one working smoke detector in my
house
I regularly change the battery in my smoke detector
I keep cleaning materials out of reach of my child
Table 119
Child Safety Statements – Yamhill County - Mean Response (1=All of the time; 2=Most of the
time; 3=Some of the time; 4=None of the time)
Child Safety (Mean Response)
Yamhill County
Study Group
Treatment
Intake
One Year
(n=15)
(n=15)
Time-point
8
Comparison
Intake One Year
(n=16)
(n=16)
I use a safety seat or seat belt for my child when
riding in the car
1.00
1.00
1.00
1.00
I keep medicines in childproof bottles
I keep medicines out of children's reach
1.07
1.27
1.07
1.00
1.06
1.06
1.00
1.06
Child safety items were analyzed with ANCOVA. None of the items generated statistically significant results.
123
I have at least one working smoke detector in my
house
I regularly change the battery in my smoke detector
I keep cleaning materials out of reach of my child
I keep cleaning materials in locked cabinets
I keep matches and cigarette lighters out of my
child's reach
I supervise my child when he or she is in the bathtub
1.20
1.07
1.19
1.00
1.40
1.33
1.93
1.20
1.33
1.40
2.27
1.27
1.44
1.19
1.44
1.00
1.31
1.06
1.13
1.06
1.00
1.20
1.00
1.00
Table 120
Child Safety Statements – Washington Treatment Neighborhood (Marion Co.) - Mean Response
(1=All of the time; 2=Most of the time; 3=Some of the time; 4=None of the time)
Child Safety (Mean Response)
Washington
Time-point
I use a safety seat or seat belt for my child when riding in the car
I keep medicines in childproof bottles
I keep medicines out of children's reach
I have at least one working smoke detector in my house
I regularly change the battery in my smoke detector
I keep cleaning materials out of reach of my child
I keep cleaning materials in locked cabinets
I keep matches and cigarette lighters out of my child's reach
I supervise my child when he or she is in the bathtub
Intake
(n=26-27)
One Year
(n=27)
1.00
1.04
1.04
1.00
1.26
1.30
1.89
1.04
1.04
1.00
1.04
1.00
1.22
1.04
1.44
1.19
1.04
1.00
Table 121
Child Safety Statements – Swegle Treatment Neighborhood (Marion Co.) - Mean Response
(1=All of the time; 2=Most of the time; 3=Some of the time; 4=None of the time)
Child Safety (Mean Response)
Swegle
Intake
(n=27-28)
1.11
One Year
(n=28)
1.00
I keep medicines in childproof bottles
I keep medicines out of children's reach
I have at least one working smoke detector in my house
I regularly change the battery in my smoke detector
I keep cleaning materials out of reach of my child
I keep cleaning materials in locked cabinets
I keep matches and cigarette lighters out of my child's reach
1.29
1.11
1.61
1.93
1.25
2.96
1.07
1.25
1.07
1.07
1.64
1.14
2.21
1.04
I supervise my child when he or she is in the bathtub
1.19
1.00
Time-point
I use a safety seat or seat belt for my child when riding in the car
124
Table 122
Child Safety Statements – Hallman Comparison Neighborhood (Marion Co.) - Mean Response
(1=All of the time; 2=Most of the time; 3=Some of the time; 4=None of the time)
Child Safety (Mean Response)
Hallman
Intake
(n=29)
One Year
(n=29)
I use a safety seat or seat belt for my child when riding in the car
1.00
1.00
I keep medicines in childproof bottles
I keep medicines out of children's reach
1.10
1.07
1.17
1.10
1.14
1.00
1.45
1.14
1.14
1.14
1.72
1.00
1.62
1.10
1.00
1.00
Time-point
I have at least one working smoke detector in my house
I regularly change the battery in my smoke detector
I keep cleaning materials out of reach of my child
I keep cleaning materials in locked cabinets
I keep matches and cigarette lighters out of my child's reach
I supervise my child when he or she is in the bathtub
Table 123
Child Safety Statements – Hoover Comparison Neighborhood (Marion Co.) - Mean Response
(1=All of the time; 2=Most of the time; 3=Some of the time; 4=None of the time)
Child Safety (Mean Response)
Hoover
Time-point
I use a safety seat or seat belt for my child when riding in the car
I keep medicines in childproof bottles
I keep medicines out of children's reach
I have at least one working smoke detector in my house
I regularly change the battery in my smoke detector.
I keep cleaning materials out of reach of my child
I keep cleaning materials in locked cabinets
I keep matches and cigarette lighters out of my child's reach
I supervise my child when he or she is in the bathtub
125
Intake
(n=20)
One Year
(n=20)
1.00
1.55
1.05
1.00
1.55
1.30
2.25
1.05
1.05
1.05
1.10
1.00
1.00
1.30
1.10
2.05
1.00
1.00
Table 124
Child Safety Statements – Sue Buel Treatment Neighborhood (Yamhill Co.) - Mean Response
(1=All of the time; 2=Most of the time; 3=Some of the time; 4=None of the time)
Child Safety (Mean Response)
Sue Buel
Intake
(n=15)
One Year
(n=15)
I use a safety seat or seat belt for my child when riding in the car
1.00
1.00
I keep medicines in childproof bottles
I keep medicines out of children's reach
I have at least one working smoke detector in my house
I regularly change the battery in my smoke detector.
I keep cleaning materials out of reach of my child
I keep cleaning materials in locked cabinets
I keep matches and cigarette lighters out of my child's reach
I supervise my child when he or she is in the bathtub
1.07
1.27
1.20
1.40
1.33
1.93
1.20
1.00
1.07
1.00
1.07
1.33
1.40
2.27
1.27
1.20
Time-point
Table 125
Child Safety Statements – Edwards Comparison Neighborhood (Yamhill Co.) - Mean Response
(1=All of the time; 2=Most of the time; 3=Some of the time; 4=None of the time)
Child Safety (Mean Response)
Edwards
Intake
(n=16)
One Year
(n=16)
1.00
1.00
I regularly change the battery in my smoke detector.
1.06
1.06
1.19
1.44
1.00
1.06
1.00
1.31
I keep cleaning materials out of reach of my child
I keep cleaning materials in locked cabinets
I keep matches and cigarette lighters out of my child's reach
I supervise my child when he or she is in the bathtub
1.19
1.44
1.00
1.00
1.06
1.13
1.06
1.00
Time-point
I use a safety seat or seat belt for my child when riding in the car
I keep medicines in childproof bottles
I keep medicines out of children's reach
I have at least one working smoke detector in my house
126
Background Information Form, Item 17 – Neighborhood Statements
Caregivers responded to a number of statements about their neighborhoods. Tables 126 –
132 present results, both overall and by neighborhood. Overall, respondents were most apt to
agree that they would like to remain a resident of their neighborhood, would be willing to work
with people in their neighborhood to improve the neighborhood, that they like living in their
neighborhood, as well as that they feel safe in their neighborhood. Overall, treatment
caregivers demonstrated the greatest increase in agreement with the item ‘I invite my
neighbors to my home to visit’ between intake and the one year time-point. Comparison
caregivers demonstrated the greatest increase in agreement with the item ‘there is a strong
feeling of friendship between me and other people in my neighborhood.’
Table 126
Neighborhood Statements – Overall - % Yes
Please answer "yes" or "no" to the statements
about your neighborhood. (% Yes)
Treatment
Comparison
Intake
(n=70)
One Year
(n=70)
Intake
(n=65)
One Year
(n=62-63)
If I can, I will remain a resident of my
neighborhood for a long time.
81.4%
80.0%
89.2%
82.5%
There is a strong feeling of friendship between me
and other people in my neighborhood.
52.9%
52.9%
50.8%
61.9%
75.7%
75.7%
73.8%
77.8%
71.4%
78.6%
81.5%
81.0%
If I needed advice about something personal, I
could go to someone in my neighborhood.
37.1%
40.0%
38.5%
47.6%
I would be willing to work with the people in my
neighborhood to improve my neighborhood.
94.3%
92.9%
92.3%
92.1%
I think I agree with most people in my
neighborhood about what is important in life.
62.3%
48.6%
64.6%
68.3%
Time-point
I feel loyal to people in my neighborhood.
I believe people in my neighborhood would help
me in an emergency.
I am similar to the people who live in my
neighborhood.
I feel like I belong in my neighborhood.
If I had the chance, I would like to move out of my
neighborhood.
46.4%
28.6%
33.8%
39.7%
84.1%
80.0%
69.2%
72.6%
38.6%
41.4%
53.8%
58.7%
Overall, I like living in my neighborhood.
I visit with my neighbors in their home.
I invite my neighbors to my home to visit.
I feel safe in my neighborhood.
94.3%
37.1%
42.9%
80.0%
90.0%
35.7%
51.4%
84.3%
87.3%
41.5%
47.7%
91.9%
82.5%
46.0%
57.1%
93.7%
127
Table 127
Neighborhood Statements – Washington Treatment Neighborhood (Marion Co.)
Please answer "yes" or "no" to the statements about your
neighborhood. (% Yes)
Washington
Intake
(n=27)
One Year
(n=27)
If I can, I will remain a resident of my neighborhood for a long time.
85.2%
88.9%
There is a strong feeling of friendship between me and other people in
my neighborhood.
48.1%
55.6%
74.1%
63.0%
74.1%
81.5%
If I needed advice about something personal, I could go to someone in
my neighborhood.
44.4%
44.4%
I would be willing to work with the people in my neighborhood to
improve my neighborhood.
92.6%
96.3%
I think I agree with most people in my neighborhood about what is
important in life.
59.3%
63.0%
I am similar to the people who live in my neighborhood.
I feel like I belong in my neighborhood.
If I had the chance, I would like to move out of my neighborhood.
Overall, I like living in my neighborhood.
I visit with my neighbors in their home.
I invite my neighbors to my home to visit.
I feel safe in my neighborhood.
48.1%
88.9%
44.4%
100.0%
40.7%
48.1%
88.9%
37.0%
85.2%
29.6%
92.6%
22.2%
37.0%
88.9%
Time-point
I feel loyal to people in my neighborhood.
I believe people in my neighborhood would help me in an emergency.
128
Table 128
Neighborhood Statements – Swegle Treatment Neighborhood (Marion Co.)
Please answer "yes" or "no" to the statements about your
neighborhood. (% Yes)
Swegle
Intake
(n=27-28)
85.7%
One Year
(n=28)
75.0%
50.0%
60.7%
71.4%
64.3%
78.6%
60.7%
21.4%
39.3%
I would be willing to work with the people in my neighborhood to
improve my neighborhood.
96.4%
100.0%
I think I agree with most people in my neighborhood about what is
important in life.
55.6%
50.0%
I am similar to the people who live in my neighborhood.
I feel like I belong in my neighborhood.
If I had the chance, I would like to move out of my neighborhood.
Overall, I like living in my neighborhood.
I visit with my neighbors in their home.
I invite my neighbors to my home to visit.
I feel safe in my neighborhood.
48.1%
85.2%
28.6%
96.4%
35.7%
35.7%
82.1%
42.9%
75.0%
39.3%
78.6%
32.1%
32.1%
89.3%
Time-point
If I can, I will remain a resident of my neighborhood for a long time.
There is a strong feeling of friendship between me and other people in
my neighborhood.
I feel loyal to people in my neighborhood.
I believe people in my neighborhood would help me in an emergency.
If I needed advice about something personal, I could go to someone in
my neighborhood.
129
Table 129
Neighborhood Statements – Hallman Comparison Neighborhood (Marion Co.)
Please answer "yes" or "no" to the statements about your
neighborhood. (% Yes)
Hallman
Intake
(n=27-29)
One Year
(n=29)
If I can, I will remain a resident of my neighborhood for a long time.
100.0%
82.8%
There is a strong feeling of friendship between me and other people in
my neighborhood.
51.7%
58.6%
75.9%
82.8%
75.9%
79.3%
51.7%
41.4%
I would be willing to work with the people in my neighborhood to
improve my neighborhood.
89.7%
96.6%
I think I agree with most people in my neighborhood about what is
important in life.
72.4%
62.1%
I am similar to the people who live in my neighborhood.
I feel like I belong in my neighborhood.
If I had the chance, I would like to move out of my neighborhood.
Overall, I like living in my neighborhood.
I visit with my neighbors in their home.
I invite my neighbors to my home to visit.
I feel safe in my neighborhood.
44.8%
79.3%
44.8%
92.6%
41.4%
41.4%
88.9%
34.5%
75.9%
58.6%
79.3%
44.8%
55.2%
82.8%
Time-point
I feel loyal to people in my neighborhood.
I believe people in my neighborhood would help me in an emergency.
If I needed advice about something personal, I could go to someone in
my neighborhood.
Table 130
130
Neighborhood Statements – Hoover Comparison Neighborhood (Marion Co.)
Please answer "yes" or "no" to the statements about your
neighborhood. (% Yes)
Hoover
Intake
(n=19-20)
One Year
(n=20)
If I can, I will remain a resident of my neighborhood for a long time.
There is a strong feeling of friendship between me and other people in
my neighborhood.
80.0%
90.0%
45.0%
65.0%
I feel loyal to people in my neighborhood.
I believe people in my neighborhood would help me in an emergency.
70.0%
90.0%
70.0%
85.0%
If I needed advice about something personal, I could go to someone in
my neighborhood.
25.0%
55.0%
I would be willing to work with the people in my neighborhood to
improve my neighborhood.
95.0%
95.0%
I think I agree with most people in my neighborhood about what is
important in life.
70.0%
75.0%
I am similar to the people who live in my neighborhood.
15.0%
45.0%
I feel like I belong in my neighborhood.
If I had the chance, I would like to move out of my neighborhood.
Overall, I like living in my neighborhood.
I visit with my neighbors in their home.
I invite my neighbors to my home to visit.
I feel safe in my neighborhood.
55.0%
65.0%
80.0%
45.0%
50.0%
94.7%
75.0%
55.0%
85.0%
55.0%
60.0%
85.0%
Time-point
131
Table 131
Neighborhood Statements – Sue Buel Treatment Neighborhood (Yamhill Co.)
Please answer "yes" or "no" to the statements about your
neighborhood. (% Yes)
Sue Buel
Intake
(n=15)
66.7%
One Year
(n=15)
73.3%
66.7%
53.3%
86.7%
66.7%
80.0%
86.7%
If I needed advice about something personal, I could go to someone in
my neighborhood.
53.3%
33.3%
I would be willing to work with the people in my neighborhood to
improve my neighborhood.
93.3%
93.3%
I think I agree with most people in my neighborhood about what is
important in life.
80.0%
60.0%
I am similar to the people who live in my neighborhood.
I feel like I belong in my neighborhood.
If I had the chance, I would like to move out of my neighborhood.
40.0%
73.3%
26.7%
73.3%
46.7%
53.3%
Overall, I like living in my neighborhood.
I visit with my neighbors in their home.
I invite my neighbors to my home to visit.
I feel safe in my neighborhood.
80.0%
33.3%
46.7%
60.0%
93.3%
26.7%
53.3%
93.3%
Time-point
If I can, I will remain a resident of my neighborhood for a long time.
There is a strong feeling of friendship between me and other people in
my neighborhood.
I feel loyal to people in my neighborhood.
I believe people in my neighborhood would help me in an emergency.
132
Table 132
Neighborhood Statements – Edwards Comparison Neighborhood (Yamhill Co.)
Please answer "yes" or "no" to the statements about your
neighborhood. (% Yes)
Edwards
Intake
(n=16)
One Year
(n=16)
If I can, I will remain a resident of my neighborhood for a long time.
81.3%
75.0%
There is a strong feeling of friendship between me and other people in
my neighborhood.
56.3%
75.0%
75.0%
93.8%
81.3%
93.8%
31.3%
56.3%
I would be willing to work with the people in my neighborhood to
improve my neighborhood.
93.8%
100.0%
I think I agree with most people in my neighborhood about what is
important in life.
43.8%
81.3%
I am similar to the people who live in my neighborhood.
I feel like I belong in my neighborhood.
If I had the chance, I would like to move out of my neighborhood.
Overall, I like living in my neighborhood.
I visit with my neighbors in their home.
I invite my neighbors to my home to visit.
I feel safe in my neighborhood.
37.5%
68.8%
56.3%
87.5%
37.5%
56.3%
93.8%
56.3%
93.8%
56.3%
93.8%
56.3%
62.5%
81.3%
Time-point
I feel loyal to people in my neighborhood.
I believe people in my neighborhood would help me in an emergency.
If I needed advice about something personal, I could go to someone in
my neighborhood.
Background Information Form, Items 15a,b,c - Financial Problems
The survey queried numerous types of financial problems. As shown in Table 135,
respondents reported a variety of financial hardships including inadequate funds for
rent/mortgage payments, utility payments, or to buy food. Results are presented by county and
neighborhood for both the intake and one year time-points. Among the treatment
neighborhoods, residents of the Washington neighborhood demonstrated the biggest
improvement from intake to one year, with fewer participants indicating that they experienced
eleven out of the twelve financial hardships at the one year time-point.
133
Table 133
Financial Problems in the Past 12 Months - % Yes – Overall
Financial Problems: In the past 12 months, was there
ever a time when... (% Yes)
Study Group
Time-point
You did not pay the full amount of the rent or mortgage
because you didn't have enough money?
You were evicted from your home or apartment for not
paying the rent or mortgage?
You missed a payment or were late with the gas,
electricity, or water bill because you didn't have enough
money?
Overall
Tx. (n=68-70)
Intake
1 Year
Comp. (n=64-65)
Intake
1 Year
30.0%
30.0%
30.8%
17.2%
4.3%
1.4%
0.0%
1.6%
62.9%
60.0%
72.3%
54.7%
Note. Tx = Treatment; Comp. = Comparison
Table 134
Financial Problems in the Past 12 Months - % Yes – Marion County
Financial Problems: In the past 12 months,
was there ever a time when... (% Yes)
Study Group
Time-point
You did not pay the full amount of the rent
or mortgage because you didn't have
enough money?
You were evicted from your home or
apartment for not paying the rent or
mortgage?
You missed a payment or were late with
the gas, electricity, or water bill because
you didn't have enough money?
Marion County
Treatment
Intake
One Year
(n=54-55)
(n=53-55)
Comparison
Intake
One Year
(n=48-49)
(n=48-49)
30.9%
27.3%
26.5%
16.7%
5.5%
1.8%
0.0%
2.1%
69.1%
63.6%
73.5%
60.4%
134
Table 135
Financial Problems in the Past 12 Months - % Yes – Yamhill County
Financial Problems: In the past 12 months,
was there ever a time when... (% Yes)
Study Group
Time-point
You did not pay the full amount of the rent
or mortgage because you didn't have
enough money?
You were evicted from your home or
apartment for not paying the rent or
mortgage?
You missed a payment or were late with
the gas, electricity, or water bill because
you didn't have enough money?
Yamhill County
Treatment
Intake
One Year
(n=15)
(n=16)
Comparison
Intake
One Year
(n=15-16)
(n=15)
26.7%
40.0%
43.8%
18.8%
0.0%
0.0%
0.0%
0.0%
40.0%
46.7%
68.8%
37.5%
Table 136
Financial Problems in the Past 12 Months - % Yes – Washington Treatment Neighborhood
(Marion Co.)
Financial Problems: In the past 12 months, was there ever a time
when... (% Yes)
Washington
Intake
(n=26-27)
One Year
(n=26-27)
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
25.9%
22.2%
You were evicted from your home or apartment for not paying the
rent or mortgage?
7.4%
0.0%
You missed a payment or were late with the gas, electricity, or water
bill because you didn't have enough money?
74.1%
63.0%
Time-point
Table 137
Financial Problems in the Past 12 Months - % Yes – Swegle Treatment Neighborhood (Marion
County)
Financial Problems: In the past 12 months, was there ever a time
when... (% Yes)
Swegle
Intake
(n=28)
One Year
(n=27-28)
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
35.7%
32.1%
You were evicted from your home or apartment for not paying the
rent or mortgage?
3.6%
3.6%
You missed a payment or were late with the gas, electricity, or water
bill because you didn't have enough money?
64.3%
64.3%
Time-point
135
Table 138
Financial Problems in the Past 12 Months - % Yes – Hallman Comparison Neighborhood (Marion
County)
Financial Problems: In the past 12 months, was there ever a time
when... (% Yes)
Hallman
Intake
(n=29)
One Year
(n=28)
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
27.6%
21.4%
You were evicted from your home or apartment for not paying the
rent or mortgage?
0.0%
0.0%
You missed a payment or were late with the gas, electricity, or water
bill because you didn't have enough money?
72.4%
57.1%
Time-point
Table 139
Financial Problems in the Past 12 Months - % Yes – Hoover Comparison Neighborhood (Marion
County)
Financial Problems: In the past 12 months, was there ever a time
when... (% Yes)
Hoover
Intake
(n=19-20)
One Year
(n=20)
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
25.0%
10.0%
You were evicted from your home or apartment for not paying the
rent or mortgage?
0.0%
5.0%
You missed a payment or were late with the gas, electricity, or water
bill because you didn't have enough money?
75.0%
65.0%
Time-point
Table 140
Financial Problems in the Past 12 Months - % Yes – Sue Buel Treatment Neighborhood (Yamhill
County
Financial Problems: In the past 12 months, was there ever a time
when... (% Yes)
Sue Buel
Intake
(n=15)
One Year
(n=15)
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
26.7%
40.0%
You were evicted from your home or apartment for not paying the
rent or mortgage?
0.0%
0.0%
You missed a payment or were late with the gas, electricity, or water
bill because you didn't have enough money?
40.0%
46.7%
Time-point
136
Table 141
Financial Problems in the Past 12 Months - % Yes – Edwards Comparison Neighborhood (Yamhill
County)
Financial Problems: In the past 12 months, was there ever a time
when... (% Yes)
Edwards
Intake
(n=15-16)
One Year
(n=16)
You did not pay the full amount of the rent or mortgage because you
didn't have enough money?
43.8%
18.8%
You were evicted from your home or apartment for not paying the
rent or mortgage?
0.0%
0.0%
You missed a payment or were late with the gas, electricity, or water
bill because you didn't have enough money?
68.8%
37.5%
Time-point
Background Information Form, Items 14 and 16 – Household Income and Aid Received
When asked to report an estimate of their household’s total income, the majority of
caregivers indicated an income of less than $30,000. Disparities between treatment and
comparison families were most notable in Yamhill County. One quarter of treatment families
reported incomes of $30,001-$40,000 whereas 80% of comparison neighborhood respondents
indicated household incomes of $20,000 or less (Table 142).
Table 142
Estimate of Household Income Overall and by County
Estimate of the total household
income for a year
Study Group
$0-$10,000
$10,001-$20,000
$20,001-$30,000
$30,001-$40,000
$40,001-$50,000
More than $50,000
Overall
Marion County
Yamhill County
Tx.
(n=61)
Comp.
(n=63)
Tx.
(n=49)
Comp.
(n=48)
Tx.
(n=12)
Comp.
(n=15)
13.1%
49.2%
26.2%
6.6%
3.3%
1.6%
28.6%
47.6%
15.9%
3.2%
4.8%
0.0%
14.3%
57.1%
22.4%
2.0%
4.1%
0.0%
29.2%
45.8%
20.8%
2.1%
2.1%
0.0%
8.3%
16.7%
41.7%
25.0%
0.0%
8.3%
26.7%
53.3%
0.0%
6.7%
13.3%
0.0%
Note. Tx. = Treatment; Comp. = Comparison
137
Table 143
Estimate of Household Income Overall and by County- Hispanic/Latino Participants
Estimate of the total household
income for a year
Study Group
$0-$10,000
$10,001-$20,000
$20,001-$30,000
$30,001-$40,000
$40,001-$50,000
More than $50,000
Overall
Marion County
Yamhill County
Tx.
(n=44)
Comp.
(n=53)
Tx.
(n=33)
Comp.
(n=43)
Tx.
(n=11)
Comp.
(n=10)
9.1%
47.7%
31.8%
6.8%
2.3%
2.3%
30.2%
49.1%
17.0%
1.9%
1.9%
0.0%
9.1%
57.6%
27.3%
3.0%
3.0%
0.0%
27.9%
46.5%
20.9%
2.3%
2.3%
0.0%
9.1%
18.2%
45.5%
18.2%
0.0%
9.1%
40.0%
60.0%
0.0%
0.0%
0.0%
0.0%
Note. Tx. = Treatment; Comp. = Comparison
Table 144
Estimate of Household Income by Neighborhood
Estimate of the total
household income
Marion County
for a year
Study Group
Tx.
Comp.
Washington Swegle Hallman Hoover
Neighborhood
(n=24)
(n= 25) (n=28)
(n=20)
$0-$10,000
20.8%
8.0%
39.3%
15.0%
$10,001-$20,000
45.8%
68.0%
32.1%
65.0%
$20,001-$30,000
29.2%
16.0%
21.4%
20.0%
$30,001-$40,000
0.0%
4.0%
3.6%
0.0%
$40,001-$50,000
4.2%
4.0%
3.6%
0.0%
More than $50,000
0.0%
0.0%
0.0%
0.0%
Yamhill County
Tx.
Sue Buel
(n=12)
8.3%
16.7%
41.7%
25.0%
0.0%
8.3%
Comp.
Edwards
(n=15)
26.7%
53.3%
0.0%
6.7%
13.3%
0.0%
Note. Tx. = Treatment; Comp. = Comparison
Almost all caregivers reported receiving some form of Federal or state aid. Food stamps
(SNAP), Women Infants Children (WIC) funds, Temporary Assistance for Needy Families (TANF),
Medicaid, and “other” sources of support were reported most often (Tables 145 and 146).
138
Table 145
Sources of Federal and State Aid Overall and by County
Select all of the aid or income you
currently receive
Overall
Marion County
Yamhill County
Tx.
(n=70)
Comp.
(n=65)
Tx.
(n=55)
Comp.
(n=49)
Tx.
(n=15)
Comp.
(n=16)
I do not receive any federal or state aid
1.4%
0.0%
1.8%
0.0%
0.0%
0.0%
Food stamps (SNAP)
WIC
TANF
SSI (Supplemental Security Income)
82.9%
90.0%
15.7%
1.4%
28.6%
4.3%
5.7%
2.9%
2.9%
40.0%
90.8%
98.5%
21.5%
1.5%
36.9%
3.1%
7.7%
7.7%
3.1%
46.2%
80.0%
89.1%
14.5%
1.8%
32.7%
5.5%
7.3%
3.6%
3.6%
29.1%
89.8%
100.0%
26.5%
2.0%
38.8%
2.0%
10.2%
10.2%
4.1%
49.0%
93.3%
93.3%
20.0%
0.0%
13.3%
0.0%
0.0%
0.0%
0.0%
80.0%
93.8%
93.8%
6.3%
0.0%
31.3%
6.3%
0.0%
0.0%
0.0%
37.5%
Study Group
Medicaid
Rental certificates or vouchers
HUD apartment/subsidized housing
Telephone assistance program
Unemployment compensation
Other
Note. Tx = Treatment; Comp. = Comparison
Table 146
Sources of Federal and State Aid by Neighborhood
Select all o.f the aid or income
you currently receive
Study Group
Neighborhood
I do not receive any federal or
state aid
Food stamps (SNAP)
WIC
TANF
SSI (Supplemental Security
Income)
Medicaid
Rental certificates or
vouchers
HUD apartment/ subsidized
housing
Telephone assistance
program
Unemployment
compensation
Marion County
Treatment
Yamhill County
Comparison
Tx.
Comp.
Washington
(n=27)
Swegle
(n=28)
Hallman
(n=29)
Hoover
(n=20)
Sue Buel
(n=15)
Edwards
(n=16)
0.0%
3.6%
0.0%
0.0%
0.0%
0.0%
81.5%
81.5%
11.1%
78.6%
96.4%
17.9%
86.2%
100.0%
20.7%
95.0%
100.0%
35.0%
93.3%
93.3%
20.0%
93.8%
93.8%
6.3%
0.0%
3.6%
0.0%
5.0%
0.0%
0.0%
22.2%
42.9%
37.9%
40.0%
13.3%
31.3%
3.7%
7.1%
0.0%
5.0%
0.0%
6.3%
11.1%
3.6%
13.8%
5.0%
0.0%
0.0%
7.4%
0.0%
13.8%
5.0%
0.0%
0.0%
3.7%
3.6%
6.9%
0.0%
0.0%
0.0%
139
Select all o.f the aid or income
you currently receive
Study Group
Other
Marion County
Treatment
37.0%
Yamhill County
Comparison
21.4%
55.2%
40.0%
Tx.
Comp.
80.0%
37.5%
Note. Tx. = Treatment; Comp. = Comparison
C. Decreased Likelihood of Child Maltreatment: Findings
Parenting Stress Index (PSI)
The PSI includes scales measuring perceived stress from the Parent Domain and the Child
Domain. These two scales are summed to calculate Total Stress. The PSI also includes a scale
designed to detect defensive (socially desirable) responding. A total of 17 participants were
eliminated from PSI analyses due to defensive responding, including 11 from the treatment
group and six from the comparison group. Results of ANCOVAs on each of these three scales
are presented below. Only the results for the Total Stress scale approach statistical
significance, and the effect size of .028 is not noteworthy.
• PSI Parent Domain: F(1, 115) = 2.72, p = .102
• PSI Child Domain: F(1, 117) = 2.16, p = .144
• PSI Total Stress: F(1, 115) = 3.30, p = .072; η2p = .028
To further explore the data, the same analyses were conducted for Marion County
neighborhoods only:
• PSI Parent Domain: F(1, 89) = 4.76, p = .032; η2p = .051
• PSI Child Domain: F(1, 90) = 4.52, p = .036; η2p = .048
• PSI Total Stress: F(1, 89) = 5.81, p = .018; η2p = .061
Results were also conducted for Hispanic participants only:
• PSI Parent Domain: F(1, 86) = 3.22, p = .076
• PSI Child Domain: F(1, 88) = 10.04, p = .002; η2p = .102
• PSI Total Stress: F(1, 86) = 7.48, p = .008; η2p = .080
Finally, ANCOVAs were conducted for Hispanic participants in Marion County:
• PSI Parent Domain: F(1, 66) = 5.33, p = .024; η2p = .075
• PSI Child Domain: F(1, 67) = 11.87, p = .001; η2p = .150
• PSI Total Stress: F(1, 66) = 9.55, p = .003; η2p = .126
The results of these subgroup analyses indicate that the Fostering Hope Initiative (FHI) may
have had a greater impact, at least in terms of reducing parenting stress, in Marion County. The
FHI also appears to have been more effective in reducing stress among Hispanic participants,
and particularly among Hispanic participants residing in the two Marion County neighborhoods.
For this latter analysis, sample sizes were quite small (n=31 in the treatment group and 39 in
the comparison group), but yielded somewhat noteworthy effect sizes in the Child Domain (η2p
= .150) and in Total Stress (η2p = .126).
140
Group mean scores at baseline and 12-months for all analyses described above are
presented in the table below. Reductions in scores over time represent reduced levels of
perceived stress.
Table 147
PSI Scale Means at Baseline and 12-months
Overall
PSI Parent Domain
Baseline
12-months
PSI Child Domain
Baseline
12-months
PSI Total Stress
Baseline
12-months
Marion County
Hispanic
Participants
Marion County
Hispanic
Participants
Tx.
Comp.
Tx.
Comp.
Tx.
Comp.
Tx.
Comp.
(n=58)
136.96
129.23
(n=59)
107.36
105.63
(n=58)
244.77
234.53
(n=60)
127.48
130.62
(n=61)
101.02
108.54
(n=60)
228.43
239.16
(n=47)
135.91
127.66
(n=47)
108.54
104.47
(n=47)
244.45
232.13
(n=45)
123.57
130.20
(n=46)
101.61
108.88
(n=45)
225.11
239.10
(n=41)
136.59
127.32
(n=42)
106.93
102.24
(n=41)
244.16
229.02
(n=48)
125.68
129.73
(n=49)
102.88
110.73
(n=48)
228.51
240.52
(n=31)
135.02
125.26
(n=31)
107.82
100.67
(n=31)
242.84
225.93
(n=38)
124.64
130.34
(n=39)
103.54
110.07
(n=38)
228.14
240.46
Note. Tx. = Treatment; Comp. = Comparison
PSI subscale analyses were also conducted. Results are summarized below, beneath
subscale descriptions duplicated from the Parenting Stress Index Third Edition Professional
Manual.
Life Stress Subscale on the PSI
Parents who earn high life stress scores find themselves in stressful situational
circumstances that are often beyond their control (e.g., the death of a relative, loss of a job).
The Life Stress scale provides some index of the amount of stress outside the parent-child
relationship that the parent is currently experiencing (Parenting Stress Index Third Edition
Professional Manual, p. 12). Analysis of covariance (ANCOVA) comparing results for all
treatment and comparison participants did not generate a statistically significant result
(p=.735).
•
PSI Life Stress Subscale: F(1,121) = .115, p = .735
To further explore the data, the same analyses were conducted for Marion County
neighborhoods only:
• PSI Life Stress Subscale: F(1,94)=.297, p=.587
Results were also conducted for Hispanic participants only:
141
•
PSI Life Stress Subscale: F(1, 90)=.000, p=.993
Finally, ANCOVAs were conducted for Hispanic participants in Marion County:
• PSI Life Stress Subscale: F(1,69)=.035, p=.852
Similarly, the subgroup analyses did not generate statistically significant results.
Depression Subscale on the PSI
High scores on this subscale are suggestive of the presence of significant depression in the
parent. The general impact of high scores on this subscale is that the parent finds it difficult to
mobilize the psychic and physical energy needed to fulfill parenting responsibilities (Parenting
Stress Index Third Edition Professional Manual, p.11). Analysis of covariance (ANCOVA)
comparing results for all treatment and comparison participants did not generate a statistically
significant result (p=.709).
•
PSI Depression Subscale: F(1,116)=.140, p=.709
To further explore the data, the same analyses were conducted for Marion County
neighborhoods only:
• PSI Depression Subscale: F(1,89)=1.304, p=.257
Results were also conducted for Hispanic participants only:
• PSI Depression Subscale: F(1,87)=.107, p=.744
Finally, ANCOVAs were conducted for Hispanic participants in Marion County:
• PSI Depression Subscale: F(1,66)=1.36, p=.248
Similarly, the subgroup analyses did not generate statistically significant results.
Isolation Subscale on the PSI
Parents who earn high scores in this area are under considerable stress, and it is necessary
to establish an intervention program as soon as possible. These parents are often socially
isolated from their peers, relatives, and other emotional support systems. In many instances,
their relationships with their spouses are distant and lacking in support for their efforts as
parents (Parenting Stress Index Third Edition Professional Manual, p.10). Analysis of covariance
(ANCOVA) comparing results for all treatment and comparison participants did not generate
statistically significant results.
•
PSI Isolation Subscale: F(1,116)=.829, p=.364
To further explore the data, the same analyses were conducted for Marion County
neighborhoods only:
• PSI Isolation Subscale: F(1,89)=1.484, p=.226
Results were also conducted for Hispanic participants only:
142
•
PSI Isolation Subscale: F(1,87)=2.301, p=.133
Finally, ANCOVAs were conducted for Hispanic participants in Marion County:
• PSI Isolation Subscale: F(1, 66)=3.87, p=.054; η2p=.055
As shown above, when analyzed separately, Hispanic participants in Marion County
treatment neighborhoods approached a statistically significant improvement in isolation as
compared to treatment group participants (p=.054). The effect size estimate was not
noteworthy, however. Group mean scores at baseline and 12-months for the Life Stress,
Depression, and Isolation subscale analyses are presented in the table below. Reductions in
scores over time represent improvement.
Table 148
PSI Subscale Scale Means at Baseline and 12-months
Overall
PSI Life Stress
Baseline
12-months
PSI Depression
Baseline
12-months
PSI Isolation
Baseline
12-months
Marion County
Hispanic
Participants
Marion County
Hispanic
Participants
Tx.
Comp.
Tx.
Comp.
Tx.
Comp.
Tx.
Comp.
(n=62)
18.65
14.29
(n=59)
22.05
21.39
(n=59)
15.40
14.17
(n=62)
12.16
10.65
(n=60)
21.48
21.45
(n=60)
13.85
14.30
(n=50)
19.12
13.96
(n=47)
21.47
20.66
(n=47)
15.63
14.17
(n=47)
11.19
9.98
(n=45)
20.38
21.31
(n=45)
13.07
14.27
(n=43)
18.79
14.30
(n=42)
22.14
21.29
(n=42)
15.38
13.67
(n=50)
11.72
10.34
(n=48)
21.44
21.27
(n=48)
13.44
14.10
(n=32)
19.22
13.59
(n=31)
21.42
20.42
(n=31)
15.81
13.61
(n=40)
10.75
9.40
(n=38)
20.95
21.37
(n=38)
13.11
14.16
Note. Tx. = Treatment; Comp. = Comparison
Caregivers’ Assessment of Protective Factors (CAPF)
The CAPF was developed for QIC-EC grantees, and is intended to measure the Strengthening
Families Protective Factors. Midway through the QIC-EC grant period, psychometric testing of
the CAPF indicated that the scale intended to measure parent knowledge of child development
was inadequate. In addition, the psychometric analysis indicated that items intended to
measure parental resilience appeared to be measuring two separate constructs. Hence, the
final version of the measure contained five scales. Results of ANCOVAs conducted on each of
these scales are presented below.
• Nurturing Children’s Social and Emotional Competence: F(1, 132) = 2.20, p = .141; η2p =
.016
• Social Connections: F(1, 132) = 0.46, p = .497
• Concrete Support in Times of Need: F(1, 132) = 0.90, p = .345
143
•
•
Parental Resilience 1: F(1, 132) = 0.00, p = .988
Parental Resilience 2: F(1, 132) = 0.29, p = .590
Analyses did not reveal any noteworthy differences between treatment and comparison
group participants. Similarly, ANCOVAs conducted on subgroups of interest (Marion County
only, Hispanic participants, Marion County Hispanic participants) yielded no results approaching
statistical significance. The descriptive data presented in the table below includes scale totals
as well as item means for ease of comparison across the protective factor subscales. Higher
scores indicate greater levels of the protective factors.
Table 149
CAPF Scale and Item Means at Baseline and 12-months
Overall Scale
Scores
CAPF Nurturing Children’s Social and Emotional
Competence (Max = 65)
Baseline
12-months
CAPF Social Connections (Max = 30)
Baseline
12-months
CAPF Concrete Support in Times of Need (Max = 15)
Baseline
12-months
CAPF Resilience 1 (Max = 30)
Baseline
12-months
CAPF Resilience 2 (Max = 30)
Baseline
12-months
Item Means
(Scale of 1-5)
Tx.
(n=69)
Comp.
(n=66)
Tx.
(n=69)
Comp.
(n=66)
62.24
61.74
63.15
62.98
4.79
4.75
4.86
4.84
26.93
28.07
25.67
27.33
4.49
4.68
4.28
4.56
9.80
11.49
9.83
11.15
3.27
3.83
3.28
3.72
25.45
25.77
26.76
26.29
4.24
4.29
4.46
4.38
26.83
26.96
26.86
27.27
4.47
4.49
4.48
4.55
Note. Tx. = Treatment; Comp. = Comparison
The data presented in the table above suggests that the CAPF may suffer from a ceiling
effect, with treatment and comparison group participants reporting very high levels of the
protective factors even at baseline on all but one scale. Only the scale measuring Concrete
Support in Times of Need had baseline item means less than 4.0. Both treatment and
comparison group participants reported improvement on this scale from baseline to the 12month time point, but the other four scales left little room for improvement after baseline.
Due to the ceiling effect, it is difficult if not impossible to reach any conclusions regarding how
the protective factors may have changed during the study period for either treatment or
comparison group participants.
144
2. Changes in Child Maltreatment Administrative Data over the Course of the
Project in the Communities of Focus
As stated in previous sections, administrative data from DHS assessing child maltreatment
rates in the study neighborhoods will not become available until 2014. FHI was not able to
establish agreements with local hospitals to obtain emergency room visit data. Further,
hospitals do not collect data at the neighborhood level, making it unlikely that results would be
meaningful as relates to the current project.
The Department was able to confirm that none of the study participants in any of the
treatment or comparison neighborhoods had been the subject of a substantiated case of child
maltreatment during the study period.
D. Additional Local Outcomes: Findings
The local evaluation measures of child wellbeing were chosen because they were a part of
the Healthy Start~Healthy Families service delivery model. The Ages and Stages Questionnaire
Third Edition (ASQ-3) and ASQ Social-Emotional (ASQ SE) are highly reliable and valid screening
tools primarily used to identify children in need of additional support.
When assessed with the ASQ-3, a child is identified as being in one of three zones: 1) above
the cutoff, indicating that the child’s development appears to be on schedule; 2) close to the
cutoff, indicating that the child should receive learning activities and continued monitoring;
and, 3) below the cutoff, in which case further assessment with a professional is recommended.
None of the study participants were identified as below the cutoff at intake or one year. As
such, Table 150 below presents the percentage of children in each study group who scored in
the second zone, which indicated that additional supports were needed.
Table 150
ASQ-3: Percentage Close to the Cutoff – Learning Activities
and Continued Monitoring Recommended
As shown, concerns about
Time-point
Intake One Year Intake One Year communication increased among
both treatment and comparison
(n=67)
(n=49)
(n=65)
(n=59)
participants, a finding that one
Communication
7.5%
24.5%
16.9%
28.8%
would expect given that the
Gross Motor
13.4%
8.2%
24.6%
3.4%
children aged over the course of
Fine Motor
10.4%
2.0%
16.9%
16.9%
the study period and language
Problem Solving
10.4%
8.2%
7.7%
19.0%
development would become an
Personal-Social
11.9%
8.2%
6.2%
10.3%
increasing concern as they
developed their verbal abilities. Among treatment group participants, the proportion in the
second zone decreased from intake to one year for the gross motor, fine motor, problem
Study Group
Tx.
Comp.
145
solving, and personal-social subscales. In the comparison group, the proportion of children in
this zone increased for three of the subscales: communication, problem solving, and personalsocial.
Table 151
ASQ SE: Number of Children above the Cutoff – Referral
Recommended
The ASQ SE is used to identify
Time-point
Intake
One Year Intake
One Year children that should receive a
mental health evaluation. If a
Communication
n=2
n=4
n=3
n=4
child’s score on the instrument is
above the cutoff, he/she should be referred unless contextual factors such as a stressful event
taking place on the day of the assessment, developmental delay, or illness, for example, can
explain the child’s behavior. Table 151 summarizes the number of children in each study group
whose score indicated that further assessment may be necessary. The results are not
noteworthy.
Study Group
Treatment
Comparison
E. Relationship among Outcomes: Findings
With the exception of the Expectations of Children subscale on the APPI, the PSI was the
only measure that generated statistically significant results. As such, analyses to examine the
relationships among the three outcomes were not conducted.
F. Community and Societal Domain Outcomes: Findings
Administrative data from DHS was expected to address the community level of the social
ecology. The data will be analyzed in 2014 when data files are provided by DHS. Policy-level
work is addressed in other sections of this report.
 Interpretation of Findings
A meeting was held with key project leadership members to discuss the results of the
outcome measures and interpret the meaning of the findings. The discussion focused on the
most notable differences generated by the analyses. Specifically, the group discussed the
meaning of differences between the two counties (Marion and Yamhill), as well as why Latino
participants tended to generate lower p-values and larger effect sizes when examined
separately. A summary of staff members’ reflections is provided below.
Meaning of County Differences – PSI Results were better in Marion County
• As the backbone organization for the Collective Impact Initiative, CCS has operated in
Marion County since the 1930’s and has strong and longstanding connections with many
individuals and organizations there. CCS has worked to develop similar relationships in
Yamhill County, but has been present in that location for a significantly shorter period of
time. Approximately six months into the study period a collaboration survey was
146
•
administered among Implementation Team members representing both counties.
Yamhill County respondents reported notably lower satisfaction and involvement when
compared to Marion County. Ratings of collaborative functioning were also consistently
lower among Yamhill County partner members. While efforts were made to shift these
perceptions, CCS’ Executive Director reflected that the Initiative continued to be
perceived as a threat by established early childhood providers in Yamhill County who
viewed CCS and the Marion County partners as seeking to gain a foothold on limited
funding. Partner agency engagement in leadership and decision-making for the Initiative
was low among Yamhill County partners, and as a result, fewer support services were
available through interagency resource and referral mechanisms. Similarly, the
neighborhood engagement activities were not successful and Community Cafés and
dinners in Yamhill County were discontinued early on in the project period.
Staffing differences between the two counties also may have played a role in outcome
differences. The four visitors in Marion County were CCS employees, benefitting from a
peer culture and a high level of supervisory support. The Yamhill County visitor,
however, was a Yamhill County employee and regularly expressed feeling isolated and
under-resourced in her work. These factors, along with the county’s low level of
investment in the Initiative, may have limited the quality of services that families in that
county received. The visitor was ultimately hired on as a CCS employee where she
received a greater level of guidance and supervision, but this occurred well into the
study period.
Meaning of Differences between Latino and Anglo Participants – Results were better among
Hispanic/Latino Participants
• The FHI model is neighborhood-based, informal, and based on an empowerment model.
These design elements are particularly relevant to and were embraced by Latinos in the
target neighborhoods.
• The Initiative partnered with a local Latino outreach organization and service providers,
and members of these agencies participated in the Implementation Team and
associated PEP meetings. This resulted in increased reach in the Latino community.
Services were also provided by bilingual, bi-cultural staff.
• Because a greater proportion of participating families were Hispanic, there may have
been a (false) perception that the program was a Latino program for Latino participants.
These perceptions could explain the lower enrollment rates of Anglo families in home
visiting, in addition to influencing their receptiveness to using the variety of Initiative
services available in the neighborhoods (community dinners, Community Cafés, etc.).
• During the community dinners, Hispanic families tended to take up entire tables with
immediate and extended family members, choosing to mobilize everyone in the family
system to receive the benefit of the community meal. Non-Hispanic families tended to
be less receptive to increasing family connections and may have experienced more
stress because of the emphasis of the intervention on connecting family members to
each other.
147
•
•
Many Latinos in high poverty neighborhoods are undocumented, ineligible for many
social services, and therefore must rely on social networks to survive. Through word of
mouth they identify sources of support through local churches, food banks, or
organizations such as Mano a Mano that specialize in serving undocumented individuals
and families. Many Anglo families participating in the Initiative represented the second
or third generation living in poverty. These Anglo families, while typically living in social
isolation, tend to be fairly adept at working through the social service system to meet
their needs. These differences may have contributed to the higher level of participation
demonstrated by Latino participants, in addition to generating greater program effects.
Staffing differences were present when comparing Latino and non-Latino home visitors.
Latino visitors tended to employ the “friendship model” (Exchange Club), embracing
their role as neighborhood organizers and extending direct invitations to program
participants to engage in the various community events. Non-Latino visitors, however,
viewed themselves more narrowly as home visiting professionals, focusing on
implementing the HFA model with fidelity and allocating less time to the community
engagement activities.
 Implications of the Findings
The results of the outcome analysis indicate that the intervention produced a statistically
significant effect on parent stress. Caregivers from FHI neighborhoods demonstrated a greater
decrease in stress as demonstrated by the Parent, Child, and Total Stress Domains and the
Competence Subscale of the PSI when compared to caregivers who did not receive coordinated
services. Further, effects were stronger in Marion County and among Hispanic/Latino
participants.
According to the QIC-EC logic model, these findings are hypothesized to support an
increased likelihood of optimal child development and a decrease in the likelihood of child
maltreatment. As such, these results provide some evidence that replication or expansion of
the Initiative is warranted under certain conditions. One condition under which replication
would be recommended is in the case of strong interagency collaboration or a commitment to
Collective Impact. This is supported by the results generated when data were disaggregated for
Marion County, the location where the partnership had a long history of collaboration and the
relationships were marked by trust and commitment to the mission, vision, and goals of the
Initiative.
A second condition appropriate for replication is that of communities or neighborhoods that
are primarily composed of Hispanic residents, or similarly, those that are primarily populated by
any minority group living in poverty. While integration is always a goal within the social service
sector, it may be appropriate to work specifically with minority residents as the Initiative is first
implemented, expanding to include other racial or ethnic groups as the intervention gains
traction in the community.
148
VI.
Sustainability/Integration
A. The Parts of the Project that have been Most Effective in Obtaining Support in
Moving toward Sustainability; Parts FHI Plans to Sustain and How They will be
Sustained; Agencies or Funders that have been Most Responsive to this Project
CCS has been able to obtain support for several aspects of FHI:
• Safe Families for Children (SFFC). CCS has recruited 12 faith communities to participate
in this volunteer respite program, in which carefully vetted and trained Host Families
open their homes to families in stress who could benefit from a break in child care
responsibilities. This program often helps families to get through a difficult time,
without needing the intervention of DHS and Child Welfare. CCS has been able to
obtain funding from several sources for the coordination, materials, and training for the
Host Families and other volunteers, including Catholic Charities of Oregon.
• Collective Impact. The Meyer Memorial Trust has funded a Collective Impact
Coordinator to expand and deepen relationships with partners, and to develop a health
care pilot project.
• Collaboration. The United Way of the Mid-Willamette Valley, for its second two-year
cycle, funded FHI to support collaboration across partners. This grant supports
subcontracts to FHI partners to support their participation in the Executive Council, data
systems and other aspects of FHI. Prior to United Way support, CCS was able to obtain
funding from a local donor to provide funds for collaborators.
• Neighborhood Mobilization. The Ford Family Foundation has provided support to
embed “Neighbor Connectors” within rural FHI neighborhoods in Dallas and
Independence (Polk County) and Woodburn (Marion County). A recent award from the
Kaiser Permanente Community Fund of the Northwest Health Foundation will allow
expanding the availability of Neighbor Connectors to all six Fostering Hope
neighborhoods.
FHI will be sustained after the end of the QIC-EC funding. The significant parts of the project
that will be sustained, and the funders that have been most responsive are described below.
•
•
Collective Impact Backbone Support for Collaboration. CCS has chosen to stop providing
funded direct services in early childhood, including its contract for providing Healthy
Start~Healthy Families services, in order to not compete with partners for service
contracts and focus on being a backbone organization for the collective impact initiative.
CCS will continue to seek funding to sustain and improve the functions of a backbone
organization, as well as to support the collaboration activities of its partners. CCS has
had success with regional foundations and local donors to support this work.
Funding to Support Collaboration. CCS understands the issues that smaller organizations
have when they try to collaborate with other organizations—the extra time required to
meet with partners and to adjust internal systems to align with collaborative systems
are difficult to fund within a small organization’s budget. Therefore, CCS will continue
149
•
•
to seek support for collaboration to provide funding to partners for their engagement
with FHI. The United Way of the Mid-Willamette Valley has been interested in funding
collaborative projects over at least the last two funding cycles. In addition, individual
donors have provided funding to support collaboration. CCS will continue to seek
similar funding in the future.
Safe Families for Children: Voluntary Respite Care. CCS is committed to continuing to
work with faith communities in the three-county area that are interested in sponsoring
this faith-based respite care program. CCS currently is engaged in a recruitment
campaign to dramatically increase the number of volunteers thus expanding capacity to
handle increased referrals.
Neighborhood Mobilization. CCS and its partners have used several different strategies
for mobilizing neighborhoods, particularly to help neighborhood residents be aware of
the Protective Factors and support each other to make sure the neighborhood is a great
place to raise children. Some of the specific strategies used have emerged from the
neighborhoods—e.g., La Casita and Community Dinners. CCS has adopted the AssetsBased Community Development approach to community-building, and has sought
additional funding to support Neighbor Connectors for each FHI neighborhood.
Since the beginning of the Fostering Hope Initiative, several funders have been particularly
supportive of the efforts, in particular Meyer Memorial Trust, The Ford Family Foundation,
Kaiser Permanente Community Fund of the Northwest Health Foundation, The United Way of
the Mid-Willamette Valley, and Catholic Charities of Oregon. In addition, CCS has strong
relationships with local businesses and donors who have contributed to the development or
expansion of strategies within FHI.
B. The Role Collaboration has Played in Moving toward Sustainability and its Future
Working with a group of collaborators in a Collective Impact Initiative broadens the range of
connections beyond those of a single organization. Therefore, we strongly believe that FHI’s
collaborators have a critical role in sustaining FHI. Indeed, with the addition of a Collective
Impact Coordinator—focused on extending and deepening relationships, as well as improving
systems to support collective impact, the collaboration is becoming stronger. The new
Executive Council, consisting of executive directors of partner organizations, will have an
important role in ensuring FHI continues beyond current funding.
The addition of Center 50+ to the collaboration also points to project sustainability. Center
50+ has hired a home visitor to provide outreach and support to seniors who are homebound.
The Center also is coordinating with FHI Neighbor Connectors. FHI is working to expand this
collaboration to include recruiting senior volunteers to assist with supporting FHI families and
neighborhood activities.
150
C. Practices, Programs, Administrative, or Policy Changes that will be Sustained after
the Project Ends
•
•
Practices and Programs. After funding from CSSP ends, many of the practices and
programs of FHI will continue. This includes home visiting services and parenting
education (now funded through typical funding channels), Safe Families for Children
(donor and foundation support), and Community Cafés (CCS sponsored a day-long
training session for Community Café facilitators, attended by approximately 20 partners
and parents, in October). In order to focus on its role as a backbone organization and no
longer compete with FHI partners for service funding, CCS did not apply for a contract
renewal for its Healthy Start~Healthy Families services.
Policy Changes. At least one of the FHI partners, Mano a Mano Family Center, has
imbedded the Protective Factors in their organizational policies. At a statewide level, FHI
succeeded in advocating for legislative changes to expand the eligible families to receive
Healthy Start services to any birth meeting risk factor criteria, no longer limiting the
service to first birth families only.
D. How the Use of a Strengths-Based, Protective Factors Approach been Integrated into
Policy, Norms, and Practice/Service Delivery at Different Levels of the Social Ecology.
•
•
•
•
Individual/Caregiver Domain. Supporting development of the protective factors has
been built into home visiting, parenting education, and the work of Neighbor
Connectors. FHI service providers often frame their work based on protective factors.
Relationship (Neighborhood) Domain. Community Cafés focus on supporting dialog
among neighbors related to developing family protective factors. The work of Neighbor
Connectors, not funded by this project, includes a focus on building protective factors.
Community (Service System) Domain. Each of the partners working with FHI is now
familiar with the Protective Factors and considers how to incorporate them in their
work. Mano A Mano, for example, has built the Protective Factors Framework into their
organizational policies.
Systems (Policy) Domain. The Fostering Hope: Closing the Gap Summit which is targeted
to state and community leaders has presented information on the Protective Factors at
each of the three annual events that have been held. Both the Parents’ Council and the
Center for the Study of Social Policy have presented on the Protective Factors at the
Summits. The Yamhill County early learning system design team incorporated the
Protective Factors into their plan, submitted in response to the state’s RFA for the
restructured early learning system. Their plan organized the county’s goals and
indicators under the five Protective Factors. Yamhill County was the only plan
submitted tat incorporated Protective Factors, and they were one of six applications
selected in this initial round of early learning hub development.
E. Products Developed as a Result of the Project
151
CCS and other FHI partners have developed several products related to FHI:
• Memorandum of Understanding. FHI has had several MOUs developed over the past
several years, each usually related to a proposal being submitted. The current MOU is
based on the current United Way funding for Impact Collaboration and is included in
Appendix B.
• Theory of Change. With the help of the Frontiers of Innovation project at Harvard
University’s Center on the Developing Child, CCS has worked on improving the theory of
change for FHI, to make sure it is based in science. The most current version is available
at: http://fosteringhopeinitiative.org/images/Theory%20of%20Change.pdf .
• FHI Website. CCS developed an FHI website, which is now being redesigned and
updated. http://www.fosteringhopeinitiative.org/
• Protective Factors Grid. Pacific Research and Evaluation, in collaboration with the Center
for the Study of Social Policy and the collaborative partners, is developing a data
collection instrument that can be used with caregivers to track their progress in building
protective factors, reducing/managing toxic stress, and achieving financial stability. The
instrument is currently undergoing pilot testing. The Grid is provided in Appendix C.
• FHI Newsletters and Brochures. FHI distributed newsletters to stakeholders a few times
during the project, created a brochure on kindergarten readiness, and prepared a
simplified summary of the Strengthening Families Protective Factors. Most of these are
available on the FHI website: http://www.fosteringhopeinitiative.org/
•
•
FHI Videos. FHI has developed two videos, including one about a service recipient, “Brande’s
Story.” (Brande’s Story is available at: http://youtu.be/e7liGpOUWRE)
FHI Neighborhoods Map. This map depicts the general location of each of the FHI
neighborhoods.
In addition to the above, staff developed materials for specific events, including the Fostering
Hope: Closing the Gap Summits, a reception for Dr. Melissa Brodowski of the federal Children’s
Bureau, and specific presentations on FHI made by staff.
F. Cost Tracking
1. Summarize the actual costs to implement the project based on the categories
below. To the extent that projects are able to summarize the costs using a “per
family” or “per child” metric, whichever is most appropriate based upon the
intervention design, this would be
helpful, but is not required.
Table 152
Aggregate Costs to Implement the Project
a. Salaries and Fringe Benefits
b. Volunteer/In-Kind Labor (if can be determined)
c. Contracted Services (including staff training)
d. Incentives for Participantsa
152
Grant Funds
560,275
23,779
650
Match
282,826
Total
843,100
0
23,779
650
e. Office Space
f. Supplies and Materials
g. Travel
h. Indirect Costs
i. Developing Collaborative Relationships and
Working through Existing Relationships to Align
Goals and Strategies with Partners (if can be
determined)
j. Local Evaluation and Quality Improvement
Activities (e.g., supervision; data
Totalsb
a
b
22,980
31,880
24,900
193,830
94,604
8,926
201,257
441,156
1,299,450
0
117,584
31,880
33,826
395,087
441,156
587,613
1,887,063
Additional incentive costs are included in the Local Evaluation budget
Includes estimated evaluation costs for the month of December, 2013 not yet billed.
VII. Conclusions
A. Respond to the QIC-EC’s overarching research question:
“How and to what extent do collaborative interventions that increase protective
factors and decrease risk factors in core areas of the social ecology result in increased
likelihood of optimal child development, increased family strengths, and decreased
likelihood of child maltreatment within families of young children at high-risk for child
maltreatment?”
Results of the quasi-experimental outcome study suggest that the intervention was
effective in that participants receiving coordinated services demonstrated a decrease in stress
associated with parenting as measured with the Parenting Stress Index. Statistically significant
results were also generated with Construct A of the Adult Adolescent Parenting Inventory. The
treatment group experienced a slightly larger improvement over time than the comparison
group in terms of their knowledge of the needs and capabilities of children at various stages of
growth and development. In combination, these findings indicate that the intervention was
successful in reducing a subset of the targeted risk factors among participating families.
Unfortunately, due to a ceiling effect, the Caregivers Assessment of Protective Factors did
not generate meaningful results, negating efforts to quantitatively assess change in the
protective factors among participating caregivers.
Optimal child development was assessed with three measures: 1) Sense of Competence
Subscale on the Parenting Stress Index; 2) Adult-Adolescent Parenting Inventory; and, 3) Ages
and Stages Questionnaire. In addition to the Parent, Child, and Total Stress Domains of the PSI,
the Sense of Competence Subscale also generated statistically significant results overall, as well
as when data were disaggregated for Marion County and Hispanic participants. Although four
of five constructs assessed with the APPI did not generate statistically significant findings, as
stated previously, statistically significant results generated by the Expectations of Children
construct suggest that the intervention had a small effect in this area. Additionally, the local
measures (ASQ-3, ASQ SE) found that none of the participating families were in need of a
153
developmental intervention beyond the addition of learning activities and continued
monitoring, and a very small number of participants required referral for mental health
services. It follows that optimal child development was supported by the Initiative, though to a
moderate degree.
Increased family strengths were measured with the Self-Report Family Inventory, Social
Network Map, and six items addressing home and neighborhood safety and financial solvency
(Background Information Form). The Health/Competence, Conflict, and Cohesion Subscales of
the SRFI did not generate statistically significant results, however, the Expressiveness Subscale
approached significance (p=.058). The Expressiveness Subscale assesses the verbal and
nonverbal expression of warmth, caring, and closeness within the family unit, indicating that
there may have been some improvement in this area among caregivers receiving FHI services
over and above that of comparison group participants. Results of the Social Network Map,
being analyzed for all project sites through QIC-EC, are not yet available.
The items assessed with the BIF cannot be directly attributed to the intervention due to
analysis limitations posed by the categorical data. Results generated with descriptive statistics
were generally positive, however. With regard to home safety knowledge and practices, as well
as respondents’ use of emergency numbers (BIF item #18), responses for both the treatment
and comparison participants increased for most of the items queried. For all the safety
practices addressed in the BIF (item #19), respondents in the treatment and comparison
neighborhoods indicated employing most of the behaviors “all of the time”, on average, at both
intake and one year. When asked a series of statements about their neighborhoods (BIF item
#17), the majority of both treatment and comparison group respondents agreed that they
would like to remain a resident of their neighborhood, would be willing to work with people in
their neighborhood to improve the neighborhood, that they like living in their neighborhood, as
well as that they feel safe in their neighborhood.
With regard to financial solvency, the BIF also queried financial problems (Item #15),
household income (Item #14), and use of federal and state aid (Item #16). Participants from
both study groups reported experiencing a variety of financial hardships including inadequate funds
for rent/mortgage payments, utility payments, or to buy food. Treatment group participants did not
demonstrate a notable change in this area. The majority of all caregivers indicated a total
household income of less than $30,000, and almost all were receiving some form of
government aid. These results did not change from intake to one year.
It remains to be determined whether rates of child maltreatment changed in the study
neighborhoods. When data become available through DHS they will be analyzed in 2014. The
Department was able to confirm that none of the study participants in any of the treatment or
comparison neighborhoods had been the subject of a substantiated case of child maltreatment during
the study period.
154
B. The overall impact in helping families to build protective factors, using observations
and case examples, as well as evaluation data. The overall impact of the project on
the children, adults, and families served.
While the CAPF was not useful, ultimately, in assessing the presence of the protective
factors among caregivers, qualitative data gathered with parent interviews generated specific
examples of the building of protective factors among caregivers. A representative summary of
comments garnered from the interviews is provided below.
Parent Telephone Interviews –Quotes Addressing the Protective Factors
•
•
•
•
•
•
Nurturing and attachment: “Before, I didn’t play with my kids. I would give them their
meals and bathe them and take care of them, but I didn’t take time to just enjoy them.
Now I set aside time simply to play with them and I have much more patience and
tolerance than I used to have.”
Knowledge of parenting and child development: “Every week I learn more so I continue
…I wondered why my child couldn’t walk yet and [my home visitor] explained that all
children are different. It is always different at each visit so I stay with it.”
Parental resilience: “The home visitor also taught me that it is very important that I take
time to relax and calm down. If I take better care of myself then I will be better able to
take care of the needs that the children have.”
Social connections: “I have met new people that live in this neighborhood and it is all
because of the program.”
Concrete supports for parents: “My worker… found health insurance [for my child] and I
am really happy about that.”
Social and emotional competence of children: “[I have learned] how to calm down my
child when he is upset.”
The home visitors and parent educators also discussed the building of protective factors
during a focus group conducted during the first year of the evaluation. According to the visitors,
attending to families’ basic needs (food, housing, etc.) or providing “crisis services” (mental
health, domestic violence) often came first, and as a result families gained trust in the home
visitors and saw them as a source of concrete and social support. Once crisis services and basic
needs had been addressed, home visitors reported that they worked with all of the protective
factors to some degree, catering services to families’ individualized needs. In both home
visiting and parent education, staff reported placing special emphasis on the Nurturing and
Attachment protective factor.
In addition to addressing other protective factors, according to the facilitators, parent
education classes and community cafés are especially effective in building social support among
attendees. Educators recommended that neighbors carpool to the parenting education classes,
further cultivating connections among attendees.
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C. Overall Impact of the Project on the Individual Agencies and Organizations Involved
The Fostering Hope Initiative and, in particular, the research project funded by QIC-EC have had
a profound impact on the individual agencies and organizations involved. Some of these are
listed below.
•
•
•
•
The Strengthening Families Protective Factors have provided a framework, not only for
service delivery, but how we think about supporting families, neighborhoods and
communities to support optimum child development.
o FHI partners have embraced the Protective Factors in their work, including
incorporating them into their policies/procedures.
o While many agencies, including CCS, have used a strengths-based approach to
services for many years, the Protective Factors provide a framework for how to
implement that approach.
o With the help of CSSP, PRE drafted a measurement tool, the Strengthening
FamiliesTM Protective Factors Grid (Appendix C), for assessing the presence of
protective factors within families. In addition to use by CCS and Mano a Mano,
DHS is using the Strengthening FamiliesTM Protective Factors Grid for interviewing
their families.
o The Yamhill County design team for their application to become an early learning
hub used the Protective Factors Framework as a basis for their work to redesign
their Early Learning System. A copy of their planning document is included in
Appendix D. The Yamhill County application was one of six selected for funding
by the state’s Early Learning Council in the first round of applications.
Opportunities for collaboration have expanded, and the nature of collaboration has
moved beyond cooperation to support collective impact to better achieve complex
community issues.
o School districts involved have embraced the neighborhood-based initiative and
welcome the opportunity to collaborate on early learning opportunities that will
increase the number of children entering Kindergarten prepared to succeed.
Center 50+ saw the potential of the initiative to increase the involvement of isolated
seniors in their respective neighborhoods and disseminate information to seniors about
how to be a good neighbor. The Center has now received a grant and hired a half time
person to provide home visiting and follow-up, including helping seniors to develop
social connections.
Agencies and organizations are developing an increased understanding of the science
behind best practice approaches. FHI has had wonderful opportunities to learn from
the Center for the Study of Social Policy, Harvard’s Center on the Developing Child, and
other researchers as a basis for improving our work. Among other results from science,
FHI partners now understand:
o That the same science underlies optimal child development, success at school,
and future economic self-sufficiency.
o The impact of toxic stress on the ability of adults to parent well, as well as its
long-term negative effects on the developing child. As described by the
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•
Sanctuary Model, the issue isn’t “What is wrong with you,” but rather “What
happened to you” when looking at an individual needing support.
o That safe, stable, nurturing relationships are the key factor in supporting optimal
child development.
There is a growing awareness that the current funding system creates perverse
incentives for state funders and service providers, emphasizing reactive measures and
separating children from their families, and things need to change. Evidence of this
awareness is a new initiative supported by Governor Kitzhaber to develop legislative
support for “Pay for Prevention” in which cost reductions based on outcomes that
reduce the need for foster care and other costly services are used, instead, to pay for
supports that strengthen families.
D. Impact in the Communities Where FHI Operated
•
•
The shift in emphasis from “neighborhood outreach,” as implemented early in the
project, to “neighborhood mobilization” has had a great impact on FHI neighborhoods
and how people live together in those neighborhoods.
o Formerly isolated families with young children are getting to know others,
building their social connections support systems, and becoming involved in a
variety of neighborhood activities.
o Community Cafés have provided opportunities for neighborhood residents to
take on leadership roles, as well as to work together based on the Protective
Factors to develop ways to make their neighborhood a great place to raise
children.
o Adding an exercise component to neighborhood activities resulted in 50
participants attending Zumba classes, and others developing a walking club.
o The neighborhood, school building and city were all beneficiaries of the local
neighborhood projects to clean-up the park, build a community garden, and
clean-up/redesign school grounds.
o Community dinners in one neighborhood, once a week provide an opportunity
for neighbors to get to know each other and for families with food insecurity to
eat. At the same time, these dinners have given a church in the Swegle
neighborhood another means for being a good neighbor.
o La Casita has provided a place for neighbors to gather, for agencies to meet to
coordinate their work, and an effort by a church in the Washington
neighborhood to become a better neighbor.
The community is addressing equity issues.
o The state has charged all school districts with narrowing the significant
achievement gap, in particular, between Latino and white students. FHI’s success
in recruiting Latino families for participation has significant implications to assist
school districts in narrowing the achievement gap by increasing the number of
children entering kindergarten prepared to succeed.
o The Early Learning mandates require that all plans provide for strategies that
reflect an equity lens.
157
o Local church community members, predominantly older and Caucasian, have
reported a higher level of comfort and involvement with their younger, mostly
Latino neighbors.
It is clear that the project has had a great impact on communities; however, we are
convinced that even greater impacts are yet to be revealed.
VIII. Key Recommendations
A. Recommendations to administrators of future, similar projects
•
•
•
•
FHI is not a linear project. Administrators of future, similar projects must be
prepared for staff to become imbedded in the target neighborhoods and to
“follow the energy” that arises from the residents and programs in each
neighborhood. Each neighborhood will be different. FHI, working in six
neighborhoods spread across three counties, has experienced the great
difference between neighborhoods, for example, in smaller, rural communities
with few assets and those in larger communities such as Salem.
In order to maximize collaborative impact efforts, it is critical to involve the CEOs
and key decision-makers of the respective agencies, business partners and
community organizations. FHI’s experience with the Participatory Evaluation and
Planning team, largely composed of mid-managers, did not lead to the top-level
commitment that was needed for true collective impact.
The project needs to be considered as a long term process, one that will take
time to develop, grow, and achieve its desired impact. Both our experience with
learning more about how to achieve collective impact, and the work it takes to
align very different agencies and organizations around a common goal, and the
nature of relationships in neighborhoods, that must grow naturally as trust
develops, point to the need for a long-term commitment.
To change community norms around how to achieve optimum child
development, it would be important to implement a community marketing
campaign that emphasizes the importance of reaching families and children
before age five. While FHI has not been able to do this, partners in FHI are board
members of the new Early Learning Hub, Inc., in Marion County. ELH is building
such a campaign so that the whole community, in places throughout Marion
County, understands the critical importance of the first few years of a child’s life.
B. Recommendations to current project funders as well as potential funders
•
The project needs to “stand behind” and empower families and neighborhood
residents—finding natural leaders, supporting opportunities that emerge. A
project such as FHI which is imbedded in neighborhoods cannot be fully planned
in detail, as it must be able to be responsive to what is happening in the
neighborhood and with families. FHI initially struggled trying to work in rural
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•
•
•
neighborhoods, because of their very different nature from city-based
neighborhoods. It was important that FHI’s funder for that effort—The Ford
Family Foundation—understood that FHI needed to extend the duration of that
project to progress to achieving the desired outcomes.
Do not overlook funding for training, e.g., Community Cafés and evidence-based
parent education. Community volunteers are willing to provide leadership
support, offer venues, and share skills without charge. Partners often will
volunteer to absorb some costs related to backbone support or staff time.
However, trainings and skill-building activities can present a significant cost but
are integral to success and sustainability. These activities should be included in
the budgeted costs. When FHI has sponsored training, we have observed
tremendous gains—in the skills of individuals attending, and in the way in which
organizations have approached their work.
Funding support for interpreting and translation support is essential. The system
is overwhelmed with requests for “volunteers” to provide these critical services
when bilingual staff persons are not available. Although FHI seeks to hire persons
who are bilingual/bicultural when working in the FHI neighborhoods with a high
proportion of Hispanic/Latino residents, sometimes a monolingual English
person is the best qualified for a position. In those cases, FHI has needed to
support that worker with an interpreter in times when she will be working with
monolingual Spanish families.
Funders should support projects that emphasize the benefits of investing in early
learning opportunities and how this has emerged as one of the most promising
strategies to help strengthen school success, impact the workforce, and
influence future economic development. Such messages are needed to be heard
by businesses as well as by families. FHI submitted a project proposal that would
have supported a communications campaign in high poverty neighborhoods, but
was not successful in getting it funded.
C. Recommendations to agencies or collaborative partnerships about developing or
implementing similar projects
•
•
Consider carefully who is involved from each partner at all points in the ongoing
collaboration. While Executive Directors are required to meet together for
decisions about committing their organizations and resources, staff from partner
organizations providing services, such as home visitors, also need opportunities
to work together to share insights and coordinate their efforts. This is also true
for community volunteers. FHI has worked most smoothly when partners work
together at multiple levels of each organization.
Successful collaboration requires investment from all parties, but particularly
from the “backbone” organization to ensure that all partners are engaged.
Relationships and ongoing communication are key. Funding received from the
Meyer Memorial Trust has supported a full-time Collective Impact Coordinator.
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•
•
•
This investment has had tremendous returns in the strength of the relationships
among members of the collaborative and in developing systems to support
collective impact.
Relationship-building is a process and requires time. Administrators must be
realistic and plan accordingly in order to reach a level of trust that will ensure
efficient, collaborative teamwork and synergy. The return on the time
investment is definitely worth the effort.
Quantify commitments from partners and revisit them occasionally to ensure
that commitments are honored. FHI had to work at defining “partner” and what
was expected of different organizations that were supporters of FHI.
Establish a track record of results. Share successes. Organizations are more
willing to join a successful collaborative effort, than one that is at a standstill.
D. Recommendations to the general field about supporting the building of protective
factors at the individual and relationship (family) domains of the social ecology and
what services or interventions seem to be the most effective in doing so
•
•
Many of the families with whom FHI worked had multiple generations living in
the same home. It was important that the home visitor assist the entire family—
to gain trust and help others to improve their caregiving—rather than solely the
target child and primary caregiver. In FHI, these actions helped the families to
more quickly trust the home visitor and welcome them into their homes.
Sharing information about the protective factors is more effective when it is
infused across a variety of family and neighborhood activities, goals and
supports, using vocabulary and examples that are culturally and linguistically
relevant.
E. Recommendations to the general field about supporting the building of protective
factors at the community domain and societal domain of the social ecology
•
•
Projects must be alert for natural opportunities that arise within the various
communities and domains to bring in building of protective factors. This may
include, for example, participating in community/neighborhood events to have
information available on the protective factors.
Each person working on the project to support building protective factors likely
will need to work in more than one domain of the social ecology—e.g., home
visitors work at the Individual/Caregiver level but must also support building
protective factors in the Relationship (Neighborhood) domain. Administrators
may want to focus on advocacy to change public policy, but to do that must also
work at the Community (Service Provider) domain to ensure that providers are
adopting methods to build protective factors.
160
•
Craft specific communications for the business community and other partners
emphasizing pertinent messages, e.g. child development is economic
development; the importance of early learning and how the architecture of the
brain is affected; and the economic benefits of investing in the young child.
F. Recommendations to the general field about forging partnerships with parents
•
•
•
•
•
•
•
•
•
Provide families with support for transportation and child care, which may
include stipends, bus passes, or on-site child care, as well as incentives for
attendance (e.g., goods such as diapers, or food).
Follow-through on all promises.
Listen actively to parents’ concerns, dreams and priorities.
Be respectful of their multiple priorities.
Empower and engage parents to serve in leadership roles.
Choose a safe environment to meet and share information.
Coordinate the various systems and services available from multiple agencies.
Families from different cultures may have limited awareness and understanding
of services available to support them.
Identify key parent leaders in the community and partner with them to initiate
contacts and help disseminate information.
Provide trained interpreters when necessary. Do not use family members to
interpret.
G. Recommendations to the general field and funders about addressing multiple
domains of the social ecology in a research study
•
•
•
Studying multiple domains of the social ecology in a research study is critical to
successfully addressing the complex systems in families, neighborhoods, and
communities. The domains of the social ecology provide a framework for teasing
out aspects of that complexity inherent in community-based research.
Research addressing multiple domains of the social ecology requires projects
that are funded for longer than the typical one-to-three year funding cycle of
most public and private funders.
A study addressing multiple levels of the social ecology requires a high quality
evaluation, funded well enough to support input, process, output, and outcome
measurements at a frequency that will support taking action for continuous
improvement. Thus, funding for such a research study must include substantial
funds for evaluation.
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IX.
Dissemination
A. Ways in which information about the project has already been disseminated within
Oregon and the impact of these dissemination efforts
A Fostering Hope: Closing the Gap Summit was held each fall since 2011 to share
implementation progress and early research results, as well as to build interest and momentum
around the goals of the Initiative.
CCS and partner staffs often share information about FHI, its strategies, and the science
underlying those strategies, informally in meetings with state and local agencies. It has become
much more common to hear others talk about protective factors, toxic stress, and the primacy
of safe, stable, nurturing relationships to optimum child development.
B. Ways in which information about the project has already been disseminated beyond
Oregon and the impact of these dissemination efforts
Dissemination beyond the state of Oregon has primarily occurred through presentations at
conferences, listed below.
• Canadian Child and Youth Care Conference in Banff, Canada (October, 2012). The theme
of the conference was “Inspiring Resiliency”. Dr. Rider and Ms. Winters (PRE)
contributed a presentation titled Fostering Hope: An Innovative Approach to Child
Maltreatment Prevention. The presentation included a description of the program
design and interactive discussion about the preliminary results of the evaluation.
• 18th National Conference on Child Abuse and Neglect in Washington D.C. (April, 2012).
Dr. Rider contributed to a group presentation in which the lead evaluators from each of
the four QIC-EC grantee sites provided an update on progress to date.
• 18th National Conference on Child Abuse and Neglect in Washington D.C. (April, 2012).
Dr. Rider and Ms. Winters (PRE) contributed a presentation titled Participatory
Evaluation and Planning: Engaging Collaborative Partners through Issue-focused Data
Sharing in a Place-based, Federally-funded Research and Demonstration Project. Using
the FHI to frame instruction, Rider and Winters presented Participatory Evaluation and
Planning (PEP), a real-time, issue-focused data sharing partnership between evaluation
and collaborative partner agency representatives that supports implementation and
facilitates outcome achievement.
• Catholic Charities Annual Gathering in San Francisco, California (September, 2013). Dr.
Rider contributed to a presentation titled Fostering Hope: Reducing Child Maltreatment
through Collective Impact. The design and implementation of the Initiative were
presented by CCS staff. Dr. Rider contributed preliminary evaluation results and shared
his perspective about working with an agency engaging in social innovation.
• Annual Meeting of the American Evaluation Association, Evaluation 2013, in Washington
D.C. (October, 2013): Dr. Rider and Ms. Winters (PRE) contributed to a panel
162
presentation titled Evaluating the Use of Evidence-Based Principles across the Social
Ecology. Others contributing to the panel included Dr. Charlyn Harper Browne (Center
for the Study of Social Policy), Dr. Patricia Jessup (InSites), Marah Moore (InSites), and
Dr. Beverly Parsons (InSites). Using the Protective Factors Framework as an example of
evidence-based principles, the QIC-EC R&D projects were used to disseminate
implications for single and multi-site evaluations of innovative, complex interventions
implemented at multiple levels of the social ecology.
C. Research publications completed or in progress.
An article is currently under development for publication in the journal Zero To Three
(special issue, November 2014).
D. Presentations about the Project at Local, Regional, National, and International
Meetings or Conferences
Formal conference presentations are summarized in Table 153. In addition, the Fostering Hope
Initiative was the focus of three convenings in Salem, Oregon. Fostering Hope: Closing the Gap
conferences, held each fall in 2011, 2012, and 2013, included presentations and discussions of
Fostering Hope and the science on which it is based. Presenters at each conference included
nationally recognized experts in fields such as neuroscience, community-building,
Strengthening Families Protective Factors, and Collective Impact
.
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Table 153
Conference Presentations on FHI
Convening
Organization
Presentation
Date/Location
Canadian Child and
Fostering Hope: An Innovative Approach to
Youth Care Conference Child Maltreatment Prevention.
October, 2012
The presentation included a description of the
Banff, Canada“
program design and interactive discussion
Conference Theme:
about the preliminary results of the
“Inspiring Resiliency”
evaluation.
th
18 National
Group presentation in which the lead
Conference on Child
evaluators from each of the four QIC-EC
Abuse and Neglect
grantee sites provided an update on progress
April, 2012
to date.
Washington D.C.
18th National
Participatory Evaluation and Planning:
Conference on Child
Engaging Collaborative Partners through
Abuse and Neglect
Issue-focused Data Sharing in a Place-based,
April, 2012
Federally-funded Research and Demonstration
Washington D.C
Project.
Presentation on Participatory Evaluation and
Planning (PEP), a real-time, issue-focused data
sharing partnership between evaluation and
collaborative partner agency representatives
that supports implementation and facilitates
outcome achievement.
Catholic Charities
Fostering Hope: Reducing Child Maltreatment
Annual Gathering
through Collective Impact.
September, 2013
The design and implementation of the
San Francisco,
Initiative, preliminary evaluation results, and
California
perspectives about working with an agency
engaging in social innovation.
Annual Meeting of the Panel presentation, Evaluating the Use of
American Evaluation
Evidence-Based Principles across the Social
Association
Ecology. Using the Protective Factors
October, 2013
Framework as an example of evidence-based
Washington D.C.
principles, presentation on how the QIC-EC
Conference Theme:
R&D projects were used to disseminate
Evaluation 2013
implications for single and multi-site
evaluations of innovative, complex
interventions implemented at multiple levels
of the social ecology.
164
Presenters
Dr. Rider and Ms.
Winters (PRE)
Dr. Rider (PRE)
Dr. Rider and Ms.
Winters (PRE)
Dr. Rider (PRE)
CCS staff
Dr. Rider and Ms.
Winters (PRE)
Dr. Charlyn Harper
Browne (Center
for the Study of
Social Policy),
Dr. Patricia Jessup,
Marah Moore &
Dr. Beverly
Parsons (InSites)
E. Plans to disseminate information about the project when the project period ends.
CCS has several plans for disseminating information about the project when the project period
ends:
• Provide the Implementation Manual to the United Way of the Mid-Willamette Valley,
related to the Impact Collaboration grant received by CCS on behalf of FHI.
• Continue to present information on the Fostering Hope Initiative locally, and within our
region of the state to continue to expand and deepen local support for FHI.
• Maintain the FHI Website.
• Publish an article in a special issue of the journal Zero To Three.
• Participate in webinars sponsored by QIC-EC.
• Work at a state level to support “Pay for Prevention” by providing information to
legislators and others about FHI.
• Present at state, regional, and national conferences as opportunities arise.
165
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