Engaging and retaining families is a common challenge when serving families at high risk. McCurdy and Daro’s (2001) Integrated Theory of Parental Involvement (ITPI) proposes factors that impact engagement and retention in services. While several studies have found varying family demographic and risk factors to be associated with family engagement in home-based services, (withheld citation for purpose of review) identified program and provider characteristics that predicted engagement and retention (withheld citation for purpose of review). Specifically, SafeCare (SC) had greater enrollment (4 times) and retention (8.5 times) rates than services as usual (SAU), likely due to SC’s skill-based approach targeting desired topics. As a follow-up to this quantitative study, we conducted separate focus groups with parents who engaged and who failed to engage in SC (N= 16) and SAU (N=18). Provider characteristics (e.g., caring, experienced with children, nonjudgmental) was the strongest themes for engagement across groups. Program and provider flexibility and providers’ persistent support for parents despite life chaos facilitated retention. Results suggest that provider characteristics and program approach are key in engagement of families in home-based services. These results suggest expansion of the ITPI to address social context. Results suggestfocusing on specific provider characteristics and program approach for work force and program development to increase program engagement and decrease attrition.

Key Take Away Points

Results suggest that:

  • Provider characteristics, approach, and support are key in engagement of families in home-based services.
  • Expansion of the Integrated Theory of Parent Involvement (ITPI) model is needed to address factors of engagement related to specific provider and program factors and for attrition focus on provider and program factors as well as integrated factors.
  • Focus within home-based services should be on specific provider characteristics and program approach to increase program engagement and decrease attrition

Author Biography

Lana O. Beasley, PhD is a clinical child psychologist and Assistant Professor of Psychology at Oklahoma State University. She is a mixed-methods researcher with a focus on child abuse prevention within home visitation models. She is also has research interests in cultural adaptation of treatments, family environment of children exposed to maltreatment, and foster children.

Jane F. Silovsky, PhD is a clinical child psychologist and Associate Director of the Center on Child Abuse and Neglect at the University of Oklahoma Health Sciences Center. Her research interests include child maltreatment prevention, treatment outcome, children with problematic sexual behavior, and evaluating RCTs of SafeCare augmented to address risk factors.

Leigh E. Ridings, MA is a clinical psychology doctoral student at Oklahoma State University. Leigh’s research interests are child maltreatment prevention, risk and protective factors, and child outcomes related to trauma. She is interested in the impact of intimate partner violence on child functioning and treatment outcomes for children with problematic sexual behavior.

Tyler J. Smith, B.A., is a post-baccalaureate research technician at the University of Oklahoma Health Sciences Center. He received his Bachelors of Arts in Psychology from University of Oklahoma. He has served as a volunteer research assistant for the Youth with Problematic Sexual Behaviors Lab (YPSB) at the Center on Child Abuse & Neglect (CCAN) and was appointed as the Program Coordinator for the YPSB cognitive-behavioral group treatment program. He also works full-time as a research technician at CCAN. He works primarily on the Maternal, Infant, and Early Childhood Home Visitation Project (MIECHV), which uses a mixed-methods approach to understand engagement and attrition in home visitation programs.

Arthur Owora, MPH is a Biostatistician at the Behavioral and Developmental Pediatrics section at OUHSC. His training includes epidemiology, bio-statistical methods, health promotions, health economics and mixed methods research. His research includes application of causal inference to observational/clinical trials, multi-level statistics, survival analyses, disease transmission dynamics modeling, and economic evaluations statistical methods.


Funding: State of Oklahoma – DHS Centers for Disease Control and Prevention (1R49 CE000449-03) Oklahoma State University Faculty Grant