Nationally, approximately 61 percent of children have been exposed to violence during the past year, and there is reason to believe that the problem has grown worse in recent decades (Finkelhor et al., 2009). Children’s exposure to violence (CEV) can have serious consequences, including a variety of psychiatric disorders and behavioral problems, such as posttraumatic stress disorder (PTSD), depression, and anxiety. School performance has also been shown to suffer as a result. Moreover, research suggests that the effects of exposure to violence may persist well into adulthood (Margolin and Gordis, 2000). Though some research has shown that early childhood interventions...

In recent years, the risk to children exposed to violence at home and in communities has gained wider recognition (Kracke and Hahn, 2008). A recent national study of the prevalence of children’s exposure to violence (CEV) found that 61 percent of children had experienced or witnessed violence in the past year, with many experiencing multiple types of violence exposure (Finkelhor et al., 2009). Common sources of CEV are direct child maltreatment, witnessing domestic violence, and community and school violence. Child protective services agencies accepted 3.3 million referrals for neglect and abuse in 2008, and from these referrals, 772,000 children were...

Prior to using program funds, hiring staff, or conducting other implementation activities, each site participated in the Green Light process. (This process and resulting changes in each site are more fully described in our companion report, Schultz et al. [2010]). The purpose of the process was to make sure that sites were (1) ready to start implementation and (2) ready to be part of the evaluation. No formal evaluation data were collected until after the Green Light process was completed.

This process consisted of a review by the national evaluation team of a checklist of criteria. The checklist was developed...

To assess outcomes at each site, we used a set of measures that captured background and contextual factors, as well as a broad array of outcomes, including PTSD symptoms, depressive symptoms, behavior/conduct problems, social-emotional competence, caregiver-child relationship, school readiness/performance, and violence exposure.

As described in the introduction of this report and in our summary of the process evaluation (Schultz et al., 2010), the 15 Safe Start sites differed in intervention, setting, and target population. Thus, choosing measures that could be used across all 15 sites was challenging. Our goal was to identify measures meeting the following criteria:

The measure could...

Data sources for the outcome evaluation were primary caregiver interviews, child interviews (for ages 3 and over), and family/child-level service utilization data provided by the Safe Start program staff. All caregiver assessments were interviewer administered. Child assessments were interviewer administered for ages 3 through 10. Children ages 11 and older completed a self-administered assessment packet, but research staff was available to assist the child as needed. The sites mailed data on a monthly basis to RAND for data entry, cleaning, and analysis.

In order to standardize procedures across each of the 15 Safe Start sites, the RAND evaluation team developed...

Each of the 15 sites developed its own research design or designs as part of the Green Light process. In this section, we discuss the general designs at the sites, power analyses, and analytic strategies for the different types of designs and for handling issues related to missing data, multiple tests of significance, and low numbers of participants in cells. This chapter gives a general overview of these strategies, with site-specific details appearing in each of the respective site reports.

Table 5.1 presents the evaluation designs employed at each site. As can be seen in the table, the majority of...

In this chapter, we review the outcome data collected across the 14 sites that participated fully in the national evaluation, discussing characteristics of enrollees, as well as patterns of enrollment, retention, power, and outcomes that were observed.

As noted earlier in this report, there was a good deal of variation across the SSPA sites, including their target populations for programs. Although all of the programs sought to improve outcomes for children exposed to violence, their use of different settings, focus on different age ranges and types of violence, and varying referral streams resulted in great diversity in the families who...