Effects of Telehealth Augmentation of a Home Nursing Care Program for Women with Children at Risk for Child Abuse and Neglect

Child abuse and neglect have devastating financial and psychological effects on families and Communities. Research indicates that unless intervention occurs early, similar behaviors and coping patterns are perpetuated. Early intervention in the form of home visitation can reduce the risk of child abuse by enhancing parent-child interaction and decreasing the use of physical punishment. Reports of child abuse reported in the Army indicate substantial numbers in 1998. As one goal of the Putting Prevention Into Practice (PPIP) model at Tripler AMC is to reduce domestic violence, the purpose of this study is to investigate a home visitation program augmented by telehealth technology in reducing the potential for child abuse. The specific aims are to determine the effects of a home visitation program augmented by telehealth technology on: 1) decreasing risk for child abuse and neglect, 2) decreasing incidence of injuries, emergency visits and hospitalizations, 3) improving mother/child interactions, 4) increasing cost effectiveness, and 5) increasing client satisfaction when compared to the visitation program alone. Utilizing Johnson's Behavioral System Model for Nursing, the study will utilize an experimental, randomized, longitudinal design. All pregnant women screened during their first trimester and identified as at-risk for child abuse or neglect are eligible. Subjects will be randomized into the treatment telehealth or control standard home care group. Measures include the Child Abuse Potential Inventory, Home Assessment Visit questionnaire, Family Health Profile, Nursing Child Assessment by Satellite Training scale, Health Service Utilization Profile and Client Satisfaction Scale. Data will be collected at entry, eight weeks postpartum and when the child is one year old. Data analysis will be completed utilizing a 2x2x2 factorial structure to determine group differences on the research questions. Findings will provide useful information on this new intervention method with potential for increasing cost-effectiveness of service delivery and decrease in the potential for child abuse and neglect because of increased access to care.