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Paper

Crisis nursery service outcomes for caregivers at multiple sites in Illinois

• issue: Issue 3 / 2008
• authors: Susan Cole, Pedro Hernandez
• keywords: Usa, nursery service, prevention, crisis intervention

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• downloaded: 0
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abstract

Background. Although crisis nursery services were developed in the early 1970's to prevent child welfare placements, assessing the effects of their services for families and children presenting with specific problems has been elusive. The limited studies of emergency support services for families in stress (such as crisis nurseries services) have reported positive effects on caregivers' perceptions of child safety and prevention of out-of-home placement. A recent study (ARCH National Respite Network, 2006) showed that families served by crisis nurseries in California had more allegations, but fewer substantiated cases of abuse and neglect than like families not served. The results of the first outcome study of individual caregivers using crisis nursery services at multiple sites in Illinois are discussed in this paper.

The paper reports empirical evidence on the characteristics of all families accessing crisis nurseries in Illinois, those families who provide feedback on the effect of services they receive, and the characteristics that are correlated with greater positive effects for crisis nursery use. Future directions for empirical studies of crisis nursery outcomes are discussed.

Research questions

• What are the characteristics of the families who use crisis nursery services?
• What characteristics are associated with caregiver report of more positive outcomes for decrease in stress, enhancement in parenting skills, and potential for child abuse and neglect?

 Methods. Using administrative data regularly collected by all five crisis nurseries in Central and Northern Illinois and reported to the Illinois Department of Human Services (IDHS), analyses were done to assess the effects of crisis nursery services on individual caregiver service recipients.

Characteristics of the primary caregivers (parents, grandparents, step-parents) and young children served were used to identify the characteristics of families who reported the best effects from crisis nursery services received in FY 2005.

Study design. A cross-sectional design was used to analyze the responses of caregivers regarding the effect of crisis nursery services on stress, potential for abuse, and parenting skills. Service recipients are surveyed on the three outcomes variables quarterly by the nurseries. Because single users were surveyed at least once and provided the largest pool of respondents for analysis, the responses of caregivers to the first evaluation survey completed were used for outcome analyses. Initial caregiver responses also showed the greatest change in outcomes assessed even for multiple recurrent crisis nursery users.

Visit data from FY 2005 (the most complete data set for the five nurseries to-date) were linked with caregiver and child demographic data from visits to form a single database for use in analyzing the outcomes for specific caregivers with specific characteristics. The integrated database that was created contained data from four nurseries - complete outcome data for three nurseries and partial outcome data from one nursery. No outcome data were available from one nursery.

Testing of the effects of the independent variables on the three outcome variables of interest was limited by the data contained in the crisis nurseries' databases. The independent variables available in the integrated data base included ethnicity, marital status, income, education, number of children, ages of children, reasons for accessing crisis nursery services. These variables were used to identify factors associated with the changes reported by survey respondents on the three dependent variables (caregiver stress, potential for abuse and neglect, and enhancement of parenting skills) after receiving crisis nursery services.

Study Sample. Although consent for the use of caregiver and child data is not necessary to obtain crisis nursery services, it is a regular part of the intake process for all five crisis nurseries. The case data of all caregivers who provided consent for their electronic records to be used for crisis nursery evaluation purposes in FY 2005 (N=1151) were included in the sample for this study.

Key findings. Results indicated that caregivers had improved outcomes in stress, risk of abuse, and parenting skills after receiving crisis nursery services. Ordinal regression analysis showed that evaluation survey respondent caregivers (55% of those served FY 2005) who were Caucasian, single, with higher incomes, had children four years of age or older and sought crisis nursery services because of a home, mental health, or family violence crisis were more likely to report greater stress reduction (See Table 1).

Crisis nurseries have positive effects on the lives of families with young children as reported by caregiver consumers of their services. They provide support for families when they are most in need. Few other services available to young families are free and immediate. This study that was the first to examine the effects of crisis nursery services for individual caregivers served in Illinois found that crisis nurseries provided positive support for caregivers. The results showed that in addition to being available when families most need assistance, crisis nurseries often provide support to the most vulnerable families.

Tab. 1 - Multivariate Ordered Logistic Regression Analysis for Stress Change, ARCH Caregiver Respondentsa (N = 600)

Key references

ARCH National Respite Network and Resource Center (2000). ARCH 5.2. Chapel Hill: ARCH National Respite Network and Resource Center, Chapel Hill Training Project, Inc.

Cole, S. A., Wehrmann, K. C., Dewar, G., & Swinford, L. (2005). Crisis nurseries: A vital component in the system of care for families and children. Children and Youth Services Review, 27, 995-1000.

Doyle, J. J. (In press). Child protection and child outcomes: Measuring the effects of foster care. American Economic Review.

Contacts: Susan A. Cole, Assistant Professor, School of Social Work, University of Illinois at Urbana-Champaign, 1207 W. Oregon, mc-140, Urbana, IL 61801, sacole@uiuc.edu, 1-217-244-5231.