Kate Guastaferro
Kate Guastaferro
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Assistant Professor of Social and Behavioral Sciences
Associate Director of the Center for the Advancement and Dissemination of Intervention Optimization
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Professional overview
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Kate Guastaferro, PhD is an intervention scientist by training, her work is devoted to the development, optimization, implementation and evaluation of effective, efficient, affordable and scalable interventions with high public health impact. She is an expert in the multiphase optimization (MOST) strategy and her expertise is in parent-focused, multicomponent behavioral interventions to prevent child maltreatment. Dr. Guastaferro co-led a statewide trial focused on the coordinated implementation of three evidence-base child sexual abuse prevention programs; included in this trial was the parent-focused child sexual abuse program that she developed, piloted and evaluated. Her current work is focused on the integration of intervention optimization into the prevention of child maltreatment.
Prior to joining NYU, Dr. Guastaferro was an assistant research professor in human development and family studies at the Pennsylvania State University, and an affiliate of its Prevention Research Center and Child Maltreatment Solutions Network. In 2020, she was awarded the Victoria S. Levin Award for Early Career Success in Young Children’s Mental Health Research from the Society for Research in Child Development. She has been published in Child Maltreatment, Translational Behavioral Medicine, and the American Journal of Public Health.
Dr. Guastaferro received her PhD and MPH from Georgia State University’s School of Public Health, and her BA in anthropology from Boston University. She also completed a year of postdoctoral training at the Pennsylvania State University.
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Education
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Postdoctoral Fellow, Prevention and Methodology Training Program (T32 DA017629), The Pennsylvania State UniversityPhD Public Health, Georgia State UniversityMPH Health Promotion, Georgia State UniversityBA Anthropology, Boston University
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Honors and awards
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Victoria S. Levin Award, Society for Research on Child Development (2020)NIH Loan Repayment Program Award: Toward the Optimization of Behavioral Interventions to Prevent Child Maltreatment (201820192020)Public Health Achievement Award, Georgia State University (2016)Scarlet Key Honor Society, Boston University (2008)
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Publications
Publications
Virtual Delivery of A School-Based Child Sexual Abuse Prevention Program: A Pilot Study
AbstractGuastaferro, K., Holloway, J. L., Trudeau, J., Lipson, L. B., Sunshine, S., Noll, J. G., & Pulido, M. L. (n.d.).Publication year
2022Journal title
Journal of Child Sexual AbuseVolume
31Issue
5Page(s)
577-592AbstractUniversal child sexual abuse (CSA) prevention is a public health priority. The prevailing prevention strategy is school-based CSA prevention programming. School closures during the COVID-19 pandemic highlighted the need for flexible modes of delivery, including virtual programs. This pilot examined the virtual delivery of an evidence-based, school-based CSA prevention program, Safe Touches, designed to teach CSA-related knowledge and concepts. Using mixed methods, the pilot sought to determine the feasibility of the virtually delivered CSA prevention program. One school district that had previously received Safe Touches in-person participated. A total of 176 second grade students participated in the virtual workshop. Post-workshop survey responses from virtual (N = 37) and in-person workshops (N = 60) were compared descriptively. Mean item scores and response patterns from students who received the virtual workshop were nominally comparable to the student scores from the in-person workshop. Following the virtual workshop, one teacher notified the research team of a disclosure of CSA. Qualitative input from the facilitator and school staff was positive, indicating high student engagement. Results suggest the viability and feasibility of virtual school-based CSA preventive programs. Investment in virtual modes of delivery would ensure all students have access to CSA prevention programming in the future.A Hybrid Evaluation-Optimization Trial to Evaluate an Intervention Targeting the Intersection of Alcohol and Sex in College Students and Simultaneously Test an Additional Component Aimed at Preventing Sexual Violence
AbstractTanner, A. E., Guastaferro, K. M., Rulison, K. L., Wyrick, D. L., Milroy, J. J., Bhandari, S., Thorpe, S., Ware, S., Miller, A. M., & Collins, L. M. (n.d.).Publication year
2021Journal title
Annals of Behavioral MedicineVolume
55Issue
12Page(s)
1184-1187AbstractBackground: Using the multiphase optimization strategy (MOST), we previously developed and optimized an online behavioral intervention, itMatters, aimed at reducing the risk of sexually transmitted infections (STI) among first-year college students by targeting the intersection of alcohol use and sexual behaviors. Purpose: We had two goals: (a) to evaluate the optimized itMatters intervention and (b) to determine whether the candidate sexual violence prevention (SVP) component (included at the request of participating universities) had a detectable effect and therefore should be added to create a new version of itMatters. We also describe the hybrid evaluation-optimization trial we conducted to accomplish these two goals in a single experiment. Methods: First year college students (N = 3,098) at four universities in the USA were individually randomized in a hybrid evaluation-optimization 2 × 2 factorial trial. Data were analyzed using regression models, with pre-test outcome variables included as covariates in the models. Analyses were conducted separately with (a) immediate post-test scores and (b) 60-day follow-up scores as outcome variables. Results: Experimental results indicated a significant effect of itMatters on targeted proximal outcomes (norms) and on one distal behavioral outcome (binge drinking). There were no significant effects on other behavioral outcomes, including the intersection of alcohol and sexual behaviors. In addition, there were mixed results (positive short-term effect; no effect at 60-day follow-up) of the SVP component on targeted proximal outcomes (students' self-efficacy to reduce/prevent sexual violence and perceived effectiveness of protective behavioral strategies). Conclusions: The hybrid evaluation-optimization trial enabled us to evaluate the individual and combined effectiveness of the optimized itMatters intervention and the SVP component in a single experiment, conserving resources and providing greatly improved efficiency. Trial Registration: NCT04095065.Applying the Multiphase Optimization Strategy for the Development of Optimized Interventions in Palliative Care
AbstractWells, R. D., Guastaferro, K., Azuero, A., Rini, C., Hendricks, B. A., Dosse, C., Taylor, R., Williams, G. R., Engler, S., Smith, C., Sudore, R., Rosenberg, A. R., Bakitas, M. A., & Dionne-Odom, J. N. (n.d.).Publication year
2021Journal title
Journal of Pain and Symptom ManagementVolume
62Issue
1Page(s)
174-182AbstractRecent systematic reviews and meta-analyses have reported positive benefit of multicomponent “bundled” palliative care interventions for patients and family caregivers while highlighting limitations in determining key elements and mechanisms of improvement. Traditional research approaches, such as the randomized controlled trial (RCT), typically treat interventions as “bundled” treatment packages, making it difficult to assess definitively which aspects of an intervention can be reduced or replaced or whether there are synergistic or antagonistic interactions between intervention components. Progressing toward palliative care interventions that are effective, efficient, and scalable will require new strategies and novel approaches. One such approach is the Multiphase Optimization Strategy (MOST), a framework informed by engineering principles, that uses a systematic process to empirically identify an intervention comprised of components that positively contribute to desired outcomes under real-life constraints. This article provides a brief overview and application of MOST and factorial trial design in palliative care research, including our insights from conducting a pilot factorial trial of an early palliative care intervention to enhance the decision support skills of advanced cancer family caregivers (Project CASCADE).Parent and Child Reports of Parenting Behaviors: Agreement Among a Longitudinal Study of Drug Court Participants
AbstractGuastaferro, K., Osborne, M. C., Lai, B. S., Aubé, S. S., Guastaferro, W. P., & Whitaker, D. J. (n.d.).Publication year
2021Journal title
Frontiers in PsychiatryVolume
12AbstractIdentifying ways to support children of parents with substance use disorder is a critical public health issue. This study focused on the parent-child relationship as a critical catalyst in child resilience. Using data from a longitudinal cohort study, the aims of this study were to: (1) examine the agreement between parent and child reports of parenting behaviors and (2) describe the association between agreement and child mental health. Participants were 50 parent-child dyads that included parents enrolled in an adult drug court and their children, aged 8–18. Overall, agreement (i.e., concordance) between parent and child reports of parenting was slight to fair. Parents reported their parenting behaviors to be slightly more positive than how children rated the same behaviors in the areas of: involvement, 0.53 (SD = 0.80); positive parenting, 0.66 (SD = 0.87), and monitoring behaviors, 0.46 (SD = 0.90). Parents also rated themselves, in comparison to their children's reports, as using less inconsistent discipline, −0.33 (SD = 1.00), and less corporal punishment, 0.13 (SD = 1.01). Agreement was related to some, but not all, child mental health outcomes. When parents rating their parenting as more positive than their child reported, that had a negative effect on child self-esteem and personal adjustment. Contrary to hypotheses, we did not find a significant relationship between positive parenting and internalizing problems. Findings have implications for obtaining parent and child reports of parenting within the drug court system, and for identifying children at higher risk for externalizing problems.Sexual sensation seeking, hookups, and alcohol consumption among first-year college students
AbstractThorpe, S., Ware, S., Tanner, A. E., Kugler, K. C., Guastaferro, K., Milroy, J. J., & Wyrick, D. L. (n.d.).Publication year
2021Journal title
Journal of American College HealthVolume
69Issue
8Page(s)
897-904AbstractObjective: To explore sexual sensation seeking (SSS) among an ethnically-diverse sample of first-year college students and their hookup behaviors. Participants: 1,480 first-year college students who hooked up in the last 30 days were recruited from four universities in 2016. Methods: Students completed an online survey before completing an online STI and alcohol prevention intervention. Results: Male and sexual minority students had significantly higher SSS scores compared to female and heterosexual students respectively. Students with higher SSS scores were less likely to report condom use at last vaginal and anal hookup, more likely to hookup under the influence of alcohol and participate in a wide range of sexual behaviors. There were no significant mean differences in SSS scores by level of intoxication during their last hookup. Conclusion: These findings highlight the role of SSS in predicting sexual risk behaviors of first-year college students and the overall low SSS scores among this sample.The Multiphase Optimization Strategy (MOST) in Child Maltreatment Prevention Research
AbstractGuastaferro, K., Strayhorn, J. C., & Collins, L. M. (n.d.).Publication year
2021Journal title
Journal of Child and Family StudiesVolume
30Issue
10Page(s)
2481-2491AbstractEach year hundreds of thousands of children and families receive behavioral interventions designed to prevent child maltreatment; yet rates of maltreatment have not declined in over a decade. To reduce the prevalence and prevent the life-long negative consequences of child maltreatment, behavioral interventions must not only be effective, but also affordable, scalable, and efficient to meet the demand for these services. An innovative approach to intervention science is needed. The purpose of this article is to introduce the multiphase optimization strategy (MOST) to the field of child maltreatment prevention. MOST is an engineering-inspired framework for developing, optimizing, and evaluating multicomponent behavioral interventions. MOST enables intervention scientists to empirically examine the performance of each intervention component, independently and in combination. Using a hypothetical example of a home visiting intervention and artificial data, this article demonstrates how MOST may be used to optimize the content of a parent-focused in-home intervention and the engagement strategies of an intervention to increase completion rate to identify an intervention that is effective, efficient, economical, and scalable. We suggest that MOST will ultimately improve prevention science and hasten the progress of translational science to prevent child maltreatment.When Home is Not Safe: Media Coverage and Issue Salience of Child Maltreatment during the COVID-19 Pandemic
AbstractMadden, S., Guastaferro, K., Skurka, C., & Myrick, J. G. (n.d.).Publication year
2021Journal title
Howard Journal of CommunicationsVolume
32Issue
5Page(s)
474-492AbstractWhile staying at home is crucial for controlling the COVID-19 pandemic, there is concern that such public health measures may increase the risk for child maltreatment (CM). Using a qualitative content analysis of news coverage and a quantitative survey (N = 250) of media consumers, this study explored the framing of CM as an issue during COVID-19, as well as audience recall and perceived efficacy to prevent maltreatment. Findings from the content analysis indicate that domestic violence and CM are frequently discussed together, and that less frequent interaction with mandatory reporters during the pandemic was often cited as a problem. Survey results suggest that social media and public service announcements are more important compared to news media for increasing audience perceptions of salience and efficacy around CM during a pandemic. Implications for studying media coverage of intertwined public health issues, like a pandemic and CM, are discussed.Black First-Year College Students’ Alcohol Outcome Expectancies
AbstractThorpe, S., Tanner, A. E., Ware, S., Guastaferro, K., Milroy, J. J., & Wyrick, D. L. (n.d.).Publication year
2020Journal title
American Journal of Health EducationVolume
51Issue
2Page(s)
78-86AbstractBackground: Alcohol outcome expectancies (AOEs) are associated with college students’ varied alcohol consumption. Existing research on AOEs focuses primarily on heterosexual White students. Thus, it is important to explore how the intersection of multiple identities such as race, gender, and sexual orientation influence the endorsement of specific AOEs. Purpose: This paper examines AOEs among Black first-year college students, with specific attention to the influence of gender and sexual orientation. Methods: Participants were 307 Black students from four universities in the United States. We conducted bivariate analyses using the 2-factor and 4-factor B-CEOA scale. Results: Most students did not hold positive AOEs such as tension reduction and sexual enhancement. Students were more likely to endorse negative AOEs such as behavioral and cognitive impairment and social risk. Discussion: Black first-year college students reported more negative expectations associated with alcohol use, including those related to negative social risks and consequences. Thus, AOEs may serve as a protective factor against alcohol use among Black college students. Translation to Health Education Practice: Alcohol interventions should be tailored to focus on the intersection of race, gender, and sexual orientation. Culturally relevant alcohol interventions have the potential to reduce the immediate and long-term consequences of alcohol use.Drug Court as an Intervention Point to Affect the Well-Being of Families of Parents with Substance Use Disorders
AbstractGuastaferro, K., Guastaferro, W. P., Brown, J. R., Holleran, D., & Whitaker, D. J. (n.d.).Publication year
2020Journal title
Substance Use and MisuseVolume
55Issue
7Page(s)
1068-1078AbstractBackground: A high proportion of justice-involved individuals have a substance use disorder and many of those individuals serve in a caregiving role to a child under 18. Given the negative impact of substance use and justice-involvement on the wellbeing of children, the criminal justice system may offer a unique intervention point with high public health impact. This study describes characteristics of adult drug court participants (DCP) that affect the wellbeing of their children and families and compares the DCP parenting and mental health characteristics to their child’s other caregiver in order to understand how parenting differs within drug court families. Method: Data were collected from a sample of 100 DCP; 58 had a matched other caregiver. Drug court data regarding substance use and criminogenic risk/need were collected. Analyses differentiated the parenting behaviors and mental health needs of DCP from other caregivers. Results: The DCP were at moderate to high risk for recidivism and presented with multiple and significant criminogenic and psychosocial functioning needs. Risk for potential maltreatment and poor parenting behaviors were elevated, and significantly higher compared to other caregivers. DCP demonstrated clinically elevated mental health needs, and were significantly different across all indicators of mental health compared to other caregivers. Conclusions: Adult drug courts address the occurrence of substance use disorders but there are additional needs to be intervened upon. Adult drug courts may be a viable intervention point to address issues of parenting and mental health to improve the wellbeing of criminal justice-involved individuals, their children, and families.Engagement in Home Visiting Services during the Transition from Pregnancy to Postpartum: A Prospective Mixed Methods Pilot Study
AbstractDamashek, A., Kothari, C., Berman, A., Chahin, S., Lutzker, J. R., Guastaferro, K., Whitaker, D. J., Shanley, J., & Self-Brown, S. (n.d.).Publication year
2020Journal title
Journal of Child and Family StudiesVolume
29Issue
1Page(s)
11-28AbstractObjectives: This pilot study used a prospective mixed methods approach to examine predictors of retention in services during the transition from pregnancy to postpartum. Home visiting programs that serve pregnant women are an important means of improving child and maternal well-being. Providing services to women during the transition from pregnancy to postpartum is particularly important, because children under the age of 1 are at high risk for mortality. Morever, mothers face amplified levels of stress during the postpartum period. Unfortunately, home visiting programs in the United States that support pregnant and postpartum women suffer from high rates of attrition. General research on home visiting engagement suggests that the client-provider relationship is an important factor in predicting client engagement in services; however, few studies have examined factors related to maternal engagement during the transition from pregnancy to postpartum. Methods: Measures administered during pregnancy for 39 pregnant women were used to predict attrition up to 15 months postpartum. Semi-structured interviews were conducted at 3 months postpartum with 33 of the original 39 women to qualitatively assess factors related to engagement in services during the transition from pregnancy to postpartum. Results: Both quantitative and qualitative analyses indicated that clients’ perceptions of the client-provider relationship was a critical factor in maintaining mothers’ engagement in services. Both types of analyses indicated that perceived provider reliability was related to mothers’ engagement in services. Quantitative analyses also found that perceived provider cultural competence predicted engagement in services. Other findings from qualitative analyses indicated that mothers’ perception of the home visitor as trustworthy/supportive, personable/having good communication skills, knowledgeable, and collaborative/flexible, were factors that mothers noted when discussing engagement in services. Conclusions: These results advance the literature on engagement in home visiting services by overcoming some of the limitations of previous literature and may have implications for home visitor training.Engagement in Home Visiting: An Overview of the Problem and How a Coalition of Researchers Worked to Address this Cross-model Concern
AbstractGuastaferro, K., Self-Brown, S., Shanley, J. R., Whitaker, D. J., & Lutzker, J. R. (n.d.).Publication year
2020Journal title
Journal of Child and Family StudiesVolume
29Issue
1Page(s)
4-10AbstractHome visiting is a widely supported intervention strategy for parents of young children who are in need of parenting skill improvement. However, parental engagement limits the potential public health impact of home visiting, as these programs often have low enrollment rates, as well as high attrition and low completion rates for those who enroll in these programs. The Coalition for Research on Engagement and Well-being (CREW) provided support for three pilot projects representing different home visiting models and aspects of engagement. The results of these pilot projects are presented in this special section. The purpose of this commentary is to introduce CREW and highlight the importance of a cross-model project to improve engagement among home visiting programs.itMatters: Optimization of an online intervention to prevent sexually transmitted infections in college students
AbstractWyrick, D. L., Tanner, A. E., Milroy, J. J., Guastaferro, K., Bhandari, S., Kugler, K. C., Thorpe, S., Ware, S., Miller, A. M., & Collins, L. M. (n.d.).Publication year
2020Journal title
Journal of American College HealthVolume
70Issue
4Page(s)
1-11AbstractObjective: To describe an iterative approach to developing an online intervention targeting the intersection of alcohol use and sexual behaviors among first year college students. Methods and Participants: Using the multiphase optimization strategy (MOST), we conducted two iterative optimization trials to: (1) identify candidate intervention components (i.e., descriptive norms, injunctive norms, outcome expectancies, perceived benefits of protective behavioral strategies, and self-efficacy to use strategies); (2) revise components; and (3) identify the optimized intervention. Participants were first year college students at six geographically diverse universities (optimization trial 1 N = 5,880; optimization trial 2 N = 3,551) Results: For both optimization trials, the results indicated that only descriptive and injunctive norms produced a significant effect (p<.05). Conclusions: The iterative process of MOST allowed us to develop an optimized intervention which is an essential tool to maximize intervention effectiveness and efficiency to improve uptake, sustainability, and public health impact.Substance Use and Mental Health Outcomes During Emerging Adulthood Among Individuals With Different Patterns of Child Maltreatment
AbstractGuastaferro, K., & Bray, B. C. (n.d.).Publication year
2020Journal title
Emerging AdulthoodVolume
8Issue
6Page(s)
542-547AbstractThe aim of the current study was to identify patterns of child maltreatment experienced prior to age 18 and examine the relationship between those patterns and substance use and mental health disorders among emerging adults. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III. The analytic sample consisted of 5,194 adults between 18 and 25 years old. Latent class analysis revealed a three-class model: Rare Maltreatment (59%); Occasional Maltreatment, Rare Sexual Abuse (37%); and Frequent Maltreatment, Some Sexual Abuse (4%). Risk of substance use disorders and poor mental health was higher for the two classes who experienced maltreatment; however, those with Frequent Maltreatment had higher risk of poor mental health, but not substance use disorders compared to those with Occasional Maltreatment. Patterns of child maltreatment are important predictors of substance use and mental health disorders in emerging adulthood, but different patterns may necessitate specific intervention efforts.A Methodological Review of SafeCare®
AbstractGuastaferro, K., & Lutzker, J. R. (n.d.).Publication year
2019Journal title
Journal of Child and Family StudiesVolume
28Issue
12Page(s)
3268-3285AbstractObjectives: More than 500,000 children experience neglect each year in the United States, yet few evidence-based parent-training programs focus primarily on preventing and mitigating the risk factors for neglect. A notable exception is SafeCare®. This review focuses on the research designs used at three phases of the SafeCare model: development, evaluation, and dissemination. Methods: Presented in chronological order, the purpose is to highlight the 40-year evidence-base of the SafeCare model and to demonstrate that certain research designs are specific to phases of intervention development. Results: The cumulative evidence from those 40 years for the SafeCare model and its predecessor is powerful. Conclusions: Future research with a variety of experimental designs related to dissemination and implementation research are discussed.A Parent-focused Child Sexual Abuse Prevention Program: Development, Acceptability, and Feasibility
AbstractGuastaferro, K., Zadzora, K. M., Reader, J. M., Shanley, J., & Noll, J. G. (n.d.).Publication year
2019Journal title
Journal of Child and Family StudiesVolume
28Issue
7Page(s)
1862-1877AbstractObjectives: Child sexual abuse (CSA) affects nearly 60,000 children in the U.S. annually. Although prevention efforts targeting adults in the community and school-aged children have been somewhat successful, there is a clear gap in the current prevention efforts: parents. Generalized parent-education (PE) programs have effectively reduced the rates of physical abuse and neglect; however, currently no PE program targets risk factors for CSA specifically. We sought to develop a brief parent-focused CSA prevention module to be added onto existing PE programs thereby leveraging the skills and implementation infrastructure to ensure sustainability. Methods: In three phases, we developed the curriculum, refined content and presentation while simultaneously developing and psychometrically evaluating a measurement tool, and conducted an acceptability and feasibility pilot. These phases are described in detail such that intervention scientists wishing to develop a module to be added onto existing programs can follow our procedures. Results: The results of each phase are described so that the reader can see how information gleaned in one part of a phase informed subsequent phases of research. This was an iterative process of development, refinement, and piloting. Conclusions: The resultant parent-focused CSA prevention module is designed to be added onto extant evidence-based PE programs. The module, and the additive approach of the intervention, will be evaluated in a future randomized controlled trial.Achieving the goals of translational science in public health intervention research: The multiphase optimization strategy (MOST)
Guastaferro, K., & Collins, L. M. (n.d.).Publication year
2019Journal title
American journal of public healthVolume
109Page(s)
S128-S129Is Sexual Abuse a Unique Predictor of Sexual Risk Behaviors, Pregnancy, and Motherhood in Adolescence?
AbstractNoll, J. G., Guastaferro, K., Beal, S. J., Schreier, H. M., Barnes, J., Reader, J. M., & Font, S. A. (n.d.).Publication year
2019Journal title
Journal of Research on AdolescenceVolume
29Issue
4Page(s)
967-983AbstractThis study tested sexual abuse as a unique predictor of subsequent adolescent sexual behaviors, pregnancy, and motherhood when in company with other types of maltreatment (physical abuse, neglect) and alternative behavioral, family, and contextual risk factors in a prospective, longitudinal study of maltreated (n = 275) and comparison (n = 239) nulliparous females aged 14–19 years old assessed annually through 19 years old. Hierarchical regression was used to disentangle risk factors that account for the associations of maltreatment type on risky sexual behaviors at 19 years old, adolescent pregnancy, and adolescent motherhood. Findings indicate that sexual and physical abuse remain significant predictors of risky sexual behaviors, and that sexual abuse remains a significant predictor of adolescent motherhood when alternative explanatory variables are controlled.Modification to a Systematically Braided Parent-support Curriculum: Results from a Feasibility Pilot
AbstractGuastaferro, K., Miller, K., Lai, B. S., Shanley, J., Kemner, A., Whitaker, D. J., & Lutzker, J. R. (n.d.).Publication year
2019Journal title
Journal of Child and Family StudiesVolume
28Issue
7Page(s)
1780-1789AbstractObjectives: There are a variety of parent-support programs designed to improve parenting and, thereby, the safety and well-being of children. Providers trained in multiple programs are likely to select components of interventions they feel will meet the needs of the families they serve leaving out aspects they deem unnecessary or redundant. In so doing, the fidelity of the evidence-based program is at risk. A potential solution is systematic braiding in which evidence-based programs are combined such that the fidelity to each original model and its implementation are maintained. Methods: Drawing on qualitative feedback from a prior iteration, this paper discusses results of a feasibility and acceptability pilot of a modified version of the systematically braided Parents as Teachers and SafeCare at Home (PATSCH) curriculum. This modification removed a provider-perceived “redundant” portion from the original PATSCH curriculum. A pre-post design (N= 18) was used to evaluate the efficacy of the modified curriculum. Results: Significant improvements were seen in trained parent behaviors surrounding home safety and child health. There was also improvement in self-reported parenting behaviors, the portion of the braided curriculum removed, suggesting that the PAT curriculum adequately teaches these skills. Providers and parents were highly satisfied with the modified curriculum. Conclusions: If a curriculum is modified to reflect provider and parent preferences, then the potential for delivery without fidelity is minimized.The effect of substantiated and unsubstantiated investigations of child maltreatment and subsequent adolescent health
AbstractKugler, K. C., Guastaferro, K., Shenk, C. E., Beal, S. J., Zadzora, K. M., & Noll, J. G. (n.d.).Publication year
2019Journal title
Child Abuse and NeglectVolume
87Page(s)
112-119AbstractChildren with substantiated child maltreatment (CM) experience adverse health outcomes. However, it is unclear whether substantiation vs. an investigation not resulting in substantiation has a greater impact on subsequent adolescent health. Propensity scores were used to examine the effect of investigated reports on the subsequent health of 503 adolescent females. CM was categorized into three levels: 1) investigated and substantiated, 2) investigated but unsubstantiated, and 3) no investigation. Models using inverse propensity score weights estimated the effect of an investigation on subsequent teen motherhood, HIV-risk behaviors, drug use, and depressive symptoms. Females with any investigation, regardless of substantiation status, were more likely to become teen mothers, engage in HIV-risk behaviors, and use drugs compared to females with no investigated report. Substantiated CM was associated with depressive symptoms. Findings underscore the importance of maintaining case records, regardless of substantiation, to better serve adolescents at risk for deleterious outcomes. Prospective methods and propensity scores bolster causal inference and highlight how interventions implemented following investigation are an important prevention opportunity.Braiding Two Evidence-Based Programs for Families At-Risk: Results of a Cluster Randomized Trial
AbstractGuastaferro, K., Lai, B. S., Miller, K., Shanley Chatham, J., Whitaker, D. J., Self-Brown, S., Kemner, A., & Lutzker, J. R. (n.d.).Publication year
2018Journal title
Journal of Child and Family StudiesVolume
27Issue
2Page(s)
535-546AbstractChild maltreatment is a significant public health problem best addressed through evidence-based parent-support programs. There is a wide range of programs with different strengths offering a variety of options for families. Choosing one single evidence-based program often limits the range of services available to meet the unique needs of families. This paper presents findings from a study to examine the systematic braiding of two evidence-based programs, Parents as Teachers and SafeCare at Home (PATSCH), with the goal to provide a more robust intervention for higher risk families. A cluster randomized effectiveness trial was conducted to examine if PATSCH improved parenting behaviors known to decrease the risk for child maltreatment compared to Parents as Teachers (PAT) Alone. Parents (N = 159; 92 PAT Alone; 67 PATSCH) were enrolled to complete a baseline, 6-month and 12-month assessment. Results indicate the groups did not differ on number of environmental hazards in the home, parents’ health care decision-making abilities, child abuse potential, and physical assault over time. However, with regard to the potential for child abuse, the PATSCH group showed a decrease in nonviolence discipline and increase in psychological aggression compared to the PAT group. Further research is needed to better examine this concept and its implications for the field.Linking Patterns of Substance Use With Sexual Risk-Taking Among Female Adolescents With and Without Histories of Maltreatment
AbstractRivera, P. M., Bray, B. C., Guastaferro, K., Kugler, K., & Noll, J. G. (n.d.).Publication year
2018Journal title
Journal of Adolescent HealthVolume
62Issue
5Page(s)
556-562AbstractPurpose: This study aimed to determine the associations between patterns of substance use and sexual risk-taking among female adolescents with and without histories of maltreatment. Methods: Data are from a prospective cohort study examining the impact of maltreatment on subsequent female adolescent sexual health (N = 504). Participants averaged 18.24 years in age (SD = 1.12), and approximately 63% had substantiated incidences of maltreatment filed with Child Protective Services prior to age 18. The present study used latent class analysis to examine patterns in adolescent substance use, and negative binomial regression models to examine the links between patterns of substance use and sexual risk-taking and to determine whether these associations were moderated by adolescents' maltreatment status. Results: Six classes emerged from latent class analysis labeled as follows: abstainers (25% of sample); polysubstance users—early initiators (13%); polysubstance users—late initiators (23%); alcohol and cannabis users—late initiators (9%); alcohol users—late initiators (18%); and tobacco users (12%). Patterns of adolescent polysubstance use were associated with the highest levels of sexual risk-taking, and patterns of late-initiated polysubstance use, late-initiated alcohol use, and tobacco use were more strongly related to sexual risk-taking for female adolescents with histories of maltreatment. Conclusions: This study is the first to determine the specific patterns of substance use that are more strongly related to sexual risk-taking for maltreated female adolescents. By doing so, this study demonstrates how a person-centered approach can facilitate our understanding of how to best leverage sexual risk-taking prevention efforts.Implementing a braided home-based parent-support curriculum: Lessons learned
AbstractGuastaferro, K., Miller, K., Lutzker, J. R., Whitaker, D. J., Shanley Chatham, J., Lai, B. S., & Kemner, A. (n.d.).Publication year
2017Journal title
Psychosocial InterventionVolume
26Issue
3Page(s)
181-187AbstractA singular parent-support program is limited in its ability to address multiple child and family needs. One innovative solution is braiding, a process in which two evidence-based programs are systematically combined as a newly tailored, cohesive curriculum. In this paper we describe the systematic braiding of two parent-support curricula, Parents as Teachers® and SafeCare®. We highlight implementation challenges to inform future planning and braiding efforts. Based on qualitative data (n = 13), we discuss five lessons learned, including identifying a pedagogical approach and sustainability at the model- and site-level. Implications and future directions for braiding and implementation are also discussed.Systematic Braiding of 2 Evidence-Based Parent Training Programs: Qualitative Results from the Pilot Phase
AbstractGuastaferro, K., Miller, K., Shanley Chatham, J. R., Whitaker, D. J., McGilly, K., & Lutzker, J. R. (n.d.).Publication year
2017Journal title
Family and Community HealthVolume
40Issue
1Page(s)
88-97AbstractAn effective approach in early intervention for children and families, including child maltreatment prevention, is home-based services. Although several evidence-based programs exist, they are often grouped or delivered together, despite having different foci and approaches. This article describes the development and pilot phases of a trial evaluating the systematic braiding of 2 evidence-based home-based models, SafeCare and Parents as Teachers. We describe the methodology for braiding model implementation and curriculum, specifically focusing on how structured qualitative feedback from pilot families and providers was used to create the braided curriculum and implementation. Systematic braiding of 2 models at the implementation and curriculum levels is a mechanism that has the potential to meet the more comprehensive needs of families at risk for maltreatment.Child maltreatment prevention
AbstractMorales, Y., Lutzker, J. R., Shanley, J. R., & Guastaferro, K. M. (n.d.). In Children and Childhood (1–).Publication year
2016Page(s)
75-88AbstractChild maltreatment is a significant public health problem, with almost 25% of all reports occurring in Latino families. Child maltreatment and intimate partner violence (IPV) often co-occur, and the sequelae of IPV frequently appear in the victimized mother and her children. Home visitation programs such as SafeCare® are intervention strategies to reduce the risk of child maltreatment, but these programs are rarely adapted for Latino populations. The importance of cultural sensitivity in parenting programs has been highlighted as a means of producing successful outcomes when working with Latino families. The present study includes multiple methods: a single-case research design study evaluated the effects of the SafeCare Parent-Infant Interaction (PII) module when delivered in Spanish to a Latino mother with prior IPV experiences; self-reported quantitative measures assessed exposure to IPV and changes in mental health, parenting stress, and the risk of child maltreatment; and qualitative data provided suggestions for culturally adapting PII for Latino families. Data from this study suggest that PII improves parent-infant interactions when delivered in Spanish and can reduce the risk of child maltreatment. Additionally, self-reported measures confirmed that IPV, parent mental health distress, and the risk of child maltreatment co-occur and can be reduced with PII. This study suggests the importance of providing culturally adapted programs when working with Latino families.Maternal substance abuse, recovery and handling their children’s Illnesses
AbstractStrong, L. E., Lutzker, J. R., Jabaley, J. J., Shanley, J. R., Self-Brown, S., & Guastaferro, K. M. (n.d.). In Public Health (1–).Publication year
2016Page(s)
55-68AbstractParents with a history of substance abuse are at high-risk for child maltreatment, including the neglect of their child’s health (medical neglect). Additionally, these parents are likely to have low health literacy levels, possibly further jeopardizing risk to their child’s health. This research examined the effectiveness of the SafeCare® Health Module for mothers in a residential recovery facility. Two mothers with children under age five were trained to 1) identify child health symptoms and illnesses and 2) to determine the most appropriate course of care. Using a multiple-baseline, single-case research design, mothers were evaluated in their ability to select the most appropriate care setting using decision-making behaviors in response to a prompted child health scenario. The mothers showed steady improvement in skill acquisition. Future research directions and intervention implementation implications are discussed.