Kate Guastaferro

Assistant Professor of Social and Behavioral Sciences

Associate Director of the Center for the Advancement and Dissemination of Intervention Optimization

Professional overview

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.

Education

Postdoctoral Fellow, Prevention and Methodology Training Program (T32 DA017629), The Pennsylvania State University

PhD Public Health, Georgia State University

MPH Health Promotion, Georgia State University

BA Anthropology, Boston University

Honors and awards

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)

Publications

Publications

The effect of substantiated and unsubstantiated investigations of child maltreatment and subsequent adolescent health

Kugler, K. C., Guastaferro, K., Shenk, C. E., Beal, S. J., Zadzora, K. M., & Noll, J. G. (n.d.).

Publication year

2019

Journal title

Child Abuse and Neglect

Volume

87

Page(s)

112-119

10.1016/j.chiabu.2018.06.005

Abstract

Abstract

Children 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

Guastaferro, K., Lai, B. S., Miller, K., Shanley Chatham, J., Whitaker, D. J., Self-Brown, S., Kemner, A., & Lutzker, J. R. (n.d.).

Publication year

2018

Journal title

Journal of Child and Family Studies

Volume

27

Issue

2

Page(s)

535-546

10.1007/s10826-017-0886-2

Abstract

Abstract

Child 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

Rivera, P. M., Bray, B. C., Guastaferro, K., Kugler, K., & Noll, J. G. (n.d.).

Publication year

2018

Journal title

Journal of Adolescent Health

Volume

62

Issue

5

Page(s)

556-562

10.1016/j.jadohealth.2017.11.293

Abstract

Abstract

Purpose: 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

Guastaferro, K., Miller, K., Lutzker, J. R., Whitaker, D. J., Shanley Chatham, J., Lai, B. S., & Kemner, A. (n.d.).

Publication year

2017

Journal title

Psychosocial Intervention

Volume

26

Issue

3

Page(s)

181-187

10.1016/j.psi.2017.03.001

Abstract

Abstract

A 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

Guastaferro, K., Miller, K., Shanley Chatham, J. R., Whitaker, D. J., McGilly, K., & Lutzker, J. R. (n.d.).

Publication year

2017

Journal title

Family and Community Health

Volume

40

Issue

1

Page(s)

88-97

10.1097/FCH.0000000000000129

Abstract

Abstract

An 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

Morales, Y., Lutzker, J. R., Shanley, J. R., & Guastaferro, K. M. (n.d.). In Children and Childhood (1–).

Publication year

2016

Page(s)

75-88

Abstract

Abstract

Child 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

Strong, 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

2016

Page(s)

55-68

Abstract

Abstract

Parents 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.

Mothers recovering from substance abuse and child maltreatment

Strong, L. E., Lutzker, J. R., Jabaley, J. J., Shanley, J. R., Self-Brown, S., & Guastaferro, K. M. (n.d.). In Children and Childhood (1–).

Publication year

2016

Page(s)

133-146

Abstract

Abstract

Parents 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.

Using a Technological Augmentation to Enhance Parent-Infant Interactions With Parents at Risk

Guastaferro, K. M., Lutzker, J. R., & Graham, M. L. (n.d.).

Publication year

2016

Journal title

Child and Family Behavior Therapy

Volume

38

Issue

1

Page(s)

15-31

10.1080/07317107.2016.1135698

Abstract

Abstract

Effective parent training programs may need to be tailored for at-risk parents by using simple language, presenting concrete concepts, and simple technologies. We present four single-case research-design studies examining if the use of digital frames enhances parent-infant interactions with a diverse range of mothers with varied levels of risk for maltreatment. Based on self-modeling, the frames contain photographs of mother-infant dyads in posed interactions representing desired criterion behaviors from the parent-infant interaction (PII) module of SafeCare®. Results indicate that the use of inexpensive digital frames appears to enhance already good outcomes of the SafeCare PII module.

An exploratory study of grandparents raising grandchildren and the criminal justice system: A research note

Guastaferro, W. P., Guastaferro, K. M., & Stuart, D. (n.d.).

Publication year

2015

Journal title

Journal of Crime and Justice

Volume

38

Issue

1

Page(s)

137-161

10.1080/0735648X.2014.909082

Abstract

Abstract

There are nearly one million grandparents living with their grandchildren without either parent present in the household according to the 2010 US Census. Furthermore, approximately 10% of these grandparents are the primary caregivers of their grandchildren due to a parent's incarceration. Yet, our understanding of grandparents raising grandchildren in relation to the criminal justice system is limited. The present research is an exploratory qualitative study of five grandparents raising grandchildren in these circumstances. Each grandparent was interviewed individually and all participated in a focus group. We first sought to shed light on the context in which the grandparent gained caregiving responsibilities. The findings indicate that the arrest of the parent was not the initiating event. We then examined the networks and services accessed when attempting to meet the multiple health, behavioral health, and financial needs of their grandchildren. Findings indicate that both formal and informal networks were utilized. There were several missed opportunities for intervention and coordinated service delivery by the social services and criminal justice systems. Research and policy implications are also discussed.

MoreWork needed to protect children but promising trend data on exposure to violence

Lutzker, J. R., Guastaferro, K., & Whitaker, D. J. (n.d.).

Publication year

2014

Journal title

JAMA Pediatrics

Volume

168

Issue

6

Page(s)

512-514

10.1001/jamapediatrics.2013.5330

Teaching young mothers to identify developmental milestones

Guastaferro, K. M., Lutzker, J. R., Jabaley, J. J., Shanley, J. R., & Crimmins, D. B. (n.d.). In Disability and Chronic Disease (1–).

Publication year

2013

Page(s)

9-22

Abstract

Abstract

Early identification of a developmental delay may allow for early intervention, a strategy shown to improve child outcomes. Often, pediatricians rely on parent observations to share concerns about development. The purpose of this research was to examine whether a combination of line-art drawings and discussion framed within SafeCare® increases a mothers' identification of developmental milestones. Thus, we examined the tDevelop, a tool designed to increase parent identification of developmental milestones and ageappropriate activities. Two high-risk families with children approximately 24-months of age were recruited from a residential program for young mothers. The mothers were presented with the tDevelop along with standard SafeCare® Parent-Child Interaction (PCI) information, including Planned Activities Training and age-appropriate activities. Data from a multiple-probe, single-case experimental design, suggest that mothers are able to recognize developmental milestones with increased accuracy upon intervention with the tDevelop. The enhanced PCI protocol may enhance parental identification of developmental milestones and may have significant implications for the early identification of developmental delays.

SafeCare®: Historical perspective and dynamic development of an evidence-based scaled-up model for the prevention of child maltreatment

Guastaferro, K. M., Lutzker, J. R., Graham, M. L., Shanley, J. R., & Whitaker, D. J. (n.d.).

Publication year

2012

Journal title

Psychosocial Intervention

Volume

21

Issue

2

Page(s)

171-180

10.5093/in2012a17

Abstract

Abstract

SafeCare is an evidence-based parent-training program that reduces child maltreatment, particularly neglect. The risk of child maltreatment, a public health issue affecting millions of U.S. children each year, can be markedly reduced by interventions such as SafeCare that deliver in-home services. Drawing from applied behavioral analysis roots, SafeCare focuses on providing parents with concrete skills in three areas: health, home safety, and parent-child/-infant interaction. This paper will include an overview of the SafeCare model, an historical perspective of its history and dynamic development, description of the theoretical underpinnings of the model, a description of the program targets and content by describing its modules and delivery, an overview of program outcomes, and data discussion of dissemination and implementation.