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
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.Mothers recovering from substance abuse and child maltreatment
AbstractStrong, 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
2016Page(s)
133-146AbstractParents 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
AbstractGuastaferro, K. M., Lutzker, J. R., & Graham, M. L. (n.d.).Publication year
2016Journal title
Child and Family Behavior TherapyVolume
38Issue
1Page(s)
15-31AbstractEffective 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
AbstractGuastaferro, W. P., Guastaferro, K. M., & Stuart, D. (n.d.).Publication year
2015Journal title
Journal of Crime and JusticeVolume
38Issue
1Page(s)
137-161AbstractThere 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
2014Journal title
JAMA PediatricsVolume
168Issue
6Page(s)
512-514Teaching young mothers to identify developmental milestones
AbstractGuastaferro, K. M., Lutzker, J. R., Jabaley, J. J., Shanley, J. R., & Crimmins, D. B. (n.d.). In Disability and Chronic Disease (1–).Publication year
2013Page(s)
9-22AbstractEarly 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
AbstractGuastaferro, K. M., Lutzker, J. R., Graham, M. L., Shanley, J. R., & Whitaker, D. J. (n.d.).Publication year
2012Journal title
Psychosocial InterventionVolume
21Issue
2Page(s)
171-180AbstractSafeCare 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.