In addition, the majority of Americans (67 percent) believe that lack of parenting experience or skills is among the primary reasons for child abuse and neglect (see table 1). Lack of experience and skills in proper parenting was the second most cited reason for abuse and neglect, behind drug and alcohol abuse, according to the study commissioned by Prevent Child Abuse America. Results of the study were released by the organization on the eve of April’s observance of Child Abuse Prevention Month at a news conference at the National Press Club in Washington, D.C.

While 74 percent responded that voluntary home visits by a private or public agency in the first weeks after the birth of their first child would have been useful, only 14 percent reported receiving such support. Of those who did receive such visits, 82 percent described them as useful. Sixty percent of new parents received donations of food, clothing or baby equipment during the first six months after the birth of their child.

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"As a society, we’re good at helping parents make sure the baby dresses well and is fed properly," said A. Sidney Johnson III, executive director of Prevent Child Abuse America. "But when it comes to helping them learn how to become good parents, they’re on their own."

Seventy-two percent of American parents surveyed would have welcomed a visit by a home visitor in their hospital rooms after the birth of their first child to determine if they wanted or needed any help in caring for the child. More than three out of four Americans believe that public funding should be available to make home visits available on a voluntary basis to parents who want to learn more about caring for their newborns and nearly one-half (47 percent) approve strongly of such public support.

One program aimed at providing the assistance parents say they want in the first years of their child’s lives is Healthy Families America (HFA), an initiative of Prevent Child Abuse America. The program offers voluntary home visitation services to expectant and new parents to promote positive parenting, improve child health and development, and reduce child abuse and neglect. The program is currently available to more than 20,000 families nationwide through 320 sites in 39 states.

HFA provides voluntary home visitor services for new parents through networks of statewide systems. HFA offers parenting education and support services, tailored to the specific needs of a family and provided on a voluntary basis in the home.

Among the range of services that may be provided by HFA home visitors are the following: linking families with primary care physicians, healthcare services, and other social services in the community; tips on how to care for a new baby; advice on positive parenting; counseling and support on responding to a child’s needs; and stress management.

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Ongoing research of Healthy Families America shows positive results, according to a report by Deborah Daro of the Chapin Hall Center for Children and Kathryn Harding of the National Center on Child Abuse Prevention Research, an arm of Prevent Child Abuse America. The review of HFA evaluation studies is scheduled to appear in "The Future of Children: Volume 8" to be published in May 1999 by the David and Lucile Packard Foundation.

The results are particularly strong in the area of parent-child interaction and parental capacity. According to Daro and Harding, various studies indicate that those engaged in HFA services also showed a significant decrease in their overall potential for child maltreatment and parental stress. Other findings reported as a result of 17 HFA evaluations indicate health benefits for children whose parents participate in HFA, as shown by the following:

• 90 percent or more of the children whose parents are enrolled are up-to-date on their immunizations (By comparison, 77.5 percent of all children and 70 percent of those below the poverty line are up-to-date on their immunizations.)
• 90 percent or more are keeping appointments for well-baby check-ups
• More than 94 percent of parents have identified an appropriate and stable source of medical care for their child

According to Daro and Harding, most HFA programs and evaluations have been ongoing for less than three years, making definitive findings regarding initial or long-term program impacts impossible. "Within this context, however, these initial findings suggest that continued program development along the lines implied by the HFA model offer significant hope for reducing child maltreatment rates and enhancing parental capacity," wrote Daro and Harding.

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Results are particularly dramatic among participants who enrolled in the HFA program during the prenatal period. In one Virginia HFA program, for example, participants who were enrolled prenatally experienced fewer birth complications, delivered a greater number of full-term babies and had fewer low birth weight babies.

"We’re greatly encouraged by the results we’re seeing with regard to Healthy Families America," said Johnson. "Certainly we have a long way to go before we can really measure the long-term impact of the program. But the preliminary research appears to illustrate that HFA is effective in promoting positive parenting, fostering the health and development of the child, and preventing child abuse and neglect before they have a chance to materialize."

With ongoing, sustained support from the Freddie Mac Foundation, and others, the initiative was launched in 1992 in partnership with Ronald McDonald House Charities. The American Academy of Pediatrics has described Healthy Families America as "one of the most hopeful and promising developments that has occurred in the recent memory of those working in the field of child maltreatment."

Source: Kirkpatrick, Kevin (1999, March). 1999 Public Awareness Survey. Chicago: Prevent Child Abuse America.