what outcomes are important for cacs?: survey results and implications ted cross, ph.d. lisa jones,...
TRANSCRIPT
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What Outcomes Are Important What Outcomes Are Important for CACs?: for CACs?:
Survey Results and Survey Results and ImplicationsImplications
Ted Cross, Ph.D.
Lisa Jones, Ph.D.
Crimes Against Children Research Center
University of New HampshireSeventeenth National Symposium on Child Sexual Abuse
Huntsville, Alabama March 13-16, 2001
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Children’s Advocacy CentersChildren’s Advocacy CentersPlay an Important RolePlay an Important Role
In 2000…
– 105,039 children received services
from CACs
– in 362 affiliated centers representing…
– 48 states, DC, and U. S. Virgin Islands
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Growth of CACsGrowth of CACs
0
50
100
150
200
250
300
350
400
1994 2000
Number ofNCACenters
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Many Other Organizations Many Other Organizations Use Components of CACsUse Components of CACs
Multi-disciplinary investigation teams
Child-friendly facilities
Case review
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Important Questions About Important Questions About CACsCACs
What is the impact of CACs on children, families, and partner agencies?
What is the impact of CACs on the prosecution of child abuse and the court system?
Are there other important outcomes of CACs for their community?
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National Trend TowardNational Trend Toward Outcomes-Based Outcomes-Based
AccountabilityAccountability Many systems are measuring outcomes
and being evaluated on them– Education– Health Care– Mental Health– Criminal Justice– Child Welfare
CACs are likely to need to examine outcomes
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Evaluation of CAC OutcomesEvaluation of CAC OutcomesMay Help...May Help...
Document the impact of CACs
Refine strategies for helping children
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National Evaluation of National Evaluation of Children’s Advocacy Centers Children’s Advocacy Centers
(CACs)(CACs)
Multi-year, multi-site study of the efficacy of CACs
CACs across the country participating in evaluation
Cases enrolled in the study starting April 2001
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One Step In The National One Step In The National Evaluation:Evaluation:
Survey on CAC OutcomesSurvey on CAC Outcomes
Identifies what outcomes are important to professionals working in CACs
First data from the National Evaluation Project
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Development of the Outcome Development of the Outcome Survey InstrumentSurvey Instrument
Consulted standards of the National Children’s Alliance
Examined other publications about CACs
Consulted national CAC experts
Survey with 84 outcomes in 6 categories
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2 Phases of CAC Outcomes2 Phases of CAC Outcomes
Investigation outcomes
Post-investigation
outcomes
What happens duringinvestigations?
What happens later?
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3 “Groups” That Have CAC 3 “Groups” That Have CAC OutcomesOutcomes
Children and FamiliesAgenciesCommunities
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6 Categories of CAC Outcomes6 Categories of CAC Outcomes
InvestigationPost-investigation
Children &Families
X X
Agencies X X
Communities X X
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Survey Instrument FormatSurvey Instrument Format
0-100 scaleMost important outcome in each
category was scored 100Least important outcome was rated
relative to the most important outcome
Other outcomes were scored in-between
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Outcomes In The Instrument Outcomes In The Instrument By CategoryBy Category
Investigation Post-investigation
Child & Family 20 outcomes 17 outcomes
Agency 19 outcomes 15 outcomes
Community 13 outcomes 7 outcomes
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RATE THE OUTCOMES SEPARATELY FOR EACH PAGE
Child and Family Investigation Outcomes
On a scale from 0-100, please score the CAC outcomes on this page based on how important you think they are for the CAC in your community. Give a score of “100” to the outcome that is most important to you. Score the outcome that is least important to you between "0" and "100" based on how important it is relative to your most important category. Now rate each of the other outcomes on the page relative to the outcomes you chose as most and least important.
Investigation Outcomes:
Importance:
Fewer interviewers ___________
Fewer repetitive interviews ___________
Fewer interview settings ___________
Shorter interviews ___________
More effective interviews ___________
More thorough investigations ___________
Fewer medical exams ___________
Decreased discomfort/stress for family and child during investigation ___________
Child feels supported by someone on team ___________
Excerpt from theOutcomes Survey
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The SampleThe Sample
Professionals working in or with CACs in the 5 national evaluation communities
Surveys were mailed to professionals identified by each CAC as most knowledgeable about it
69 respondents returned the survey
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Child & Family OutcomesChild & Family Outcomes
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Child and Family Child and Family Investigation OutcomesInvestigation Outcomes
30 40 50 60 70 80 90 100
Shorter interviews
Fewer interviewers
Fewer repetitive interviews
More thorough investigations
More effective investigations
Avg.Avg.
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Child and Family Child and Family Investigation OutcomesInvestigation Outcomes
30 40 50 60 70 80 90
Parent feels morerespected
Parent feelssupported
Child/family feelless distress
Child feelssupported
Avg.Avg.
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Child and Family Child and Family Investigation OutcomesInvestigation Outcomes
30 40 50 60 70 80 90 100
Increased use ofservices
Increasedavailability of
services
Prompt deliveryof services
Avg.Avg.
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Child and Family Child and Family Investigation OutcomesInvestigation Outcomes
Outcomes rated as most important by survey respondents:– Increased quality of the child interview– Increased support for the child– Increased identification and delivery of
needed services during investigationMore important than:
– Specific limitations on interviews (fewer, shorter, etc.)
– Improving experience for non-offending caregiver
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Child and Family Child and Family Post-Investigation OutcomesPost-Investigation Outcomes
30 40 50 60 70 80 90 100
Greater satisfaction by child inprocess
Greater sense of justice by child
Decreased stress by child
Child less likely to experiencerepeat abuse
Avg.Avg.
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Child and Family Child and Family Post-Investigation OutcomesPost-Investigation Outcomes
30 40 50 60 70 80 90 100
Greater justiceexperienced by
family members
Greatersatisfaction by
family members
Decreased stressby familymembers
Avg.Avg.
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Child and Family Child and Family Post-Investigation OutcomesPost-Investigation Outcomes Outcomes rated as most important by
survey respondents:– Decreased chance that child will experience
further abuse.– Improved emotional well-being for child.– Decreased stress for child.
More important than:– Satisfaction and sense of fairness for non-
offending caregivers.
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Agency OutcomesAgency Outcomes
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Important Agency Important Agency Investigation OutcomesInvestigation Outcomes
30 40 50 60 70 80 90 100
Increased inter-agency
communication
Faster firstresponse time
Increased caseinformation
shared
Avg.Avg.
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Important Agency Important Agency Investigation OutcomesInvestigation Outcomes
30 40 50 60 70 80 90 100
Better evidence
More expertise available
Better case dispositions
Accurate decisions aboutallegations
Avg.Avg.
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Less Important Agency Less Important Agency Investigation OutcomesInvestigation Outcomes
30 40 50 60 70 80 90 100
Better location for observation ofinterviews
Improved coordination with DVinvestigations
Decreased investigator burnout
Better understanding of otheragencies
Avg.Avg.
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Agency Investigation OutcomesAgency Investigation Outcomes
Outcomes rated as most important by survey respondents:– Faster response time– Increased case information shared, inter-
agency communication,– Better expertise, better evidence and
more accurate decisions– Better case dispositions
More important than outcomes one step removed from child and perpetrator
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Important AgencyImportant Agency Post-Investigation Outcomes Post-Investigation Outcomes
30 40 50 60 70 80 90 100
Increased % of confessions
Increased % of convictions at trial
Increased % of substantiated casesfiled for prosecution
Increased % of at-risk childrenprotected
Avg.Avg.
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Less Important Agency Less Important Agency Post-Investigation OutcomesPost-Investigation Outcomes
30 40 50 60 70 80 90 100
Increased % non-child abuse
charges
Increased %dependency
filings
Increasedarraignment
Avg.Avg.
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Agency Agency Post-Investigation OutcomesPost-Investigation Outcomes
Outcomes rated as most important by respondents:– Increased % of at-risk children protected– Increased prosecution, conviction at trial,
confessionsMore important than more specialized
law enforcement or child protection outcomes
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Community OutcomesCommunity Outcomes
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Important Community Important Community Investigation OutcomesInvestigation Outcomes
30 40 50 60 70 80 90 100
Greateradherence to best
practicestandards
More resourcesfor investigation
Avg.Avg.
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Important Community Important Community Investigation OutcomesInvestigation Outcomes
30 40 50 60 70 80 90 100
Better relationships ofprofessionals with investigatory
agencies
More joint training
Better coordination ofinvestigations
Avg.Avg.
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Less Important Community Less Important Community Investigation OutcomesInvestigation Outcomes
30 40 50 60 70 80 90 100
Increaseduniformity in
media relations
Reduced publiccriticism of
investigation
Cross-agencypeer review
Avg.Avg.
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Community Community Investigation OutcomesInvestigation Outcomes
Outcomes rated as most important by survey respondents:– More resources and training for investigation– Adherence to best practice– Coordination & relationships with
professionalsMore important than:
– Cross-agency peer review and uniform media relations
– Reduced public criticism
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Community Community Post-Investigation OutcomesPost-Investigation Outcomes
30 40 50 60 70 80 90 100
More private financial support foragencies
Greater community support forCACs
Growth in public awareness ofchild abuse
More community resources forchild abuse
Avg.Avg.
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Community Community Post-Investigation OutcomesPost-Investigation Outcomes
Outcomes rated as most important by survey respondents:– Increased awareness of child
maltreatment and resources for victims in community
More important than:– Support for CACs– Increased private financial support of
agencies
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How Much Do Professionals How Much Do Professionals Agree on Outcomes?Agree on Outcomes?
Very high agreement on very important outcomes
But people disagreed somewhat about the importance of most outcomes
“Low” importance scores were very important to some people
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More effective interviews
Very high agreement on very high scoresF
req
ue
ncy
10
8
6
4
2
0
Std. Dev = 4.68
Mean = 96
N = 14.00
Everyone ratedMore Effective Interviewsgreater than 80 in this site
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Increased availability of needed services during investigation
98
93
88
83
78
73
68
63
58
53
48
43
38
33
28
23
18
13
8
3
Some disagreement
even on important outcomesF
req
ue
ncy
7
6
5
4
3
2
1
0
Std. Dev = 19.93
Mean = 81
N = 20.00
17 of 20people gavethis > 70
3 people in this sitescored this 50 or less
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Improved coordination with domestic violence investigations
93
83
73
63
53
43
33
23
13
3
"Low" importance scores
were very important to some peopleF
req
ue
ncy
5
4
3
2
1
0
Std. Dev = 21.30
Mean = 73
N = 19.00
5 of 19 peoplescoredthis > 90
Most peoplein this site gavethis low scores
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ConclusionsConclusions
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CACs Have Many Important OutcomesCACs Have Many Important Outcomes
Responding rapidly Coordinating effectively Investigating effectively Making accurate decisions Making appropriate dispositions Reducing child & family stress
(cont.)
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CACs Have Many Important OutcomesCACs Have Many Important Outcomes
Facilitating use of servicesProsecuting offendersReducing risk of re-offendingProviding trainingEncouraging best practice
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Possible Implications of Possible Implications of Numerous Outcomes Numerous Outcomes
CACs have many demands on time and resources
Programs may need to develop gradually over time
Different CACs may specialize in different outcomes
CACs role in community larger than coordinating investigations
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Lack of Consensus on Lack of Consensus on OutcomesOutcomes
Lack of consensus on the importance of many outcomes underlines the need for coordination, communication and relationship-building
CACs may need to accommodate small groups of their participants invested in specific outcomes
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No Simple BenchmarkNo Simple Benchmark
Important outcomes tend to be holistic: quality of response and child well-being
There is no simple benchmark
Number of interviews is potentially a misleading indicator
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Implications for Implications for Program EvaluationProgram Evaluation
No simple measure of CAC success may exist
Given the number of outcomes, CACs may need to do a number of small, focused evaluations over time