Transcript The North Carolina Family Assessment Scale

The North Carolina Family
Assessment Scale
based on the work of
Raymond S. Kirk, Ph.D.
Clinical Professor
with Mark W. Fraser Ph.D.
John A. Tate Distinguished Professor for
Children in Need
7/17/2015
1
How Do We Know if Intensive
Family Preservation Services
(IFPS) Really Work?
What would you want to measure?
7/17/2015
2
North Carolina Family
Assessment Scale (NCFAS)(ReedAshcraft, Kirk, & Fraser, 2001)
• Comprehensive family functioning and outcome
instrument specifically designed for IFPS
• Developed by providers, policy makers, evaluators
• Shown to have
– internal consistency
– construct and concurrent validity
• 5 domains
• Each variable rated on 6 point ordinal scale (2=clear
strength, to -3= serious problem)
Research to Teaching
NCFAS Domains
• Environment, e.g.
– housing stability and habitability,
income/employment, adequacy of
food/nutrition, learning environment,
transportation
• Parental Capabilities, e.g.
– parenting skill, adult supervision
Research to Teaching
NCFAS Domains
• Family Interactions, e.g.
– mutual support, bonding with child, expectation
of child
• Family Safety, e.g.
– sexual abuse of child, domestic violence
• Child Well-Being, e.g.
– child’s behavior, school performance, child
mental health
Research to Teaching
NCFAS in Action (NC DHHS, 2001)
• North Carolina IFPS evaluated using
NCFAS V2.0
• Family evaluated at beginning of service,
and at conclusion
• Looked at absolute score, and change score
Research to Teaching
NCFAS and NC IFPS
Evaluation
Figure 6: Environment Ratings at Intake and Closure (N=523)
50.0
45.0
40.0
35.1
Percent of Families
35.0
30.0
23.8
25.0
20.2
19.0
20.0
19.6
17.1
16.1
15.9
15.0
13.6
9.5
10.0
8.1
5.0
2.1
0.0
Clear S.
Mild S.
Baseline A.
Intake
Research to Teaching
Mild P.
Moderate P.
Closure
Serious P.
NCFAS and NC IFPS
Evaluation
Figure 7: Parental Capabilities Ratings at Intake and Closure (N=523)
50.0
45.0
40.0
Percent of Families
35.0
28.5
30.0
25.6
25.0
26.0
24.2
20.7
20.0
17.6
18.6
13.9
15.0
8.4
10.0
8.8
5.1
5.0
2.7
0.0
Clear S.
Mild S.
Baseline A.
Intake
Research to Teaching
Mild P.
Moderate P.
Closure
Serious P.
NCFAS and NC IFPS
Evaluation
Figure 8: Family Interactions Ratings at Intake and Closure (N=523)
50.0
45.0
40.0
Percent of Families
35.0
30.0
26.2
25.0
24.9
25.0
23.5
21.9
19.0
20.0
16.5
15.0
15.0
9.7
10.0
9.5
5.0
5.0
3.7
0.0
Clear S.
Mild S.
Baseline A.
Intake
Research to Teaching
Mild P.
Moderate P.
Closure
Serious P.
NCFAS and NC IFPS
Evaluation
Figure 9: Family Safety Ratings at Intake and Closure (N=523)
50.0
45.0
40.0
35.0
Percent of Families
30.7
30.0
25.4
25.0
23.3
21.3
19.4
20.0
15.5
15.0
12.3
14.7
14.1
12.9
10.0
7.2
5.0
3.1
0.0
Clear S.
Mild S.
Baseline A.
Intake
Research to Teaching
Mild P.
Moderate P.
Closure
Serious P.
NCFAS and NC IFPS
Evaluation
Figure 10: Child Well-Being Ratings at Intake and Closure (N=523)
50.0
45.0
40.0
Percent of Families
35.0
30.0
26.6
25.6
26.4
26.2
25.0
21.0
20.0
17.9
15.7
14.6
15.0
10.0
5.0
8.5
7.8
6.8
2.9
0.0
Clear S.
Mild S.
Baseline A.
Intake
Research to Teaching
Mild P.
Moderate P.
Closure
Serious P.
NCFAS and NC IFPS
Evaluation
Figure 11. Level of Change Experienced by Families on NCFAS Domain Scores
(N=523)
70
Environment
57.6
60
Parental Capabilities
Family Interactions
Family Safety
Child Well-Being
50
Percent of Families
45.4
40
37.5
33.6
34.2
32.8
32.2
29.3
30
26.6
23.4
17.8
15.9
15.9
15.0
20
15.7
11.6 12.4
8.9
10
4.7 3.9 4.9
3.3 3.3
8.8
5.5
0
-1 or more
Research to Teaching
0
1
2
3 or more
NCFAS and NC IFPS
Evaluation
Figure 12. Overall Change on the NCFAS (N=523)
100
90
80
75.5
74.8
70
Percent of Families
62.5
60
61
58.9
60.8
48.5
50
40
29.1
30
29.7
26.4
20
10
0
Environment
Parental Capabilities
Baseline or Above @ Intake
Research to Teaching
Family Interactions
Family Safety
Child Well-Being
Baseline or Above @ Closure
Do Score Changes Relate to
Placement Outcomes?
• Significant relationship between strengths and
absence of placement, and problems and out-ofhome placement
•
•
•
•
•
Environment: chi square=8.346, df=5, p=.138
Parental Capabilities: chi square=27.352, df=5, p=<.001
Family Interactions: chi square=47.573, df=5, p=<.001
Family Safety: chi square=46.703, df=5, p=<.001
Child Well-Being: chi square=58.613, df=5, p=<.001
Research to Teaching
Conclusions
• NC IFPS can improve family functioning,
incrementally, in all domains measured by
NCFAS
• Parental Capabilities, Family Interactions,
Child Well-Being, seem more amenable to
change during this brief intervention
• NCFAS scores associated with placement
outcomes at end of IFPS
Research to Teaching