The Office of

Child Abuse

PREVENTION

ANNUAL REPORT
State Fiscal Year 2011

T
Thisreportres
spectfullysubm
mittedby:

TerryL.C
Cline,PhD AnnnetteWiskJacobi,JD
Commissioner Chief
SecretaaryofHealtha
andHumanServices FamilySupport&PrevventionServicee
StephenW.R
Ronck,MPH SusanGibsonn,MS
DeputyCommmissioner MaternnalChildHealthConsultant
munity&FamilyHealthServvices
Comm FamilySupport&PrevventionServicee
 The Office of Child Abuse Prevention ANNUAL REPORT | 2

Table of Contents

History of The Office of Child Abuse Prevention 3

Start Right: Promoting Child Well-Being and Safety 4

Parent/Caregiver Health
Child Health & Development
Family Stability
Positive Parenting and Parent-Child Interaction
Family Safety

Home Visitation Services 6

Home Visitation Data
Age and Marital Status of Parents
Number and Age of Children Living in the Household
Household Composition of Families Served
Average Length of Enrollment
Families Declining Participating and Reasons Provided

Center-Based Services 12
Structured Parent Education Groups
Circle of Parents Support Groups
Demographic Data For Families Enrolled
Marital Status
Ethnicity
Gender
Household Income
Number of Families with Children <Six Years of Age in the Home
Employment

Program Costs Per Family 14

Recommendations For Further Development and Improvement 14

Strengths
Challenges

Conclusion 16
Summary of Findings

 The Office of Child Abuse Prevention ANNUAL REPORT | 3

HISTORY
TheOfficeofChildAbusePrevention(OCAP)wascreatedin1984bytheOklahomaChildAbusePreventionAct,Title63,
O.S.Section1227.TheActdeclaredthatthepreventionofchildabuseandneglectwasapriorityinOklahoma.

DuringStateFiscalYear2011,TheOCAPawarded22contracts1tocommunitybasedagenciesforpreventionservicesto
families atrisk for child maltreatment. Services were provided by various agencies such as Oklahoma State University
CooperativeExtensionServices,youth&familyservicesandcountyhealthdepartments.Collectivelytheseprogramsare
known as theStart Right Programs. OCAP staff monitors and evaluates these prevention programs as well as provided
trainingandtechnicalassistancetolocalstaff.

Thisreportincludesthefollowingstatutorilyrequiredinformationanddataelements:
1) Ageandmaritalstatusofparents;
2) Numberandageofchildrenlivinginthehousehold;
3) Householdcompositionoffamiliesserved;
4) Numberoffamiliesacceptedintothehomevisitationservicesbycontractsiteandaveragelengthof
timeenrolled;
5) Numberoffamiliesnotacceptedintotheprogramandthereasonstherefore;and
6 ) Averageexpenditureperfamilyduringthemostrecentfiscalyear.

In addition,recommendations are included for further development and improvement of servicesand programs for the
preventionofchildabuseandneglect.

AllStartRightContractorswererequiredtoprovidetwotypesofpreventionservices:homevisitationandcenterbased.
Themajorityofstafftimeandeffortwasdedicatedtoprovidinghomevisitationservices.Onlyfamilieswithriskfactors
relatedtoabuseandneglectwereenrolledinhomevisitationservicesbecauseevidencehasshowntheybenefitthemost.
Centerbasedservicesmayhavebeenutilizedbyhomevisitedfamiliesasasupplementorhavebeenutilizedbyfamilies
thatdidnotqualifyforhomevisiting.

1
PittsburgCountyHealthDepartment,HealthyFamiliesProgramendedtheircontractDecember31,2010.

 The Office of Child Abuse Prevention ANNUAL REPORT | 4

START RIGHT: PROMOTING CHILD WELL-BEING AND SAFETY

StartRightProgramsservefamiliesthatdemonstratecharacteristicsknowntocontributetohighriskbehaviorsandpoor
health outcomes, as well as risk factors that are associated with child abuse and neglect. The majority of Start Right
families are comprised of a single mother, aged 2029 years, with less than a high school education and an average
householdincomelessthan$5,000.

The following outcome data is specific to State Fiscal Year 2011 unless otherwise noted. In areas where most recent
updatesoccurred,thetimeframevariesforeachfamilydependingontimeofenrollmentandbirthoftheidentifiedchild.

PARENT/CAREGIVER HEALTH
T O B A C C O U S E : Tobaccouseduringpregnancyremainsoneofthesinglemostpreventablecausesofpoorbirth
outcomes,includingpretermdeliveryandlowbirthweight.2StartRighthomevisitorsthatworkwithwomenduringtheir
pregnancyhaveauniqueopportunitybecausewomenaregenerallymoremotivatedtoquitsmokingatthistimeforthe
sakeoftheirbabieshealth.3DuringtheSFY2011,29%ofStartRightparticipantswereattemptingtoreducetheir
smokingattimeofenrollment.Atthemostrecentupdate,40%oftheStartRightparticipantsthatsmokereported
thattheywereattemptingtoreducetheirrateofsmoking.

V E G E T A B L E C O N S U M P T I O N : StartRightencouragesfamiliestoeatmoreproducenotonlyforgoodhealth,butto
modelhealthyeatinghabitsfortheirchildren.Ifafamilyhashealthyfoodreadilyavailableinthehome,thechildismuch
morelikelytomakebetterfoodchoices.Atenrollment,only19%oftheStartRightparticipantsconsumedthe
recommendeddailyservingsofvegetables.Atthemostrecentupdate,22.5%oftheStartRightparticipants
consumedtherecommendeddailyservingsofvegetables.Inaddition,StartRightProgramsreferredfamiliestolocal
foodbanks/pantries,Women,InfantsandChildren(WIC),andothersocialservices.

CHILD HEALTH & DEVELOPMENT

I M M U N I Z A T I O N S : Diseasepreventioniscriticalforoverallpublichealth.Immunizationspreventdiseaseamongthe
childrenthatreceivethemandprotectthosethatcomeincontactwiththem.4Ninetythreepercent(93%)oftheStart
Rightchildrenwereuptodateontheirimmunizations.Only70%ofallOklahomachildrencompletedtheprimaryseries
of15dosesaccordingtotheCentersforDiseaseControl.5

B R E A S T F E E D I N G : StartRightProgramsincludebreastfeedingeducationandsupporttowomeninanefforttopromote
bondingbetweenmothersandtheirinfants.Breastfeedingisalsoknowntoimprovechildrenshealth,decreasepost
partumdepressionanddecreasechildmaltreatment.6AmongthoseStartRightmotherswhogavebirth,72%initiated
breastfeeding.Theoverallstaterateforanywomanwhohadalivebirthandwasbreastfeedingis77%.7Consideringthe
factthatStartRightparticipantsarepartofanatriskpopulation,theStartRightrateshouldbeviewedasasuccess.

2
MarchofDimes.SmokingDuringPregnancy.http://www.marchofdimes.com/professionals/14332_1171.asp
3
OklahomaPregnancyRiskAssessmentMonitoringSystem(PRAMS),MaternalSmoking,Volume9,Number4,OklahomaStateDepartmentofHealth
4
5
HowVaccinesPreventDisease.http://www.cdc.gov/vaccines/vacgen/howvpd.htm
2009NationalImmunizationSurvey,CentersforDiseaseControl.Unpublishedtable.http://www.cdc.gov/vaccines/statsurv/nis/default.htm#nis
6
http://ok.gov/health/child_and_family_health/breastfeeding/why_and_how_long_to_breastfeed/index.html
7
OklahomaPregnancyRiskAssessmentMonitoringSystem(PRAMS),unpublished2009data.MaternalandChildHealthAssessment,OklahomaState
DepartmentofHealth

 The Office of Child Abuse Prevention ANNUAL REPORT | 5

FAMILY STABILITY
The likelihood of a child experiencing maltreatment is often associated with his/her social and economic environment.8
Children from households with lower income and lower parental education and who live in communities with greater
concentrationsofdisadvantagedpeople,housingstress,lowsocialcapitalandlackofsocialsupportaremorelikelytobe
exposedtochildmaltreatment.9

E M P L O Y M E N T : Twentyfourpercent(24%)ofStartRightparticipantswereemployedattimeofenrollment.Atthe
mostrecentupdate,thenumberofparticipantswhowereemployedincreasedto36.2%.

H O U S E H O L D I N C O M E : Atenrollment,23%ofparticipantswereearninganannualincomeof$5,000orless.Atthemost
recentupdate,thenumberofparticipantswhowereearning$5,000orlessdecreasedto15.9%.

H O U S I N G : Atenrollmentfiftyninepercent(59%)oftheStartRightparticipantslivedinrentedhousingand22%owned
theirhome.Atthemostrecentupdate,therateofStartRightparticipantsthatlivedinrentedhousingdecreasedto
55%whiletherateofthosethatownedtheirhomeincreasedto26%.StartRightreferred85familiestoappropriate
servicesforhousingassistanceandreferred91familiestoappropriateservicesforrentandutilityassistance.

POSITIVE PARENTING & PARENT-CHILD INTERACTION

D E P R E S S I O N : Studieshaveshownthatpostnataldepressionaffectsnewmothers,andthatmanyremainuntreated.
Thesemothersmaycopewiththeirbabyandwithhouseholdtasks,itispossiblethattherearelongtermeffectsforthe
child.TheEdinburghPostnatalDepressionScalehasbeendevelopedandisusedtodetectmotherssufferingfrom
postnataldepression;whichisadistressingdisordermoreprolongedthanthebluesthatoccurinthefirstweekafter
delivery.10InSFY2011,786primarycaregiverswerescreenedfordepression.Ofthese,30primarycaregivers(3.8%)
wereidentifiedwithdepressionrelatedconcerns.Thesemotherswerereferredtoaprimarycarephysicianfor
furtherevaluationandtreatment.

FAMILY SAFETY
S A F E S L E E P :InordertoreducetheriskofsleeprelateddeathsfromSuddenInfantDeathSyndromeandaccidental
suffocationandstrangulation,theAmericanAcademyofPediatricsrecommendsthatbabiesbeplacedontheirbackson
theirownfirmsleepingsurfacefreeofsoftbedding.11FamiliesparticipatinginStartRightareroutinelyeducatedabout
safesleeppractices.SixtysixpercentofStartRightparentsplacetheirbabyonhis/herbackcomparedto64.9%ofall
Oklahomaparents.Only18%ofStartRightbabiesalwaysshareasleepspacewithotherssuchastheirparentsor
otherchildrenand40%ofStartRightbabiesnevershareasleepspace.Over20%ofallOklahomababiesalwaysshare
asleepspacewithothersandonly29%nevershareasleepspace.12

8
ABetterStart:ChildMaltreatmentPreventionasaPublicHealthPriority.FrancieZimmerman,TheDorisDukeCharitableFoundation,JamesA.Mercy,
CentersforDiseaseControlandPrevention.http://www.zerotothree.org/maltreatment/childabuseneglect/
9
Kotch,Browne,Ringwalt,Dufort,&Ruina,1997;Runyan,Wattman,Ikeda,Hassan,&Ramiro,2002.Sidebotham&Heron,2006.
http://www.zerotothree.org/maltreatment/childabuseneglect/305zimmerman.pdf.
10
BritishJournalofPsychiatryJune,1987,Vol.150byJ.L.Cox,J.M.Holden,R.Sagovskyhttp://childbirthsolutions.com/articles/edinburghpostnatal
depressionscaleepds/
11
SIDSandOtherSleepRelatedInfantDeaths:ExpansionofRecommendationsforaSafeInfantSleepingEnvironment.
http://aappolicy.aappublications.org/cgi/content/abstract/pediatrics;128/5/e1341?rss=1
12
OklahomaPregnancyRiskAssessmentMonitoringSystem(PRAMS),unpublished2009data.MaternalandChildHealthAssessment,OklahomaState
DepartmentofHealth

 The Office of Child Abuse Prevention ANNUAL REPORT | 6

C A R S A F E T Y : DuringSFY2010,theOklahomaChildDeathReviewBoardreviewedandclosed127casesinvolving
accidentaldeathsofchildrenundertheageof18.Vehicularaccidentscomprised62.2%ofalloftheseaccidentaldeaths.
Ofthosechildrenthatdiedinmotorvehicleaccidents,62%werenotproperlyrestrained.13DuringSFY2011,97%ofall
StartRightparentshadacarsafetyseatproperlyinstalledintheircar.Inaddition,StartRightreferred158families
toappropriateagencies/servicesinordertoobtainacarsafetyseatandassurethatitwasproperlyinstalled.

D O M E S T I C V I O L E N C E : Therehasbeenagrowingawarenessofthecooccurrenceofdomesticviolenceandchild
maltreatment.14Researchsuggeststhatinafamilywhereeitherdomesticviolenceorchildmaltreatmentisidentified,itis
likelythatbothformsofabuseexist.15Studiesshowthatforvictimswhoexperiencesevereformsofdomesticviolence,
theirchildrenalsoareindangerofsufferingseriousphysicalharm.16InSFY2011,16StartRightfamilieswereidentified
andreferredtoDomesticViolenceCrisisIntervention.

HOME VISITATION SERVICES

StartRightProgramsprovideintensivehomevisitationservicesutilizingtheevidencebased,nationallyrecognized
HealthyFamiliesAmerica(HFA)modeltoaddressandminimizetheriskfactorsknowntocontributetochild
maltreatment.HFAisdesignedtoworkwithoverburdenedfamilieswhoareatriskforchildabuseandneglectandother
adversechildhoodexperiences.TheHFAmodelmeetstheneedsoffamilieswhomayhavehistoriesoftrauma,intimate
partnerviolenceandmentalhealthand/orsubstanceabuseissues.HFAservicesareofferedvoluntarilyandhaveastrong
researchbasewhichincludesrandomizedcontroltrialsandwelldesignedquasiexperimentalresearch.In2006,HFAwas
namedaprovenprogrambytheRANDCorporationbasedonresearchconductedontheHealthyFamiliesNewYork
programs.Additionally,theOfficeofJuvenileJusticeandDelinquencyPrevention(OJJDP)haveratedHFAasEffective.17

TheStartRightimplementationofHFAallowsafamilytoenrollinhomevisitationservicesaslongastheyhaveachildin
thehouseholdundertheageofoneyear;however,itisbesttoengageafamilyasearlyaspossibleparticularlyduringthe
prenatalperiod.18

Atthefirstcontact,aninitialscreeningisconductedtodetermineifthefamilyexhibitsriskfactorsassociatedwithchild
maltreatment.Next,theKempeFamilyStressChecklistisusedtouncovermentalhealthissues,criminalandsubstance
abusehistory,childhoodhistory,attitudestowardsandperceptionoftheirchild,disciplinestrategiesandlevelofstressin
theparentslife.Ifhomevisitingisdeemedappropriate,afamilysupportworkerwillprovideweekly,biweeklyormonthly
visitsdependingontheneedsofthefamily.Servicesmaycontinueuntilthechildssixthbirthday.

13
Oklahoma ChildDeathReviewBoardAnnualReport2010.http://www.okkids.org/CDRB/reports.htm

14
Appel,A.E.,&Holden,G.W.(1998).Thecooccurrenceofspouseandphysicalchildabuse:Afeviewandappraisal.JournalofFamilyPsychology,12(4),
578599;Edleson,J.L.(1999).Theoverlapbetweenchildmaltreatmentandwomanbattering.
15
Appel,A.E.,&Holden,G.W.(1998).Cooccurringspouseandchildabuse:ImplicatrionsforCPSpractice.APSACAdvisor,11(1),1114;Edleson,J.L.
(1999);Stark,E.,&Filcraft,A.H.(1988);Hughes,H.M.,Parkinson,D.,&Vargo,M.(1989).Witnessingspouseabuseandexperiencingphysicalabuse:A
doublewhammy?JournalofFamilyViolence,4(2),197209.
16
Barentt,O.W.,MillerPerrin,C.L.&Perrin,R.D.(1997).FamilyViolenceAcrosstheLifespan:AnIntroduction.ThousandOaks,CA:Sage;Hughes,H.M.
etal.(1989)
17
HealthyFamiliesAmericaOverview.http://www.healthyfamiliesamerica.org/about_us
18
StartRightcontractsrequirethatallparentsqualifyingforChildrenFirst(C1)Program(OklahomasNurseFamilyPartnership)bereferredtothat
programinordertoavoidduplicationofservices.C1isastatefundedhomevisitationprogramfocusingonlowincomemothersexpectingtheirfirst
child.Mothersmayenrolluptothe29thweekofpregnancy.

 The Office of Child Abuse Prevention ANNUAL REPORT | 7

-- HOME VISITATION DATA --

AGE AND MARITAL STATUS OF PARENTS

A G E : Thecaregiversagemaybeariskfactorforsomeformsofmaltreatment.Somestudiesofphysicalabusein
particularhavefoundthatmotherswhowereyoungeratthebirthoftheirchildexhibitedhigherratesofchildabusethan
didoldermothers.19Othercontributingfactors,suchaslowereconomicstatus,lackofsocialsupport,andhighstress
levelsmayinfluencethelinkbetweenyoungerchildbirthparticularlyteenageparenthoodandchildabuse.20Thetable
belowindicatesthatStartRightisreachingthisvulnerablepopulation.

AGE OF PARENTS NEW CLIENTS RETURNING CLIENTS CLIENTS WITH UNKNOWN TOTAL CLIENTS
START DATE
N % N % N % N %
Under 16 21 4.0 2 0.4 0 0 23 1.9
16-19 143 27.1 76 13.6 4 2.6 223 18.0
20-29 270 51.1 339 60.9 91 59.9 700 56.6
30-39 87 16.5 116 20.8 44 28.9 247 20.0
40 and Over 7 1.3 24 4.3 13 8.6 44 3.6
Missing 0 0.0 0 0.0 0 0 0 0.0
TOTAL 528 100% 557 100% 152 100% 1,237 100%

M A R I T A L S T A T U S : OvertwothirdsofprimarycaregiversinStartRightareunmarried.Singleparenthouseholdsare
substantiallymorelikelytohaveincomesbelowthepovertyline.Lowincome,theincreasedstressassociatedwiththe
soleburdenoffamilyresponsibilities,andfewersupportsarethoughttocontributetotheriskofsingleparents
maltreatingtheirchildren.21

MARITAL STATUS NEW CLIENTS RETURNING CLIENTS CLIENTS WITH UNKNOWN TOTAL CLIENTS
START DATE
N % N % N % N %
Married 124 23.5 187 33.6 89 58.6 400 32.3
Widowed 0 0 2 0.4 1 0.7 3 0.2
Separated 34 6.4 40 7.2 7 4.6 81 6.5
Single, Never Married 334 63.3 285 51.2 42 27.6 661 53.4
Divorced 32 6.1 38 6.8 10 6.6 80 6.5
Missing 4 0.8 5 0.9 3 2.0 12 1.0
TOTAL 528 100% 557 100% 152 100% 1,237 100%

19
Black,D.A.etal.(2001a);Straus,M.A.,Hamby,S.L.,Finkelhor,D.,Moore,D.W.,&Runyan,D.(1988).Identificationofchildmaltreatmentwiththe
parentchildconflicttacticsscales:DevelopmentandpsychometricdataforanationalsampleofAmericanParents.ChildAbuseaNeglect22,249270;
Connelly,C.D.,&Straus,M.A.(1992).MothersAgeRiskforphysicalabuse.ChildAbuseandNeglect16(5),709718.
20
Buchholz,E.S.,.&KornBursztyn,C.(1993).Childrenofadolescentmothers:Aretheyatriskforabuse?Adolescence,28,361382;Kinard,E.M.,&
Klerman,L.V.(1980).Teenageparentingandchildabuse:Aretheyrelated?AmericanJournalofOrthopsychiatry,50(3),481488.
21
http://www.childwelfare.gov

 The Office of Child Abuse Prevention ANNUAL REPORT | 8

NUMBER AND AGE OF CHILDREN LIVING IN THE HOUSEHOLD

Studieshavefoundthatcomparedtosimilarnonneglectingfamilies,neglectfulfamiliestendtohavemorechildrenor
greaternumbersofpeoplelivinginthehousehold.22

StartRightProgramseducatefamiliesaboutfamilyplanningandspacingsubsequentbirthsatleast24monthsfor
optimummaternalandchildhealthoutcomes.Referralsaregiventosupportfamilyplanningandregularprenatalvisits.
Thebenefitsoffamilyplanningasitrelatestochildabuseandneglectare:

Motherswillhavemoreenergyandbelessstressed;
Motherswillhavemoretimetobondwiththebaby;and
Familieswillhavelessfinancialstress.23

AGE AT THE END OF NEW CLIENTS RETURNING CLIENTS CLIENTS WITH UNKNOWN TOTAL CLIENTS
SFY 2011 START DATE

N % N % N % N %
Under 1 year old 234 32.4 35 4.0 4 1.4 273 14.6
1 to 2 years old 192 26.6 430 49.3 40 14.3 662 35.3
3 to 4 years old 93 12.9 157 18.0 104 37.3 354 18.9
5 to 9 years old 108 14.9 144 16.5 99 35.5 351 18.7
10 to 14 years old 66 9.1 73 8.4 21 7.5 160 8.5
15 to 18 years old 25 3.5 26 3.0 9 3.2 60 3.2
Other Ages 5 0.7 8 0.9 2 0.7 15 0.8
TOTAL 723 100% 873 100% 279 100% 1,875 100%

*Dataisonlycollectedforuptofourchildrenperfamily.

22
Sedlak,A.J.,&Broadhurst,D.D.(1996);Chaffin,M.etal.(1996);Polansky,N.A.,Guadin,J.M.,Ammons,P.W.,&Davis,K.B.(1995).Thepsychological
ecologyoftheneglectfulmother.ChildAbuseandNeglect,9,265275;Zuravin,S.J.,&Taylor,R.(1987).
23
PublicHealthDivisionofContraCostaHealthServices,CondeAgudeloetal.295(15)1809JAMA.html

 The Office of Child Abuse Prevention ANNUAL REPORT | 9

HOUSEHOLD COMPOSITION OF FAMILIES SERVED

Chronicallyneglected families oftenare characterized by a chaotic householdwith changing constellations of adult and
child figures (e.g. a mother and her children who live on and off with various others, such as the mothers mother, the
motherssister,oraboyfriend).24

ADULTS LIVING IN THE NEW CLIENTS RETURNING CLIENTS CLIENTS WITH TOTAL CLIENTS
HOUSEHOLD OTHER THAN THE UNKNOWN START
MOTHER DATES
N % N % N % N %
None 88 11.3 71 9.8 22 12.0 181 10.9

Father 228 31.2 298 41.3 87 47.3 613 37.0

Stepfather 4 0.5 8 1.1 10 5.4 22 1.3

Boyfriend/Not Father 3 0.5 18 2.5 6 3.3 27 1.6

Grandmother 148 19.8 117 16.2 19 10.3 284 17.1

Grandfather 102 13.5 74 10.3 17 9.2 193 11.6

Aunt 18 2.3 10 1.2 0 0 28 1.7

Uncle 15 2.0 4 0.6 3 1.6 22 1.3

Sister 42 5.6 30 4.2 5 2.7 77 4.6

Brother 36 4.8 23 3.2 6 3.3 65 3.9

Friend 9 1.1 10 1.4 3 1.6 22 1.3

Other 60 7.5 58 8.0 6 3.3 124 7.5

TOTAL OF ABOVE RESPONSES 753 100% 721 100% 184 100% 1,658 100%

TOTAL CLIENTS 528 557 152 1,237

24 ,
Polansky N.A.,Gaudin,J.M.,&Kilpatrck,A.C.(1992).Familyradicals.ChildrenandYouthServicesReview,14,1926.

 The Office of Child Abuse Prevention ANNUAL REPORT | 10

AVERAGE LENGTH OF ENROLLMENT

Theultimatelengthofserviceisbasedonindividualfamilysuccesses.Whilethegoalistoempowerfamilies,itisimportant
thattheyareabletomaintainstabilityspecificallyasrelatedtoasafeenvironmentfortheirchild.Thedurationoneach
levelofserviceintensitywillvarybasedonthegoalsachievedbythefamily,programlocationandcommunityresources.25
START RIGHT PROGRAMS -- COUNTIES SERVED TOTAL NEW AVERAGE
& RETURNING TIME IN
FAMILIES PROGRAM
(IN YEARS)
Center for Children & Families Inc - Bringing Up Babies - Cleveland 57 1.0
Community Childrens Shelter & Family Services Inc - Family Resource Program -
Carter, Love & Murray 36 1.0
Community Health Centers - Positive Parents - Oklahoma County 36 0.8
Great Plains Youth & Family Services Inc - Growing in Family Training (GIFT) -
Greer, Jackson, Kiowa, Tillman 38 1.1
Great Plains Youth & Family Services Inc - Growing in Family Training (GIFT) -
Beckham, Custer, Roger Mills, Washita 36 0.9
Help-In-Crisis Inc - Helping U Grow (HUG) - Adair, Cherokee, Wagoner 44 1.0
Latino Community Development Agency - Nuestras Familias - Oklahoma County 37 1.4
McClain-Garvin County Youth & Family Center - Healthy Beginnings Program -
McClain, Garvin, Southern Cleveland County 33 1.3
McCurtain County Health Department - Bright Beginnings - McCurtain 52 1.2
Northern Oklahoma Youth Services Center & Shelter Inc - Family Resource
Program - Kay 44 1.1
Northwest Family Services Inc - Family Building Blocks -
Alfalfa, Grant, Major & Woods 42 1.2
Oklahoma State University Cooperative Extension Service - Parent Child
Connections - Canadian 28 1.5
Oklahoma State University Cooperative Extension Service - Parent Child
Connections - Delaware 36 0.9
Oklahoma State University Cooperative Extension Service - Parent Child
Connections - Comanche, Cotton, Jefferson & Stephens 86 1.2
Oklahoma State University Cooperative Extension Service - Parent Child
Connections - Texas 39 1.4
Okmulgee-Okfuskee County Youth Services Inc - Family Resource & Support
Program - Okmulgee 41 1.2
Parent Child Center of Tulsa Inc - Great Beginnings Tulsa - Tulsa 168 1.1
Parent Promise - Family Resource Program - Oklahoma 102 1.3
Pittsburg County Health Department - Healthy Beginnings/ Families Program -
Pittsburg 12 1.8
Sapulpa Public Schools - Sapulpa Area Family Education Resource Center - Creek 43 1.8
Washington County Child Care Foundation - Healthy Families & Babies -
Nowata, Washington 40 1.6
Youth & Family Services for Hughes & Seminole Counties - Great Beginnings -
Hughes & Seminole 35 1.3
TOTAL NUMBER OF FAMILIES 1,085 26

25
HealthyFamiliesAmericaParticipantsManual
26
152familieshavemissingdata.

 The Office of Child Abuse Prevention ANNUAL REPORT | 11

FAMILIES DECLINING PARTICIPATION AND REASONS PROVIDED

2,199familieswerescreenedforriskfactorsassociatedwithchildmaltreatment.Ofthosescreened,78%werefurther
assessedtodetermineiftheyexhibitedriskfactorsthatwereamenabletohomevisitingservices.Theremaining22%of
familiesdidnotcontinuetheassessmentprocess.Belowarethereasonswhythesefamiliesdidnotcontinuethe
assessmentprocess.

REASON NUMBER OF PERCENT

FAMILIES

Person not interested 48 10.8

Person does not feel the need for the program 21 4.7
Person did not return phone call 38 8.6
Program was unable to contact family for assessment 46 10.4
Person moved/plans to move out of state 7 1.6
Person could not be located (wrong address, etc.) 6 1.4
Person requested additional time and never followed up 3 0.7
Person lives outside of program service area 47 10.6
Person currently participating in another program 8 1.8
The pregnancy ended in a miscarriage 3 0.7
Schedule conflict (too busy, work conflict, etc.) 11 2.5
27
Qualified for and was referred to Children First 31 7.0
Person did not provide specific reasons 3 0.7
Child Protective Services are currently involved with the family 2 0.5
Child does not meet the age requirement 128 28.7
Other 35 7.9
MISSING 6 1.4
TOTAL 443 100

27
ChildrenFirst,OklahomasNurseFamilyPartnership,isastatefundedhomevisitationprogram,focusingonlowincomemothersexpectingtheirfirst
th
child.MothersmustenrollinChildrenFirstbythe29 weekofpregnancy.

 The Office of Child Abuse Prevention ANNUAL REPORT | 12

CENTER-BASED SERVICES
Outofthe205participantswhoenrolledincenterbasedservicesduringSFY2011,104werethechildsprimarycaregiver,
20werenotthechildsprimarycaregiverandthestatuswasunknownfor81participants.AllStartRightContractorsare
requiredtoprovidecenterbasedservices.TherearetwotypesofcenterbasedservicesthattheContractorsmayprovide:

1)StructuredParentEducationgroupsor2)CircleofParents supportgroups.

Parentsthathavealowtomoderatenumberofriskfactorsassociatedwithchildmaltreatmentareofferedcenterbased
servicesasopposedtohomevisitationservices.Parentsparticipatinginhomevisitationservicesarealsoencouragedto
enrollincenterbasedservicesinordertoreduceparentsfeelingsofisolationandprovideopportunitiestodevelop
informalsupportnetworkswithotherparents.

STRUCTUREDPARENTEDUCATIONGROUPS

StructuredParentEducationgroupsareledbyprofessionalstaffutilizingcurriculaapprovedbyOCAP.Thegroupsmay
meetfromfourtotwelveweeksonaweekly,biweeklyormonthlybasis.Tentofifteenminutesofparentchild
interactionisincorporatedintoeverysession.Subjectmatterscoveredincludetopicssuchaschilddevelopment,
discipline,healthandsafety,managingpersonalfinances,preparingforjobinterviews,andstressreduction.

CIRCLEOFPARENTSSUPPORTGROUPS

Thesesupportgroupsarecofacilitatedbyaparticipatingparentorparentsandastafffacilitator.Thetopicsorthemefor
thegroupsessionsaredeterminedbytheparentsinterestsandneeds.Thisparticularmodelemphasizesparent
involvementandleadership.Thegroupsaredesignedtobeflexibleandongoing.Parentsdecidewhethertheymeetona
weekly,biweeklyormonthlybasisandsessionsusuallylastonetotwohours.Meetingsutilizeadiscussionformatandare
focusedondevelopingsocialandemotionalsupportamongparents.

-- CENTER-BASED DATA --
DataNote:Duetothedesignofthecurrentdatacollectionforms,thedataforcenterbasedservicesislimitedtothose
thatbeganparticipatingduringSFY2011.Inaddition,thedatapresentedrepresentsthosefamiliesparticipatingincenter
basedservicesonlyasopposedtothosethatparticipateinbothcenterbasedandhomevisitingservices.Plansare
underwaytoimprovethedatacollectioninthisareaforthenextcontractcyclebeginningJuly1,2012.

MARITAL STATUS

N %
Married 103 51.2
Single, never married 67 33.3
Widowed 1 0.5
Divorced 13 6.5
Separated 17 8.5
Missing 4 0%
Total 205 100%

 The Office of Child Abuse Prevention ANNUAL REPORT | 13

RACE/ETHNICITY

Freq %
White Non-Hispanic 102 50
Black Non-Hispanic 13 6
Al Non-Hispanic 15 7
Hispanic 58 30
Multiracial Non-Hispanic 9 4
Other Non-Hispanic 2 1
Missing 5 2
Total 204 100%

GENDER

N %
Males 18 9
Females 180 88
Missing 7 3
Total 205 100%

Mostparticipantsofcenterbasedservicesaremothers.However,allcaregiversareencouragedtoattendparticularly
fathers.

HOUSEHOLD INCOME

N %
Under $5,000 35 17
$5,000 - $14,999 21 10
$15,000-$24,999 23 12
$25,000-$34,999 11 5
$35,000-$44,999 1 1
$45,000 and above 12 6
Unknown 87 42
Missing 15 7
Total 205 100%

In2010,thestateofOklahomamedianhouseholdincomewas$42,072andthemedianfamilyincomewas$51,958.28

28
Amedianhouseholdisdefinedasincludingallthepeoplewhooccupyahousingunitastheirusualplaceofresidence.Amedianfamilyisdefinedasa
groupoftwoormorepeoplewhoresidetogetherandwhoarerelatedbybirth,marriage,oradoption.

 The Office of Child Abuse Prevention ANNUAL REPORT | 14

NUMBER OF FAMILIES WITH CHILDREN <SIX YEARS OF AGE IN THE HOME

N %
Zero Children 27 13.2
One Child 95 46.3
Two Children 52 25.4
Three Children 8 3.9
Four Children 2 1
Missing 21 10.2
Total 205 100%

EMPLOYMENT

N %
Full time 30 14.6
Unemployed, but looking 52 25.4
Part-time 14 6.8
Unemployed, not looking 91 44.4
Odd jobs/irregular employment 1 0.4
Medical leave/disability 5 2.4
Other 4 2.0
Missing 8 3.9
Total 205 100%

PROGRAM COSTS PER FAMILY FOR SFY 2011

TheaveragestateexpenditureperfamilyduringSFY2011was$2,129.Thisamountwascalculatedbydividingthetotal
contract expenditures of $3,070,267 by the total number of unduplicated families participating in Start Right Services:
1,442newandreturningclientsenrolledinhomevisitationandnewclientsenrolledincenterbasedservicesonly.

RECOMMENDATIONS FOR FURTHER DEVELOPMENT AND IMPROVEMENT

Inpreparationforthenextbidcycleofchildabusepreventioncontracts,theCommissionerofHealthrequestedthatan
externalevaluationoftheFamilySupportandPreventionService(FSPS)withaparticularemphasisonOCAPandtheir
associatedeffortsbeconducted.Thepurposeoftheevaluationwastodeterminethestrengthsandchallengesof
FSPS/OCAPandtoassurethatfuturefundingofcontractswouldsupportbestpracticesandthehighestqualityservicesto
families.

 The Office of Child Abuse Prevention ANNUAL REPORT | 15

Ms.JoanSharpofSeattle,Washingtonservedastheevaluator.Ms.SharpisaformerExecutiveDirectorofthe
WashingtonCouncilforChildren&FamiliesandnowservesasaconsultantwithorganizationssuchastheCenterforStudy
ofSocialPolicyandtheNationalAllianceofChildrensTrustandPreventionFunds.Shehasexpertisewithavarietyof
preventionstrategiesincludinghomevisiting,familysupportandearlylearningcenters,andpostpartumdepression
interventions.

BelowarethehighlightsofMs.Sharpsfindings:29

STRENGTHS

TheFSPSstrategyofsupportingaportfolioofevidencebasedhomevisitingmodelsissound.30
TheinclusionofHealthyFamiliesAmerica(HFA)intheFSPSportfolioofhomevisitingprograms
isasolidpolicychoice,basedonwhatiscurrentlyknownabouttheeffectivenessofhomevisiting
programmodelsandtheevidencethatisemergingregardingthevalueofsuchanapproach.
Oklahomaspublichealthapproachtothepreventionofchildabuseandneglectasdemonstrated
byitsmanyproductiveinternalandcrossagencypartnershipsisakeysystemstrength.
FSPS/OCAPcontinuestoworkcloselywithitsearlyeducationpartnerstostrengthenprofessional
development,parentleadershipandfamilyengagement.
FSPS/OCAPactivelyreachesoutandengagesspecialpopulations.Currentcontractswiththe
ChickasawNationandtheLatinoCommunityDevelopmentAgencyareevidenceofsuchwork.
Additionaleffortsinthisareaarewarranted.

AREAS OF IMPROVEMENT
DevelopinganewdatasystemiscriticaltoimprovingOCAPsinternalevaluation/accountability
capacityandstrengtheningconfidenceintheabilityofOklahomashomevisitingportfolioto
deliverdesiredoutcomes.Useofnewtechnologiesshouldbeexploredaspartofthisprocess.
Developingacomprehensive,integratedreferralsystemthatleveragesthemanyaccessportals
availableinOklahomasarrayofearlychildhoodandfamilyservicesrepresentsamajoropportunity
forsystemsimprovement.
FillingtheFSPS/OCAPstaffvacanciesquickly(especiallythatoftheepidemiologist)andwith
highlycapablestaffisacriticalearlysteptowardsimprovingFSPSinternal
evaluation/accountabilitycapacity.
ShiftFSPStowardsanexplicitlycapacitybuildingapproachbyinvitingOCAPcontractorsinto
datadrivenqualityimprovementprocessesasrespectedlearningpartnersandensurethatthe
resourcesareavailabletosupportongoingsharelearningaimedatcontinuousquality
improvement.
WhileFSPS/OCAPbenefitfrommanypartnerships,itappearsthatenhancingsomeinternal
partnershipsmaybeuseful.
SupportingtheInteragencyChildAbusePreventionTaskForce(ITF)infillingexistingparent
vacancieswillstrengthentheITFsgovernancecapacitiesandsupporttheachievementofkeygoals
identifiedintheOklahomaStatePlanforthePreventionofChildAbuseandNeglect20102013.
FSPS/OCAPmustensurethatITFmembersarewellorientedtotheirresponsibilitiesandhaveongoinglearning
opportunities.

29
30
ReporttotheCommissioneroftheOklahomaStateDepartmentofHealth.Sharp,J.10/31/2011
TheFSPSalsosupportsChildrenFirst,OklahomasNurseFamilyPartnership.

 The Office of Child Abuse Prevention ANNUAL REPORT | 16

CONCLUSION
SUMMARY OF FINDINGS
TheOfficeofChildAbusePreventionStartRightProgramisdesignedtoofferimportantservicestoneedyfamiliesinthe
mostvulnerablesituations.Basedonthefindingsfromtheexternalevaluationitisclearthatthelevelofneedandprogram
feasibilityinthepopulationisconsistentwiththeHealthyFamilieshomevisitationmodelwhichisutilized.Oklahomahas
abroadsystemsapproachtochildabusepreventionandtheOfficeofChildAbusePreventionwillcontinuewithcross
agencypartnershipsinordertostrengthentheportfolioofevidencebasedhomevisitationmodels.Thedevelopmentofa
newdatasystemwillimprovenotonlydatacollection,butstrengthenourrelationshipwiththecontractorsand
collaborativepartners.Thedevelopmentofthedatasystemisintheprocessofbeingestablished.

InconclusiontheOfficeofChildAbusePreventionStartRightProgramreacheditsgoalsofconfirmingtheneedand
feasibilityoftheprogramwithintherangeofthecurrentbestpractices.TheOfficeofChildAbusePreventionwillproceed
withthecurrentmodelandrevisethedatacollectionprocesstoshowtheeffectivenessandbenefitofthetwentyone
contractsprovidingservicesthatsupport1,237needyandvulnerablefamiliesofOklahoma.