The Future of Children, Princeton - Brookings: Providing research and analysis to promote effective policies and programs for children.

Community agencies offer family support services to promote social competencies and behaviors that contribute to parental, child, and family health and development for all families.^17,18 These services are based on the premise that all families may experience stressful life circumstances and inadequate support as a result of normal life transitions, economic pressures, changing social conditions, the emergence of new social problems, the deterioration of neighborhoods and community ties, limits in the social safety net, and an increasing number of families headed by never-married mothers.¹⁹ The programs typically focus on prevention rather than the amelioration of problems or deficits, and provide a secure and accepting climate to support the growth and development of family members. The programs are usually community based, shaped to fit local conditions, and kept flexible enough to respond to emerging needs and the interests of participating families.²⁰

Family support programs provide a wide variety of services to counteract stresses, link families together, and offer needed assistance.²¹ Often guided by social support and stress theory,²² and taking a public health approach to service delivery,²³ they may convene peer support groups; offer educational programs such as training in parenting skills or child development; and organize social and learning experiences for young children, adolescents, and parents. Many programs also advocate for families with other service institutions, or represent family interests in the community at large.^18-20

Family support programs are typically open to all who choose to participate. Some family support programs serve the community at large, while others are organized to address specific concerns such as prenatal and infant health, children's school readiness, family literacy, prevention of child abuse, teen parenting, or the challenges faced by families with special needs children.²⁴ Many programs reach out actively to invite participation by those who might benefit from service. Respect for individual and cultural differences is often reinforced by reliance on volunteers and staff who live in the community served, or who share experiences with the participating families.^18–21

While most family support programs work with individuals to enhance family capacities, some have launched or joined efforts to reform service delivery at the neighborhood level and to strengthen communities.^4,7 Local and statewide efforts to institute such programs on a broad scale are increasing.^25,26

Recent reviews of family support program evaluations suggest that the effects of family support programs are modest and inconsistent.^27-30 Some evaluations show improved child outcomes, and others show positive effects on parents, but few findings appear consistently across evaluations.

Studies indicate that improvements in child outcomes are more likely to occur in programs that include direct experiences for children, rather than those that focus only on parents.²⁷ A related finding from evaluations of preschool programs shows that once a child-focused program is in place, adding family support can strengthen its effects. Preschool programs that include a family component seem to yield higher cognitive gains for children than preschool programs that lack services for families.³¹

Reviewers of family support program evaluations^27,32 have noted that short-term effects on parents' child-rearing attitudes, behavior, or knowledge have been achieved by some family support programs. Specifically, they have stated that adult participants have shown improvements in knowledge of child development; have provided a more stimulating and emotionally encouraging environment for children; and are more likely to recognize the parent's role as teacher. Other parent outcomes found were changes in caregiving behaviors and use of more positive control and disciplining techniques. Some evaluations have found that parents' problem-solving abilities, sense of control, self-esteem, and coping were improved through family support programs. However, few of these effects were consistently repeated across studies.

A recent review of rigorous evaluations of home visiting programs exemplifies this mixed pattern of findings.³⁰ The programs studied did not improve birth outcomes for the children, although some enhanced mothers' health-promoting behaviors or their psychological functioning. They did not prevent child maltreatment, as measured in official reports, although some programs modified aspects of parenting that are thought to influence child maltreatment. This review, and others, suggest that the design of the family support program significantly influences outcomes; important program features appear to be the frequency, intensity, and comprehensiveness of the program services, and the quality of the relationship between families and staff.^27,29-31

On the whole, the limited evidence available suggests that family support programs have inconsistent effects both on children's development and on family functioning. These findings may not accurately reflect program effects, though, because of limitations in the research on family support. For instance, researchers have trouble defining and measuring progress toward goals that are complex, far-reaching, and sometimes amorphous. It is also problematic when reviews of family support evaluations compare programs with different foci serving different target populations.³³ (See Box 1 for a discussion of issues confronting evaluators of both family support and family preservation programs.) The true impact of these services will not be measured until programs enumerate measurable objectives, and researchers develop and apply appropriate methods for documenting program effects.

The field of family support is still emerging, and federal funds available as a result of the 1993 and 1997 legislation will undoubtedly spark more growth. Given continuing development and the lack of research to identify the most effective program types, it is probably too early to assess overall program impact. Nevertheless, family support programs have the potential to offer help and assurance to many different kinds of families, only some of whom are likely to become involved with the child protective services system.