Every year, millions of children are exposed to child neglect and maltreatment, with serious consequences for children’s health, safety, and development. Once maltreatment has occurred, the harm is often difficult to reverse. Prevention is therefore crucial to protect children in vulnerable life situations. The child welfare services play a key role in this work; however, the Norwegian child welfare system has over time been criticised for a lack of systematic preventive efforts and for limited use of evidence-informed interventions with sufficient scope and intensity.
In the Family Partner project, researchers, in collaboration with three municipal child welfare services and SOS Children’s Villages, developed and piloted a new intervention targeting families with children aged 0–12 years who were already receiving follow-up from the child welfare services. The intervention is based on home visiting, parental guidance, and service coordination—components that have shown positive effects in other contexts, but which have not previously been systematically adapted to and evaluated within a Norwegian child welfare context. Family Partner was implemented in three municipalities with the aim of strengthening parenting skills, improving children’s living conditions, and preventing child maltreatment in vulnerable families. The intervention was delivered by a family partner, who provided intensive and holistic follow-up through home visits. The overarching aim of the project was to provide the child welfare services with a locally adapted, research-based intervention. The evaluation was conducted as a pilot randomized study using both qualitative and quantitative methods, supplemented by a systematic literature review.
The literature review of interventions to prevent child maltreatment found that many programmes, such as home-visiting interventions, parenting programmes, and parental guidance, reported positive effects on parenting practices and child behaviour. At the same time, few studies documented a direct reduction in child maltreatment. This highlights the need for future studies that more explicitly examine direct outcomes for children.
Findings from the pilot study showed that participants, family partners, managers, and caseworkers in the child welfare services consistently reported positive experiences with and confidence in the Family Partner intervention. At the same time, conducting a randomized study within the child welfare context proved particularly challenging. The study identified key barriers related to recruitment, ethical and practical concerns, limited involvement from service providers, challenges related to participant retention and data collection, and various implementation barriers. Individual randomization was especially challenging in contexts where participation lies at the intersection of voluntariness and coercion, as the intervention may be perceived as intrusive or create a sense of implicit pressure. Recruitment was based on voluntary participation, which made it difficult to maintain blinding of caseworkers during allocation and contributed to uncertainty among participants regarding study participation. The most significant challenge for data collection, however, was the low response rate to survey questionnaires (20–40%), despite personalised follow-up and financial incentives.
These challenges should be carefully considered in a full-scale effectiveness evaluation. Greater involvement of researchers embedded within the services may help address ethical and methodological challenges. It should also be considered whether alternative study designs may be more appropriate than randomized controlled trials for evaluating the effects of the Family Partner intervention.
Utviklingen av den nye intervensjonen Familiepartner for å forebygge omsorgssvikt viser høy aksept blant familier og ansatte i barneverntjenesten. Kvalitative data indikerer at intervensjonen har gitt familiene grunnleggende støtte og veiledning som har bidratt til utvikling av foreldreferdigheter. Piloteringen av det eksperimentelle designet tyder på at det er krevende, men mulig, å gjennomføre randomiserte studier i barnevernet, men gir ikke grunnlag for å konkludere om effekt på faktisk forekomst av omsorgssvikt. Når det gjelder forbedret helse og livssjanser for barn i familier med høy risiko, foreligger det kun indirekte indikasjoner. Pilotstudien viser endringer i faktorer som foreldremestring, stress og relasjon til hjelpeapparatet, som i tidligere forskning er knyttet til risiko for omsorgssvikt, men studier med lengre oppfølging vil være nødvendig for å si noe om varige effekter. Studien viser at Familiepartner muliggjør mer individuelt tilpassede tjenester gjennom tettere oppfølging, fleksibel bruk av tiltak og bedre koordinering rundt familien. Samtidig er det uklart i hvilken grad denne arbeidsformen kan opprettholdes eller skaleres innenfor ordinære ressursrammer.
For den kommunale barnevernstjenesten
Family Partner representerer et strukturert og teoretisk forankret tiltak utviklet i tett samarbeid med praksisfeltet i kommunale tjenester. Pilotstudien viser at intervensjonen kan implementeres og evalueres i norsk barnevern, men gir ikke evidens for effekt i form av redusert omsorgssvikt. En slik kunnskapsstatus forutsetter en fullskala effektstudie, enten en randomisert studie eller et egnet kvasieksperimentelt design. Studien har identifisert konkrete utfordringer ved randomiserte design i barnevernet, noe som må tas i betraktning i effektevalueringer, f.eks. vil det være klokt å benytte vitenskapelig ansatte eller spesialtrente uten bindinger til intervensjonen, for rekruttering av prosjektdeltakere.
Studien inkluderer ikke kost–nytteanalyser, og gir derfor ikke grunnlag for å konkludere om Family Partner øker eller reduserer offentlige kostnader. Oppfølgingen innebar for mange familier økt og mer koordinert tjenestebruk, noe som på kort sikt kan ha medført høyere kostnader. Ettersom familiene ble fulgt over en begrenset tidsperiode, gir datagrunnlaget ikke grunnlag for å vurdere eventuelle økonomiske besparelser. Slike effekter vil trolig først kunne vurderes i et lengre tidsperspektiv.
Samfunnsmessig impact
Det foreligger per i dag ikke datagrunnlag for å konkludere om redusert forekomst av omsorgssvikt på samfunnsnivå. Internasjonal forskning viser at kun et mindretall av tiltak dokumenterer effekter på direkte mål for omsorgssvikt, selv når tiltakene reduserer dokumenterte risikofaktorer. Mulige samfunnsøkonomiske gevinster innen helse, utdanning og trygd virker teoretisk plausible, men er fremdeles empirisk udokumenterte og avhengige av fullskala effektstudier som følger familier og barn over en lengre tidsperiode.
FAMPART seeks to improve the services directed at the most vulnerable group in society; children growing up at risk of maltreatment. Maltreatment threatens a child’s health, dignity and trust, and can cause fatal injury, adverse health outcomes and reduced life chances. Child Welfare Services need more evidence-informed practices to prevent child maltreatment, and provide follow-up to at-risk families with complex needs.
FAMPART will develop, implement and evaluate a new intervention for the Norwegian Child Welfare Services, improve services for vulnerable children, promote agency and trust in welfare services, improve children´s life chances, and prevent child maltreatment. The Family Partner intervention will be developed to prevent child maltreatment through: 1) home visitation and intensive follow up, 2) parental training, and 3) coordination of welfare services. The intervention remains to be systematically adapted to and tested in a Norwegian context.
FAMPART is a challenging and complex undertaking in public innovation, where the co-development, adaptation, implementation and evaluation of an intervention involves several collaborators; an international research team, two municipalities, SOS Children’s Villages, user representatives and national and municipal stakeholders.
FAMPART will 1) Co-develop the Family Partner intervention manual and adapt it for the Child Welfare Services with collaborators, 2) Monitor and facilitate the implementation of the Family Partner intervention in two municipalities, 3) Evaluate the municipal implementation and trial design, regarding adaptability, acceptability, feasibility, and costs, 4) Prepare an Expansion of the Family Partner intervention in the municipal services, and examine the feasibility for a multi-site Randomised Controlled Trial, and 5) Disseminate findings to the practice field, wider public and the academic milieu.
