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Program Profile: Adults and Children Together (ACT) Raising Safe Kids Program

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on May 21, 2013

Program Summary

A national anti-violence intervention designed to prevent child maltreatment by providing education, resources, and support to parents. The program is rated Promising. Program parents reported a statistically significant decline in harsh discipline as measured by the Parent Behavior Checklist (PBC) from the pretest to 3-month follow-up period. There was no statistical difference between the comparison groups for PBC in nurturing, expectation, or parent stress measures.

Program Description

Program Goals/Target Population
The goal of the Adults and Children Together (ACT) Raising Safe Kids Program is to strengthen families and improve or change parenting skills and practices to prevent child maltreatment. The program provides education and resources and seeks to achieve the primary goal by (1) establishing partnerships with a variety of organizations and agencies, and (2) training professionals to take the program to families and caregivers in their communities. 

ACT emphasizes the important role that parents and other adults have in creating safe, nurturing, stable, and healthy environments for young children that help protect them from violence and trauma, and their consequences. The program also promotes community support and serves as a complement to existing interventions for children at high risk for maltreatment. The program is designed to be a universal approach to help groups of parents and caregivers from all backgrounds regardless of their risk level. It is also designed to be flexible so that a variety of community-based institutions and organizations can implement the program and integrate it into existing interventions and services for parents.

ACT is currently implemented in almost 100 communities in the United States and Puerto Rico, including Latino and Asian-American communities, and in Brazil, Colombia, Greece, Japan, and Peru.

Program Theory
The ACT Raising Safe Kids Program is based on research indicating that in the early years, violence, abuse, and neglect are mostly perpetrated by children’s own parents (Children’s Bureau 2010). Studies have also demonstrated that exposure to abuse and neglect early in life has long-term and serious emotional, cognitive, and behavioral trauma and consequences for children and youth. Therefore, ACT was designed to focus on the early years and the important role of parents and caregivers in shaping children’s early environment and experiences. In addition, it is based on the notion that lack of knowledge about child development and inadequate parenting skills are the primary causes of child maltreatment (Portwood, et al. 2011). Abusive parents often have inappropriate expectations about their child’s behavior and tend to react inappropriately. They are more likely to use harsh physical discipline and verbal aggression and less likely to use positive parenting strategies (Guttman, Mowder, and Yasik 2006). The framework for ACT is also informed by research related to violence prevention that shows that violence is the result of an individual’s lack of problem-solving skills to deal with conflict and can negatively affect the problem-solving abilities of children exposed to violence (Guttman, Mowder, and Yasik 2006). ACT seeks to teach caregivers how to model developmentally appropriate, non-violent social and problem-solving skills to children.

ACT is based on the Centers for Disease Control and Prevention’s (CDC) Best Practices of Youth Violence Prevention, which include social-cognitive interventions like didactic instruction, modeling, and role-playing. The CDC also suggests parent- and family-based interventions, which is why ACT was revised to address family violence and child abuse (Thorton, et al. 2002). The program is also grounded in components of social learning theory (Bandura 1973), proposing that children observe and imitate the adults in their lives. As such, parents participating in ACT are taught how to manage their anger in order to model appropriate behavior and conflict-resolution techniques for their children.

Program Activities
The ACT Program is delivered to groups of parents and caregivers by trained professionals (ACT Facilitators) with support from other organizations. The American Psychological Association (APA) established partnerships with institutions in the United States to create the ACT Regional Training Centers in various regions of the country (please see Implementation Information for additional information).

The ACT curriculum is organized in eight 2-hour interactive group sessions and addresses:

  • Understanding Children’s Behaviors: This component focuses on helping parents understand what to expect from children at various development stages and how to use skills to guide children’s behavior based on their developmental level, so that parents do not have unrealistic expectations of their children and do not resort to violence when dealing with misbehaviors.
  • Young Children’s Exposure to Violence: The purpose of this session is to help parents understand (1) how children can be exposed to violence and its consequences; (2) that children learn by observation and imitation; and (3) that their behavior, actions and the environment they provide teach children lessons for life.
  • Anger Management for Parents: This session is designed to help parents learn skills to understand, control, and manage their own feelings of anger.
  • Understanding and Helping Angry Children: This session helps parents understand children’s angry feelings and how to teach them positive ways to express and control anger. The session also covers helping families teach social problem-solving skills in a home environment based on an understanding of the developmental stages through which children learn social skills.
  • Children and Electronic Media: This part of the program emphasizes the relationship between time spent on screen and unhealthy behaviors, and between exposure to violent messages and images and aggressive behaviors so that adults can reduce the impact on their children.
  • Discipline and Parenting Style: This session helps parents understand that their parenting styles have an impact on children’s behaviors. Distinctions are also made between punishment and discipline so that parents can respond effectively.
  • Discipline for Positive Behaviors: This session teaches parents how to prevent challenging behaviors and how to use positive methods to discipline their children.
  • Take the ACT Program with You: The final session encourages participants to use the learned tools at home and in the community.

Key Personnel
APA Violence Prevention Office staff coordinates the program including development of training and educational materials, and technical assistance to the ACT Regional Centers and program sites through e-mails and conference calls, organization of the annual leadership seminar and web-based seminars, and coordination of the program listserv. Organizations that host the program include community-based social service and mental health providers, hospitals, churches, childcare centers, prisons, and schools. Professionals conducting the program’s 8-week series in the communities include psychologists, early childhood professionals, social workers, social service agency staff, and nurses.

Evaluation Outcomes

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Study 1
Harsh Discipline
Portwood and colleagues (2011) found that parents participating in the Adults and Children Together (ACT) Raising Safe Kids Program reported statistically significant declines in harsh discipline as measured by the Parent Behavior Checklist (PBC) from the pretest to 3-month follow-up. Parents in the comparison group reported slight declines during this time, but the declines were not statistically significant. The difference between the groups was also statistically significant.

Nurturing
For the PBC Nurturing measure, parents in the ACT group reported a statistically significant increase from the pretest to the follow-up. The comparison group increased from the pretest to posttest and decreased slightly at the 3-month follow-up, but the changes were not statistically significant. The overall differences between the groups were also not statistically significant.

Expectations
For the PBC Expectations measure, there were no significant changes over time and there were no overall differences between the groups.

Parent Stress
Parents in the ACT group reported a statistically significant increase from the pretest to the 3-month follow-up on parent stress as measured by the Parenting Stress Index (PSI). Parent stress in the comparison group remained constant from the pretest to the posttest and increased slightly at the follow-up, but the increase was not statistically significant. The overall differences between the groups were also not statistically significant.

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Evaluation Methodology

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Study 1
Using an experimental design, Portwood and colleagues (2011) examined whether participation in the Adults and Children Together (ACT) Raising Safe Kids Program increased positive parenting skills, improved partner conflict management skills, increased the use of supportive networks, and decreased parenting stress. A total of 162 intervention group participants and 109 comparison group participants were recruited from social service agencies and parenting programming in three sites: Chicago, IL; Newport News, VA; and Milwaukee, WI. Parents over the age of 18 were randomly assigned to ACT (treatment group) or to continue in current programming without ACT as a supplement (control group). Treatment and control conditions were present at all sites, and parents in control groups were offered the opportunity to participate in subsequent ACT classes.

The treatment group was 89.3 percent female, 68.4 percent married, and the average age was 32.9 years. Participants were 70.7 percent Hispanic, 17.8 percent white, 8.3 percent black, 0.6 percent Asian/Pacific Islander, 0.6 percent American Indian/Alaska/Native, and 1.9 percent other race/ethnicity. Approximately 40 percent of the participants had obtained their GED or high school diploma, and 35.8 percent reported annual household incomes below $20,000. Parents most commonly had one child living in the home (30.2 percent), followed by two children (28.2 percent). There were no statistically significant differences between treatment and comparison groups in the demographic characteristics of participants.

A traditional pretest-posttest study design was employed, with all participants in both treatment and control groups asked to complete a Parenting Survey at three time periods: (1) within 10 days preceding the ACT program start date; (2) at the conclusion of the ACT program; and (3) three months following the program's completion. Several measurement scales were used to assess positive parenting skills, family conflict, social support, and parenting stress. 

  • The Parenting Behavior Checklist (PBC), a 32-item measure, was used to assess levels of Discipline, Nurturing Behaviors, and Expectations. 
  • The Conflict Scale of the Family Environment (FES) scale, a 9-item true/false inventory, was used to produce a summary score reflecting aggression and conflict among family systems.
  • The Perceived Social Support (PSS) scale, a 40-item scale, was used to assess support from family and friends.
  • The Parenting Stress Index-Short Form (PSI-SF), a 36-item Likert scale, was used to assess stress levels in families with young children, including parent distress, parent-child dysfunctional interaction, and parents’ views of children’s oppositional behavior.

Four types of analysis of variance models and Tukey post-hoc comparisons were also used to examine program outcomes. Group comparisons across pretests and posttests were conducted, as well as a separate analysis of the 3-month follow-up results.

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Cost

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Some materials for the Adults and Children Together (ACT) Raising Safe Kids Program can be directly accessed from the program's Web site through the American Psychological Association (APA): http://actagainstviolence.apa.org/materials/index.html. Other materials can be ordered, and range from $10 to $20.
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Implementation Information

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Participating agencies must complete the American Psychological Association (APA) training protocol and obtain Adults and Children Together (ACT) Raising Safe Kids Program materials from the APA. Training workshops are free and conducted through a train-the-trainer model with community service providers. The APA established partnerships with institutions in the United States to create the ACT Regional Training Centers (RC) in various regions of the country. The RCs coordinate the 2-day training workshops for ACT Facilitators, and provide assistance to those implementing ACT in their communities. The RCs are: ACT Midwest RC at Pillars, a major mental health agency in the Chicago area; ACT Great Lakes RC at the University of Toledo; ACT Southeast RC at The Melissa Institute in Miami, FL; ACT Northeast RC at Brandeis University; and the ACT Mid-Atlantic at APA in Washington, DC.

 

The ACT curriculum is offered in English and Spanish, and has also been translated into Greek, Japanese, and Portuguese. ACT is also designed to be implemented alongside existing parental training programming in participating communities. More information is available at: http://actagainstviolence.apa.org/materials/index.html.

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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Portwood, Sharon G., Richard G. Lambert, Lyndon P. Abrams, and Elissa Brooks Nelson. 2011. “An Evaluation of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids Program.” Journal of Primary Prevention 32(3/4):147-160.
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Additional References

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These sources were used in the development of the program profile:

Bandura, Albert. Aggression: A Social Learning Analysis. Oxford, England: Prentice-Hall, 1973.

Burkhart, Kimberly M., Michele Knox, and Jeanne Brockmyer. 2012. “Pilot Evaluation of the ACT Raising Safe Kids Program on Children’s Bullying Behavior.” Journal of Child and Family Studies, first published online September 2012.
http://link.springer.com/article/10.1007%2Fs10826-012-9656-3#

Children’s Bureau. 2010. Child Maltreatment. Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau.
http://archive.acf.hhs.gov/programs/cb/pubs/cm10/cm10.pdf

Guttman, Michelle, Barbara A. Mowder, and Anastasia E. Yasik. 2006. “The ACT Against Violence Training Program: A Preliminary Investigation of Knowledge Gained by Early Childhood Professionals.” Professional Psychology: Research and Practice 37(6):717-723.

Guttman, Michelle and Barbara A. Mowder. 2005. “The ACT Training Program: The Future of Violence Prevention Aimed at Young Children and Their Caregivers.” Journal of Early Childhood and Infant Psychology 1:25-36.

Knox, Michele, Kimberly Burkhart, and Aaron Cromly. 2013. “Supporting Positive Parenting in Community Health Centers: The ACT Raising Safe Kids Program.” Journal of Community Psychology 41(4):395–407.

Knox, Michele, Kimberly Burkhart, and Tasha Howe. 2011. “Effects of the ACT Raising Safe Kids Parenting Program on Children’s Externalizing Problems.” Family Relations 60:491-503.

Knox, Michele S., Kimberly Burkhart, and Kimberly E. Hunter. 2011. “ACT Against Violence Parents Raising Safe Kids Program: Effects on Maltreatment-Related Parenting Behaviors and Beliefs.” Journal of Family Issues 32(1):55-74. (This study was reviewed but did not meet CrimeSolutions.gov criteria for inclusion in the overall program rating.)

Mowder, Melissa H. and Stephanie L. Orland. 2006. “The ACT Against Violence Training Program: Targeting Pre-Service Elementary School Teachers.” Journal of Early Childhood and Infant Psychology 2:40-50.

Porter, Breanne and Tasha Howe. 2008. Pilot Evaluation of the ‘ACT Parents Raising Safe Kids’ Violence Prevention Program.” Journal of Child and Adolescent Trauma 1:193-206. DOI: 10.1080/19361520802279158.

Silva, Julia M. and Adrienne Randall. 2005. “Giving Psychology Away: Educating Adults to ACT Against Early Childhood Violence.” Journal of Early Childhood and Infant Psychology 1:37-43.

Thomas, Volker, Nilufer Kafescioglu, and Dreama Plybon Love. 2009. “Evaluation of the Adults and Children Together (ACT) Against Violence Training Program with Child Care Providers.” Journal of Early Childhood and Infant Psychology 5:141-156.

Thornton, Timothy N., Carole A. Craft, Linda L. Dahlberg, Barbara S. Lynch, and Katie Baer. 2002. Best Practices of Youth Violence Prevention: A Sourcebook for Community Action (Revision). Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.
http://www.cdc.gov/violenceprevention/pub/yv_bestpractices.html

Weymouth, Lindsay A. and Tasha R. Howe. 2011. “A multi-site evaluation of Parents Raising Safe Kids Violence Prevention Program.” Children and Youth Services Review 33:1960-1967.

Weymouth, Lindsay A. 2010. “ACT Against Violence: A Multi-Site Evaluation of the Parents Raising Safe Kids Program.” Master’s Thesis, Humboldt State University: 1-108.
http://humboldt-dspace.calstate.edu/bitstream/handle/2148/638/lindsay%2Bthesis%2Bfinal%2B2%5B1%5D.pdf
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Program Snapshot

Age: 25 - 45

Gender: Both

Race/Ethnicity: Black, American Indians/Alaska Native, Asian/Pacific Islander, Hispanic, White, Other

Geography: Urban

Setting (Delivery): Other Community Setting

Program Type: Community Awareness/Mobilization, Conflict Resolution/Interpersonal Skills, Parent Training, Children Exposed to Violence, Violence Prevention

Targeted Population: Children Exposed to Violence, Families

Current Program Status: Active

Listed by Other Directories: Child Exposure to Violence Evidence Based Guide

Program Developer:
Julia Da Silva
Director, APA Violence Prevention Office
American Psychological Association
750 First Street NE
Washington DC 20002
Phone: 202.336.5817
Website
Email

Researcher:
Sharon Portwood
Executive Director, Institute for Social Capital/Professor, Department of Public Health Sciences
University of North Carolina at Charlotte, Department of Public Health Sciences
9201 University City Blvd CHHS 427
Charlotte NC 28223
Phone: 704.687.7916
Website
Email

Training and TA Provider:
Julia Da Silva
Director, APA Violence Prevention Office
American Psychological Association
750 First Street NE
Washington DC 20002
Phone: 202.336.5817
Website
Email