What Outcomes Are Important for CACs?: Survey Results and Implications Ted Cross, Ph.D. Lisa Jones, Ph.D. Crimes Against Children Research Center University of New Hampshire Seventeenth National Symposium on Child Sexual Abuse Huntsville, Alabama March 13-16, 2001

Children’s Advocacy Centers Play an Important Role In 2000… – 105,039 children received services from CACs – in 362 affiliated centers representing… – 48 states, DC, and U. S. Virgin Islands

Growth of CACs

Many Other Organizations Use Components of CACs Multi-disciplinary investigation teams Child-friendly facilities Case review

Important Questions About CACs What is the impact of CACs on children, families, and partner agencies? What is the impact of CACs on the prosecution of child abuse and the court system? Are there other important outcomes of CACs for their community?

National Trend Toward Outcomes-Based Accountability Many systems are measuring outcomes and being evaluated on them – Education – Health Care – Mental Health – Criminal Justice – Child Welfare CACs are likely to need to examine outcomes

Evaluation of CAC Outcomes May Help... Document the impact of CACs Refine strategies for helping children

National Evaluation of Children’s Advocacy Centers (CACs) Multi-year, multi-site study of the efficacy of CACs CACs across the country participating in evaluation Cases enrolled in the study starting April 2001

One Step In The National Evaluation: Survey on CAC Outcomes Identifies what outcomes are important to professionals working in CACs First data from the National Evaluation Project

Development of the Outcome Survey Instrument Consulted standards of the National Children’s Alliance Examined other publications about CACs Consulted national CAC experts Survey with 84 outcomes in 6 categories

2 Phases of CAC Outcomes Investigation outcomes Post- investigation outcomes What happens during investigations? What happens later?

3 “Groups” That Have CAC Outcomes Children and Families Agencies Communities

6 Categories of CAC Outcomes

Survey Instrument Format scale Most important outcome in each category was scored 100 Least important outcome was rated relative to the most important outcome Other outcomes were scored in- between

Outcomes In The Instrument By Category

Excerpt from the Outcomes Survey

The Sample Professionals working in or with CACs in the 5 national evaluation communities Surveys were mailed to professionals identified by each CAC as most knowledgeable about it 69 respondents returned the survey

Child & Family Outcomes

Child and Family Investigation Outcomes Avg.

Avg.

Avg.

Outcomes rated as most important by survey respondents: – Increased quality of the child interview – Increased support for the child – Increased identification and delivery of needed services during investigation More important than: – Specific limitations on interviews (fewer, shorter, etc.) – Improving experience for non-offending caregiver

Child and Family Post-Investigation Outcomes Avg.

Avg.

Outcomes rated as most important by survey respondents: – Decreased chance that child will experience further abuse. – Improved emotional well-being for child. – Decreased stress for child. More important than: – Satisfaction and sense of fairness for non- offending caregivers.

Agency Outcomes

Important Agency Investigation Outcomes Avg.

Avg.

Less Important Agency Investigation Outcomes Avg.

Agency Investigation Outcomes Outcomes rated as most important by survey respondents: – Faster response time – Increased case information shared, inter- agency communication, – Better expertise, better evidence and more accurate decisions – Better case dispositions More important than outcomes one step removed from child and perpetrator

Important Agency Post-Investigation Outcomes Avg.

Less Important Agency Post-Investigation Outcomes Avg.

Agency Post-Investigation Outcomes Outcomes rated as most important by respondents: – Increased % of at-risk children protected – Increased prosecution, conviction at trial, confessions More important than more specialized law enforcement or child protection outcomes

Community Outcomes

Important Community Investigation Outcomes Avg.

Avg.

Less Important Community Investigation Outcomes Avg.

Community Investigation Outcomes Outcomes rated as most important by survey respondents: – More resources and training for investigation – Adherence to best practice – Coordination & relationships with professionals More important than: – Cross-agency peer review and uniform media relations – Reduced public criticism

Community Post-Investigation Outcomes Avg.

Outcomes rated as most important by survey respondents: – Increased awareness of child maltreatment and resources for victims in community More important than: – Support for CACs – Increased private financial support of agencies

How Much Do Professionals Agree on Outcomes? Very high agreement on very important outcomes But people disagreed somewhat about the importance of most outcomes “Low” importance scores were very important to some people

Everyone rated More Effective Interviews greater than 80 in this site

17 of 20 people gave this > 70 3 people in this site scored this 50 or less

5 of 19 people scored this > 90 Most people in this site gave this low scores

Conclusions

CACs Have Many Important Outcomes Responding rapidly Coordinating effectively Investigating effectively Making accurate decisions Making appropriate dispositions Reducing child & family stress (cont.)

CACs Have Many Important Outcomes Facilitating use of services Prosecuting offenders Reducing risk of re-offending Providing training Encouraging best practice

Possible Implications of Numerous Outcomes CACs have many demands on time and resources Programs may need to develop gradually over time Different CACs may specialize in different outcomes CACs role in community larger than coordinating investigations

Lack of Consensus on Outcomes Lack of consensus on the importance of many outcomes underlines the need for coordination, communication and relationship-building CACs may need to accommodate small groups of their participants invested in specific outcomes

No Simple Benchmark Important outcomes tend to be holistic: quality of response and child well-being There is no simple benchmark Number of interviews is potentially a misleading indicator

Implications for Program Evaluation No simple measure of CAC success may exist Given the number of outcomes, CACs may need to do a number of small, focused evaluations over time