Prevention Science

, Volume 21, Issue 1, pp 4–14 | Cite as

Impact of a Child Abuse Primary Prevention Strategy for New Mothers

  • Kay M. G. O’NeillEmail author
  • Fallon Cluxton-Keller
  • Lori Burrell
  • Sarah Shea Crowne
  • Anne Duggan


First Steps (FS) is a brief obstetrics-based primary prevention strategy that aims to strengthen protective factors to prevent child maltreatment. This randomized controlled trial assessed how well FS services aligned with family interests and needs, how FS providers used communication strategies to build partnership with mothers, and the impact of FS on mothers’ parenting knowledge in core content areas and access to services. Mothers completed a baseline survey and were randomly assigned to FS and control conditions (n = 374 and 375, respectively). The parenting education services provided to mothers were assessed by independent participant report immediately postintervention for the full FS group and by analysis of audio-recordings of the FS encounter for a subsample (n = 150). Outcomes were measured at 4 months via maternal survey. Compared to controls at follow-up, FS mothers had significantly higher knowledge scores in some areas but similar access to needed services. Few mothers lacked access to most services at baseline, and FS content was similar to that provided by other hospital personnel. FS providers’ communication style promoted rapport, but providers did not tailor content to mothers’ educational and service access needs. Implications of the findings for similar services are discussed.


Protective factors Primary prevention of child maltreatment Universal parenting support program 



This study is the product of strong partnerships with leaders of Prevent Child Abuse Georgia, the Georgia Governor’s Office for Children and Families, the Center for Family Research at the University of Georgia, and First Steps local sites statewide. Special thanks go to Carole Steele, Marcia Wessels, Anita Brown, and Lynda Brown.

Conflict of Interest

The authors declare that they have no conflict of interest.

Funding Information

This study was funded by Grant 90CA1784 from the Office of Child Abuse and Neglect, Children’s Bureau, Administration for Children and Families, Department of Health and Human Services.

Compliance with Ethical Standards

All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Study methods were approved by the institutional review boards of the Johns Hopkins University and participating hospitals prior to implementing the study. We secured written informed consent from all First Steps mothers and providers.


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Copyright information

© Society for Prevention Research 2018

Authors and Affiliations

  1. 1.Department of Population, Family and Reproductive Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA
  2. 2.Department of PsychiatryGeisel School of Medicine at DartmouthLebanonUSA

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