# Delivering Evidence-Based Parenting Services to Families in Child Welfare Using Telehealth

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2024 · $661,957

## Abstract

ABSTRACT
The severe acute respiratory syndrome coronavirus 2 (denoted COVID-19) pandemic has shaken the
foundation of services delivered to vulnerable families involved with or monitored by the child
protective/welfare system. COVID-19 has changed the landscape of how children and families interact with the
vital services provided by the child welfare system. Home visitation, which includes a bedrock of essential and
transformative parenting support services for families involved with child welfare, was no longer safe or viable
in the presence of COVID-19. The pandemic shredded safety nets. It made evident to providers, administrators,
and policymakers how fragile our child protective system is. Under this strained state, child welfare agencies
and mental health providers innovated service delivery systems. In Washington State, the Department of
Children, Youth, and Families (DCYF) worked with local service agencies providing evidence-based programs
to revise program protocols. Provider teams and program developers worked together to transition in-person
services to remote platforms by developing and delivering telehealth services to families. The pandemic created
the conditions for a natural experiment in service delivery in Washington State. The natural experiment proved
that telehealth services are a viable service delivery system; thousands of child welfare involved families were
served via telehealth. We do not know, however, if these services were effective, or which families had the
technological capacity to engage, or for those who did engage were they able to complete the program. Did
online home visiting produce the expected outcomes? While online delivery was an innovation driven by the
necessity in response to COVID-19, many questions remain. The potential is high, but little is known about
telehealth in child welfare. This proposal is a three-arm effectiveness trail of an evidence-based home visiting
program: 1) delivered online, 2) delivered in-person, and 3) usual care. We will assess the effectiveness of
Promoting First Relationships (PFR: a 10-week model) to improve observed parent-child interaction and
caregivers’ knowledge of social and emotional development in a sample of 358 caregivers with children under
age 18 months at enrollment. We will also assess if PFR reduces child externalizing behavior and reduces out of
home placements of the child into foster care. We will assess the cost-effectiveness of providing PFR via
telehealth. We will address the degree to which families in Child Protective Services (CPS) have the technology
needed to engage with telehealth services, as well as family satisfaction and compliance. Finally, we will
measure service providers’ fidelity to the PFR model and their adherence to delivering PFR via telehealth. The
proposed study leverages a longstanding partnership between the University of Washington and Washington
State DCYF, overseeing services in child welfare to answer these questions.

## Key facts

- **NIH application ID:** 10868440
- **Project number:** 5R01HD111433-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** MONICA L OXFORD
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $661,957
- **Award type:** 5
- **Project period:** 2023-06-15 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10868440

## Citation

> US National Institutes of Health, RePORTER application 10868440, Delivering Evidence-Based Parenting Services to Families in Child Welfare Using Telehealth (5R01HD111433-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10868440. Licensed CC0.

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