Caregiver substance use is a leading risk factor for child maltreatment and removal from the home. To address this risk, since 2006, Congress has authorized funding for the Regional Partnership Grants (RPG) program. RPG supports partnerships between child welfare agencies, substance use treatment providers, and other social service systems to improve outcomes for children in or at risk of out-of-home placement due to a caregiver’s substance use. Although research has demonstrated RPG’s effectiveness in improving families’ outcomes, less is known about what makes this program effective. This paper uses data collected from over 2,500 families and linear regression models to examine how specific features of RPG service receipt—including the types of services and how much of each service families receive—are associated with a range of outcomes for adults and children. We found that completing services, attending more service contacts, and receiving more services from a peer recovery support specialist were favorably associated with several outcomes. In contrast, the associations between the types of services families received and their outcomes were mixed. These findings inform efforts by child welfare agencies, substance use treatment providers, and others to structure services in ways that are most likely to benefit families.
AchenbachT. M.RescorlaL. A. (2000). Manual for the ASEBA preschool forms and profiles. University of Vermont, Research Center for Children, Youth, & Families.
2.
AchenbachT. M.RescorlaL. A. (2001). Manual for the ASEBA school-age forms and profiles. University of Vermont, Research Center for Children, Youth, & Families.
3.
AikensN.Kopack KleinA.KnasE.HartogJ.ManleyM.MaloneL.TarulloL.LukashanetsS. (2017). Child and family outcomes during the head start year: FACES 2014–2015 data tables and study design. U.S. Department of Health and Human Services, Administration for Children and Families, Office of Planning, Research, and Evaluation.
4.
BavolekS. J.KeeneR. G. (1999). Adult adolescent parenting inventory (AAPI-2): Administration and developmental handbook. Family Development Resources, Inc.
5.
BenjaminiY.HochbergY. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society—Series B: Statistical Methodology, 57(1), 289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x
Children’s Bureau. (2019). National child abuse and neglect data systems (NCANDS) child file codebook. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth, and Families.
8.
Children’s Bureau. (2023). The AFCARS report: Preliminary FY 2022 estimates as of may 9, 2023—No. 30. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth, and Families.
9.
Children’s Bureau. (2025a). Child maltreatment 2023. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth, and Families.
10.
Children’s Bureau. (2025b). Regional partnership grants to increase the well-being of, and to improve the permanency outcomes for, children affected by substance abuse: Eighth report to congress. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth, and Families.
11.
ChengT. T.LoC.C. (2020). Collaborative alliance of parent and child welfare caseworker. Child Maltreatment, 25(2), 152–161. https://doi.org/10.1177/1077559519865616
12.
Child Welfare Information Gateway. (2021). In-home services to strengthen children and families. U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau.
13.
ColeR.BurnettA.StrongD. (2021). The impact of the regional partnership grant program on adult recovery and well-being, and child safety, permanency, and well-being outcomes. Child Abuse & Neglect, 117, Article 105069. https://doi.org/10.1016/j.chiabu.2021.105069
14.
D'AngeloA. V.AvellarS.HenkeJ.BurnettA.BessR.Jacobs JohnsonC.XueY.DeMondA. (2019). Regional Partnership Grants cross-site design report. Mathematica Policy Research. Submitted to: Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services. Contract Number: HHSP233201500035I/HHSP23337026T.
15.
DoeH. A.OsborneC.HuffmanJ.CraigS. M.SheroM. (2024). Home visiting and child welfare involvement: A matched comparison group study. Child Maltreatment, 30(2), 331–342. https://doi.org/10.1177/10775595241268227
16.
DunnW. (2002). The Infant/Toddler sensory profile. Psychological Corporation.
17.
FixenD. L.NaoomS. F.BlaseK. A.FriedmanR. M.WallaceF. (2005). Implementation research: A synthesis of the literature. Tampa, FL. University of South Florida, The National Implementation Research Network.
18.
FreisthlerB.WolfJ. P.HodgeA. I.CaoY. (2020). Alcohol use and harm to children by parents and other adults. Child Maltreatment, 25(3), 277–288. https://doi.org/10.1177/1077559519878514
19.
GaiserM. G.BucheJ. L.WaymentC. C.SchoebelV.SmithJ. E.ChapmanS. A.BeckA. J. (2021). A systematic review of the roles and contributions of peer providers in the behavioral health workforce. American Journal of Preventive Medicine, 61(4), e203–e210. https://doi.org/10.1016/j.amepre.2021.03.025
20.
GautschiJ.LätschD. (2024). The effectiveness of interventions to prevent and reduce child maltreatment in high-income countries: An umbrella review. Child Abuse & Neglect, 153, 106845. https://doi.org/10.1016/j.chiabu.2024.106845
21.
GhertnerR. (2022). National and state estimates of children with parents using substances, 2015–2019. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.
GrossM.BhagwatA.ColeR. (2023). Effects of the nurturing parenting program nurturing skills for families on child safety and permanency. Child Abuse & Neglect, 143, 106338. https://doi.org/10.1016/j.chiabu.2023.106338
24.
Hidalgo GarcíaV.Pérez-PadillaJ.Camacho Martínez-Vara de ReyC.Jiménez GarcíaL. (2025). The role of dosage and family profiles in a child welfare home-visiting program. Child and Youth Care Forum, 54(2), 435–452. https://doi.org/10.1007/s10566-024-09826-4
25.
KimH.SongE. J.WindsorL. (2024). Evidence-based home-visiting provisions and child maltreatment report rates: County-level analysis of U.S. national data from 2016 to 2018. Child Maltreatment, 29(1), 176–189. https://doi.org/10.1177/10775595221107533
26.
LebowitzE. R.MarinC.MartinoA.ShimshoniY.SilvermanW. (2020). Parent-based treatment as efficacious as CBT for childhood anxiety: A randomized noninferiority study of supporting parenting for anxious childhood emotions. J Am Acad Child Adolsc Psychiatry, 59(3), 362–372. https://doi.org/10.1016/j.jaac.2019.02.014
27.
LeryB.MalmK.McKlindonA. (2022). Engagement and persistence in child welfare services: Implications for program effectiveness. Office of Planning, Research, & Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
28.
LoBraicoE. J.FoscoG. M.CrowleyD. M.RedmondC.SpothR. L.FeinbergM. E. (2019). Examining intervention component dosage effects on substance use initiation in the strengthening families program: For parents and youth ages 10–14. Prevention Science, 20(6), 852–862. https://doi.org/10.1007/s11121-019-00994-7
29.
McLellanA.CacciolaJ.AltermanA.RikoonS.CariseD. (2006). The addiction severity index at 25: Origins, contributions, and transitions. American Journal of Addiction, 15(2), 113–124. https://doi.org/10.1080/10550490500528316
30.
McLellanA. T.KushnerH.MetzgerD.PetersR.SmithI.GrissomG.PettinatiH.ArgeriouM. (1992). Addiction severity index—Fifth edition. APA PsycTests.
31.
NationM.CrustoC.WandersmanA.KumpferK. L.SeyboltD.Morrissey-KaneE.DavinoK. (2003). What works in prevention: Principles of effective prevention programs. American Psychologist, 58(6–7), 449–456. https://doi.org/10.1037/0003-066x.58.6-7.449
32.
NiccolsA.MilliganK.SwordW.ThabaneL.HendersonJ.SmithA. (2012). Integrated programs for mothers with substance abuse issues: A systematic review of studies reporting on parenting outcomes. Harm Reduction Journal, 9(1), 14. https://doi.org/10.1186/1477-7517-9-14
33.
RadloffL. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306
34.
RosendahlJ.AlldredgeC. T.BurlingameG. A.StraussB. (2021). Recent developments in group psychotherapy research. American Journal of Psychotherapy, 74(2), 52–59. https://doi.org/10.1176/appi.psychotherapy.20200031
35.
RyanJ. P.ChoiS.HongJ. S.HernandezP.LarrisonC. R. (2008). Recovery coaches and substance exposed births: An experiment in child welfare. Child Abuse & Neglect, 32(11), 1072–1079. https://doi.org/10.1016/j.chiabu.2007.12.011
36.
SandersM. R.ClagueD.ZającT.BaxterJ.WesternM.ChaineyC.MorawskaA.TomaszewskiW.PrinzR. J.BurkeK. (2024). Parenting, child maltreatment, and social disadvantage: A population-based implementation and evaluation of the triple P system of evidence-based parenting support. Child Maltreatment, 30(1), 177–191. https://doi.org/10.1177/10775595241259994
37.
SeayK. D. (2020). Pathways from parental substance use to child internalizing and externalizing behaviors in a child protective services sample. Child Maltreatment, 25(4), 446–456. https://doi.org/10.1177/1077559520913638
38.
StephensT.GopalanG.AcriM. C.BowmanM.McKayM. M. (2018). Culturally relevant, trauma-informed engagement strategies for child welfare workers: Moving beyond compliance to engagement with families experiencing high levels of exposure to trauma. In StrandS.SprangG. (Eds.), Trauma responsive child welfare systems (pp. 67–86). Springer.
39.
Taber-ThomasS. M.KnutsonF. (2021). Association between mothers’ alcohol use histories and deficient parenting in an economically disadvantaged sample. Child Maltreatment, 26(1), 40–49. https://doi.org/10.1177/1077559520925550
40.
TracyE. M.LaudetA. B.MinM. O.KimH.BrownS.JunM. K.SingerL. (2012). Prospective patterns and correlates of quality of life among women in substance abuse treatment. Drug and Alcohol Dependence, 124(3), 242–249. https://doi.org/10.1016/j.drugalcdep.2012.01.010
41.
van der PutC. E.AssinkM.GubbelsJ.Boekhout van SolingeN. F. (2018). Identifying effective components of child maltreatment interventions: A meta-analysis. Clinical Child and Family Psychology Review, 21(2), 171–202. https://doi.org/10.1007/s10567-017-0250-5
42.
WestA. L.DauberS.GagliardiL.CorrellL.LilliA. C.DanielsJ. (2020). Systematic review of community- and home-based interventions to support parenting and reduce risk of child maltreatment among families with substance-exposed newborns. Child Maltreatment, 25(2), 137–151. https://doi.org/10.1177/1077559519866272
43.
XueY.FuN.HenkeJ.WildszewskiT. (2025). A further look into the impact of the Regional Partnership Grant (RPG) program on adult and child outcomes: Evidence from cohort five. Child Abuse & Neglect, 169(Pt 2), 107729. https://doi.org/10.1016/j.chiabu.2025.107729
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