Evaluating the effect of a school-based material needs intervention on child maltreatment investigations in Michigan: A staggered interrupted time series study

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BACKGROUND: Unmet material needs, such as food insecurity or unstable housing, can threaten child safety and increase risk of child maltreatment. In Michigan, Pathways to Potential (P2P) addressed these needs by placing caseworkers in K-12 schools. By meeting families' needs, P2P may have also improved child safety. OBJECTIVE: This study estimated the effect of P2P on maltreatment investigation rates among students in Michigan K-12 schools. PARTICIPANTS AND SETTING: Michigan K-12 students attending public schools between 2008-09 and 2018-19. METHODS: This cohort study used a staggered interrupted time series design to analyze yearly rates of child maltreatment investigations among Michigan K-12 students between 2008-09 and 2018-19. We used segmented quasi-Poisson regression models to assess whether P2P was associated with a change in investigation rates at the school level. We estimated models for each school and pooled estimates using random effects meta-analysis. To evaluate the inverse equity hypothesis, we investigated heterogeneous effects across schools using meta-regressions. RESULTS: Analyses found a 5% decrease in the yearly rates of total child maltreatment investigations (incidence rate ratio [IRR], 0.95; 95% CI: 0.90, 1.00) and a 12% decrease in the yearly rates of child physical neglect investigations (IRR: 0.88; 95% CI: 0.82, 0.95) after schools began implementing P2P. Schools with lower percentages of Black, Latine, and economically disadvantaged students, with higher percentages of White students, with higher P2P doses, and high schools benefited most from P2P. CONCLUSION: School-based interventions to address students' and their parents' basic needs can divert family contact away from the child welfare system. Tailoring such programs for the most marginalized schools could support more equitable gains in child safety.

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