Once an intervention proves its effectiveness, another important goal involves bring such programs to scale such that others are able to benefit for its use. Currently, there is a gap between advances in basic science (what we believe works) and what is provided (Chadwick Center for Children and Families, 2004; Wolfe & Wekerle, 1993). Although most practitioners who work with maltreated children and their families want to provide the best treatment possible, they do not have the opportunity, financial resources, knowledge, training, or incentives to provide best practices. Suggestions for closing the gap have included (a) financial changes and incentives (e.g., increased programmatic funding for education and direct costs for hiring more educated workers, higher reimbursement for empirically based treatments, payments for only empirically based treatments) and (b) a variety of dissemination plans, including providing materials, training, supervision and consultation opportunities from universities, research society conferences, and in-house training facilities (Brown, Zaslow, Weitzman, 2005; Chadwick Center for Children and Families, 2004; Mahler, Kreader, Godber, Knitzer, & Douglas-Hall, 2002; Malone, McKinsey, Thyer, & Straka, 2000).
One, example of bringing an intervention program to scale that targets at risk, low income first time parents involves the dissemination of The Prenatal and Early Childhood Nurse Home Visitation Project, now called the Nurse Family Partnership (Olds, Hill, & Rumsey, 1998).(3) The Nurse Family Partnership is being established in numerous states around the country. Interestingly, because this program has demonstrated benefits for mothers and children (e.g., health, child abuse prevention, cognitive, language), multiple public and private funding sources have been recruited as sponsors (e.g., Temporary Assistance to Needy Families, Medicaid, Robert Wood Johnson Foundation, and various child-abuse and crime-prevention dollars). Presently, however, this model has proved effective with families that meet certain criteria (namely, low-income, first time parents). Innovative policies and ways for funding interventions for children have been suggested elsewhere (Johnson & Knitzer, 2005; Mahler et al., 2002). As researchers and program administrators are working to test the effectiveness of intervention strategies aimed at reducing child abuse and neglect, important lessons can be learned from the important work done assessing the effectiveness of the Nurse Family Partnership program and understanding what it takes to bring an intervention to scale in communities across the country.