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1.
OBJECTIVE: This study was undertaken to determine the incidence, hospital charges, and correlates associated with inpatient treatment of child maltreatment related injuries. METHODS: The data were based on the 1995 Pennsylvania Hospital Discharge Data which included all Pennsylvania acute care hospitals that reported child maltreatment discharges. Per capita hospital discharge rates were computed for children discharged with child maltreatment related injuries according to selected variables. Odds ratios for child maltreatment related injury hospitalizations were also computed. RESULTS: A total of 348 maltreated injured children ages 0-19 years were discharged from Pennsylvania hospitals in 1995, representing an incidence rate of 10.8 per 100,000 persons. The total hospital charges for child maltreatment related injury discharges amounted to over $5.4 million, of which Medicaid alone paid for 45%. Compared to a random sample of non-maltreated injured children (n = 1052), maltreated injured children were found to be significantly younger, more likely to be females, and more likely to be Black. Child maltreatment related injury hospitalizations were more likely to be urgent and via physician referral or transfer from other health care facility. Maltreated injured children were three times as likely to die as other children. CONCLUSIONS: These findings indicate that injury from child maltreatment is a major cause of hospitalization of young children 5 years and younger and represents a significant cost to publicly financed health care. While hospital discharge data can be used for population-based surveillance of child maltreatment related trauma, there is need for improvement in the surveillance of these injuries.  相似文献   

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Policies can be powerful tools for prevention given their potential to affect conditions that can improve population-level health. Given the dearth of empirical research on policies’ impacts on child maltreatment, this article (a) identifies 37 state policies that might have impacts on the social determinants of child maltreatment; (b) identifies available data sources documenting the implementation of 31 policies; and (c) utilizes the available data to explore effects of 11 policies (selected because they had little missing data) on child maltreatment rates. These include two policies aimed at reducing poverty, two temporary assistance to needy families policies, two policies aimed at increasing access to child care, three policies aimed at increasing access to high quality pre-K, and three policies aimed at increasing access to health care. Multi-level regression analyses between within-state trends of child maltreatment investigation rates and these 11 policies, controlling for states’ childhood poverty, adults without a high school diploma, unemployment, child burden, and race/ethnicity, identified two that were significantly associated with decreased child maltreatment rates: lack of waitlists to access subsidized child care and policies that facilitate continuity of child health care. These findings are correlational and are limited by the quality and availability of the data. Future research might focus on a reduced number of states that have good quality administrative data or population-based survey data on child maltreatment or reasonable proxies for child maltreatment and where data on the actual implementation of specific policies of interest can be documented.  相似文献   

4.
Direct questions on child maltreatment in population-based surveys are often limited by ethical and methodological issues. This restricts the ability of researchers to examine an important aspect of early adversity and its relationship to health and behavior. An alternative to excluding issues of maltreatment entirely in population-based surveys is to include questions on child and family involvement with child protective services (CPS). A school-based adolescent survey that included a question on child and family involvement with CPS yielded results that were generally consistent with other studies relating child maltreatment to health and behavioral outcomes such as psychological distress symptoms, delinquency, aspects of bullying, and health service utilization. Such findings suggest that questions on involvement with CPS may be a reasonable proxy for child maltreatment. Despite the lack of information on the reason for involvement or specific categories of maltreatment, CPS involvement questions highlight the shared familial experience that surrounds CPS involvement and serves as a general reflection of an adverse experience that can be utilized by researchers interested in early experiences.  相似文献   

5.
ObjectiveThe objectives of this article are to explore the extent to which the International Statistical Classification of Diseases and Related Health Problems (ICD) has been used in child abuse research, to describe how the ICD system has been applied, and to assess factors affecting the reliability of ICD coded data in child abuse research.MethodsPubMed, CINAHL, PsychInfo and Google Scholar were searched for peer reviewed articles written since 1989 that used ICD as the classification system to identify cases and research child abuse using health databases. Snowballing strategies were also employed by searching the bibliographies of retrieved references to identify relevant associated articles. The papers identified through the search were independently screened by two authors for inclusion, resulting in 47 studies selected for the review. Due to heterogeneity of studies meta-analysis was not performed.ResultsThis paper highlights both utility and limitations of ICD coded data. ICD codes have been widely used to conduct research into child maltreatment in health data systems. The codes appear to be used primarily to determine child maltreatment patterns within identified diagnoses or to identify child maltreatment cases for research.ConclusionsA significant impediment to the use of ICD codes in child maltreatment research is the under ascertainment of child maltreatment by using coded data alone. This is most clearly identified and, to some degree, quantified, in research where data linkage is used.Practice implicationsThe importance of improved child maltreatment identification will assist in identifying risk factors and creating programs that can prevent and treat child maltreatment and assist in meeting reporting obligations under the CRC.  相似文献   

6.
Can we measure success in preventing child abuse? As the field of child abuse and neglect prevention matures intellectually and as more and more agencies require evaluative research to substantiate claims of programmatic success, this issue is emerging with ever growing vigor. This paper reviews efforts to set prevention goals in the United States, e.g., by the federal government's Surgeon General's Report on Health Promotion and Disease Prevention and by the National Committee for the Prevention of Child Abuse. For such goal setting to be defensible and socially productive, it must be linked to a research base. This research base is growing and maturing. The home health visitor concept, in particular, has received clear and powerful support as a preventive strategy. However, many issues remain concerning other strategies. Of equal or greater importance are the many difficulties we face in documenting base rates of maltreatment with which to assess the impact of preventive interventions. Questions remain about the adequacy of infant mortality data, child injury rates, and the validity of officially reported cases of child maltreatment. The paper reviews the data available to clarify and resolve these issues, and outlines a strategy for assessing success of efforts to reduce severity and incidence of child abuse in the United States. These efforts are presented in the context of a series of principles regarding child abuse prevention, e.g., the difference between prevention linked to broad social and economic reforms versus preventive programming targeted at ameliorating the lives of high-risk families in the absence of broad socioeconomic change.  相似文献   

7.
The primary purpose of the child protective services system is to protect children from the recurrence of child maltreatment. Understanding more about what predicts recurrence may help us more adequately target interventions to reduce the risk of future maltreatment. OBJECTIVE: The specific objective of this study was to identify correlates of recurrence during CPS intervention for families who were provided continuing intervention following a confirmed index report of physical abuse or neglect. METHOD: This nonconcurrent prospective study selected 446 subject families who met study eligibility requirements from 1,181 families randomly selected from the 2,902 families who had experienced a substantiated report of child abuse or neglect during the sampling year. Data were collected and coded from archival sources for 5 years following the index report. Each record was coded by two research analysts to increase inter-rater reliability. Data were analyzed with survival analysis methods: (1) Kaplan Meier and (2) the Cox Proportional Regression Model. RESULTS: Predictors of recurrence were child vulnerability, family stress, partner abuse, social support deficits, and an interaction between family stress and social support deficits. CONCLUSIONS: Implications of this and earlier research suggest that increasing social supports may help families cope with life events that increase stress and the risk of continued child maltreatment; that collaborations between CPS and domestic violence agencies are needed; and that screening maltreated children for mental health problems and other disabilities and assuring that children with these needs and their families get effective treatment may reduce the likelihood of continued maltreatment.  相似文献   

8.
This review critically examined the theories, methodologies, and methods that have been used in early childhood environmental education research over the past 10 years (2004–2014). Of the 36 studies identified, one-third were informed by research on children approaches, positioning children as objects of research. Trends revealed that EE researchers are moving toward research with children frameworks, embracing methods that honor children's perspectives. Yet a lack of congruency was also identified between participatory methodologies and the methods employed. Although researchers advocated for children's agency, adults were still positioned in the primary role of data collectors, analyzers, and interpreters. Findings are useful for EE scholars pursuing research with the very young, providing insight regarding ethical practices, child positioning, and participatory methods.  相似文献   

9.
In the interest of improving child maltreatment prevention, this prospective, longitudinal, community-based study of 499 mothers and their infants examined (a) direct associations between mothers' experiences of childhood maltreatment and their offspring's maltreatment, and (b) mothers' mental health problems, social isolation, and social information processing patterns (hostile attributions and aggressive response biases) as mediators of these associations. Mothers' childhood physical abuse--but not neglect--directly predicted offspring victimization. This association was mediated by mothers' social isolation and aggressive response biases. Findings are discussed in terms of specific implications for child maltreatment prevention.  相似文献   

10.
There has been increasing awareness of the need to prevent child maltreatment at a time of limited public funds. As a result, cost-effectiveness has become important in the planning of health care and social services. Evaluations of child maltreatment interventions that have been analyzed for their cost-effectiveness are reviewed. There has been relatively little work in this area and much of it has serious methodological flaws. Nevertheless, research suggests that home health visitors, lay group counseling, and family and group therapy are promising interventions. Medical foster care has been shown to substantially reduce costs, but its effectiveness has not been determined. Current knowledge on the effectiveness of interventions in child maltreatment is limited, and this needs to be addressed in order to answer the question of cost-effectiveness. Recommendations are made for future research in the field.  相似文献   

11.
The news media plays a vital role in providing child protection information and resources, shaping the public’s understanding and perceptions of child maltreatment, and exposing system failures and setting policy agendas. To date, little is known about how child maltreatment is portrayed in the media in societies where these issues remain largely hidden and under-recognized. The purpose of the present study was to systematically examine newspaper coverage on child abuse and neglect in Hong Kong in order to assess how child maltreatment is currently presented and framed within public discourse.A total of 579 newspaper reports relevant to child maltreatment from four local newspapers in 2016 were reviewed. Similar to prior findings, cases involving sexual abuse received disproportionately more attention compared with other maltreatment types. The vast majority of news reports focused on specific cases or events, and seldom discussed child maltreatment as a broader social issue. Differences in reporting style and media framing were also compared by newspaper credibility, and for free versus paid newspapers.As a mass communication tool, more guidelines are needed to formulate public messages about child maltreatment that can improve individual, community, and structural capacities to prevent, identify, and respond to children who are victimized by abuse and neglect. This is especially important in jurisdictions where no mandatory reporting framework exists to help identify vulnerable children, and where the majority of child maltreatment is brought to the attention of authorities by families and those living within the child’s community.  相似文献   

12.
Parents who maltreat their children have long been thought to lack support from informal and social networks. Recent writers have taken the position that this relationship is a proven, causal one, with social isolation seen as a necessary antecedent condition for the occurrence of child abuse. Concurrently, initial enthusiasm for social support as a powerful explanatory variable in other areas of psychological and health research is giving way to cautious reevaluation of the evidence. The present review was undertaken to bring into sharper focus what is now known regarding the relationship between child maltreatment and parental isolation from informal helping networks. Existing research is fraught with both conceptual and methodological problems. There is, at present, little research evidence that lack of social support plays a significant role in the etiology of physical abuse. Stronger evidence exists that neglectful parents are socially isolated, but the data are consistent with the hypothesis that this is one manifestation of the character problems of these parents. Future research must give closer attention to clearly defining social support and using reliable and valid instruments to measure it, while exploring multivariate models of child maltreatment.  相似文献   

13.
Research on factors associated with good mental health following child maltreatment is often based on unrepresentative adult samples. To address these limitations, the current study investigated the relationship between individual-level factors and overall mental health status among adolescents with and without a history of maltreatment in a representative sample.The objectives of the present study were to: 1) compute the prevalence of mental health indicators by child maltreatment types, 2) estimate the prevalence of overall good, moderate, and poor mental health by child maltreatment types; and 3) examine the relationship between individual-level factors and overall mental health status of adolescents with and without a history of maltreatment. Data were from the National Comorbidity Survey of Adolescents (NCS-A; n = 10,123; data collection 2001–2004); a large, cross-sectional, nationally representative sample of adolescents aged 13–17 years from the United States. All types of child maltreatment were significantly associated with increased odds of having poor mental health (adjusted odds ratios ranged from 3.2 to 9.5). The individual-level factors significantly associated with increased odds of good mental health status included: being physically active in the winter; utilizing positive coping strategies; having positive self-esteem; and internal locus of control (adjusted odds ratios ranged from 1.7 to 38.2). Interventions targeted to adolescents with a history of child maltreatment may want to test for the efficacy of the factors identified above.  相似文献   

14.
Maternal suicide and infanticide are merely the extreme tip of the iceberg of psychological and social morbidity associated with post-partum depression. Despite research indicating an association between maternal depression and disturbed parent-child interaction, maternal depression has been largely ignored in the literature on child maltreatment and in child protection practice. Practitioners should be alert to the potential risks to the child associated with maternal depression. In cases where child abuse has occurred, they should consider the possibility that the mother is depressed and that this needs to be treated as a problem in its own right. In terms of prevention of child maltreatment, early identification of maternal depression is an important strategy in which primary health workers have an important role. This study investigates the feasibility of broadening the traditional infant health focus of the role of the Australian Maternal and Child Health Nurse or Public Health Nurse to encompass maternal emotional and social well-being. Using quantitative and qualitative methods, the conditions under which mothers would find this acceptable, and the factors that facilitate or constrain such role redefinition are analyzed.  相似文献   

15.
This report reviews research on the community dimensions of child maltreatment and presents a study conducted in the United States designed to illuminate further the importance of social environmental effects on family functioning. The study involves 77 community areas within the Chicago, Illinois, metropolitan area. Child maltreatment rates are related to indicators of socioeconomic and demographic well being for these neighborhoods and for the subunits within them. The results reveal a strong influence of socioeconomic and demographic factors on child maltreatment rates. A further analysis involves selecting pairs of neighborhoods for additional study. In this phase of the research the character of socioeconomically similar areas with contrasting patterns of child maltreatment is revealed. The high-risk areas are characterized by social disorganization and lack of social coherence, in contrast to the low-risk areas which evidence a stronger social fabric. These effects extend to differences in child abuse fatalities.  相似文献   

16.
Child maltreatment research varies considerably in how maltreatment is measured. Although researchers have advocated for improvements in maltreatment assessment, a first step is a clear understanding of the status on how the field operationalizes maltreatment. The current paper sought to achieve this goal through reviewing research on child maltreatment over a recent 10-year span to identify trends in maltreatment assessment and operationalization. Information on maltreatment measurement was extracted from 338 articles across three major journals devoted to publishing research on child maltreatment. Among the various definitional dimensions of maltreatment, type was the most common way maltreatment was operationalized, followed by severity, frequency, and chronicity, a stable trend across the 10-year span of review. The results indicated that the majority of studies measured maltreatment as consisting of multiple types, although some studies focused on one type of maltreatment as the indicator of child maltreatment. Further, the most common assessment method was the administration of a questionnaire or the combination of two questionnaires with the second most common being summaries from case file review. Recommendations for future research are discussed.  相似文献   

17.
Child maltreatment among school children in the Kurdistan Province, Iran   总被引:3,自引:0,他引:3  
OBJECTIVE: This study examines the determinants of three types of child maltreatment: physical maltreatment, mental maltreatment, and child neglect among school children in the Kurdistan Province of Iran. The analysis examines the impact of socioeconomic, familial, demographic, and household dynamic factors on the three child maltreatment outcomes, and compares the differential impact of these factors across the three types of child maltreatment. A greater understanding of the factors associated with child maltreatment has the potential to inform public health interventions aimed at reducing specific forms of maltreatment and at identifying at risk populations. METHODS: Data were collected from 1,370 school students, age 11-18. Separate logistic models are fitted for six binary outcomes examining self-reported experiences of physical maltreatment in the home or school, mental maltreatment in the home or school, and child neglect in the home or school. RESULTS: Male children were more likely to report experiencing any kind of child maltreatment than girls. Residency in a rural area, poor parental relationships and the use of addictive substances by household members were associated with increased odds of reporting child maltreatment. Poor school performance was associated with the reporting of experiencing maltreatment at school. CONCLUSION: Each of the forms of child maltreatment is highly correlated with socioeconomic, demographic, and living condition factors. The results point to the strong influence that familial factors have in shaping a child's likelihood of reporting maltreatment. Characteristics of the mother were associated with maltreatment, but not characteristics of the father. The results highlight a number of mechanisms through which public health interventions may seek to reduce the prevalence of child maltreatment in Kurdistan; different approaches are needed to reduce child maltreatment in the home and school environments.  相似文献   

18.
Assessment and decision-making in child maltreatment cases is difficult. Practitioners face many uncertainties and obstacles during their assessment and decision-making process. Research exhibits shortcomings in this decision-making process. The purpose of this literature review is to identify and discuss methods to overcome these shortcomings. We conducted a systematic review of the published literature on decision-making using PsychINFO and MEDLINE from 2000 through May 2014. We included reviews and quantitative research studies that investigated methods aimed at improving professional decision-making on child abuse and neglect in child welfare and child protection. Although many researchers have published articles on decision-making including ideas and theories to improve professional decision-making, empirical research on these improvements is scarce. Available studies have shown promising results. Structured decision-making has created a greater child-centred and holistic approach that takes the child's family and environment into account, which has made practitioners work more systematically and improved the analysis of complex situations. However, this approach has not improved inter-rater agreement on decisions made. Shared decision-making may improve the participation of parents and children and the quality of decisions by taking client treatment preferences into account in addition to scientific evidence and clinical experience. A number of interesting developments appear in recent research literature; however, child welfare and child protection must find additional inspiration from other areas, e.g., mental health services, because research on decision-making processes in child welfare and child protection is still rare.  相似文献   

19.
《Child abuse & neglect》2014,38(12):1902-1913
Child maltreatment is one of the most commonly examined risk factors for violence in dating relationships. Often referred to as the intergenerational transmission of violence or cycle of violence, a fair amount of research suggests that experiencing abuse during childhood significantly increases the likelihood of involvement in violent relationships later, but these conclusions are primarily based on correlational research designs. Furthermore, the majority of research linking childhood maltreatment and dating violence has focused on samples of young people from the United States. Considering these limitations, the current study uses a rigorous, propensity score matching approach to estimate the causal effect of experiencing child physical abuse on adult dating violence among a large sample of South Korean emerging adults. Results indicate that the link between child physical abuse and adult dating violence is spurious rather than causal. Study limitations and implications are discussed.  相似文献   

20.
BackgroundMental health problems in parents have been identified as a risk factor for child maltreatment. The perinatal period (from conception to 1 year) is a critical period but it is unclear whether perinatal mental health problems are also associated with increased risk.ObjectiveTo review evidence on perinatal mental health and risk of child maltreatment.MethodsSearches were conducted on six databases and 24 studies reported in 30 papers identified. Studies were conducted in seven countries, mainly the USA (n = 14). Sample sizes ranged from 48-14,893 and most examined mothers (n = 17). Studies were conducted in community (n = 17) or high-risk (n = 7) samples.ResultsThe majority of studies found a relationship between parental perinatal mental health problems and risk of child maltreatment, but inconsistent findings were observed between and within studies. The few studies that examined fathers (n = 6) all found a relationship between fathers’ mental health and risk of child maltreatment. Meta-analysis of 17 studies (n = 22,042) showed perinatal mental health problems increased risk of child maltreatment by OR 3.04 (95% CI 2.29–4.03). This relationship was moderated by type of sample, with larger effects for risk of child maltreatment in high-risk samples. The relationship was not moderated by type of mental illness, child maltreatment; methodological or measurement factors.ConclusionThe association between perinatal mental health and risk of child maltreatment is similar to that observed at other times during childhood. Methodological heterogeneity and inconsistent findings mean conclusions are tentative and need to be considered alongside other individual, family and social/cultural risk factors.  相似文献   

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