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1.
BackgroundPrevious research shows a co-occurrence between children's exposure to violence and child maltreatment.ObjectiveThis study examined the risk of maltreatment allegations in children whose mothers had been hospitalised due to an assault.Participants and settingThe study used a retrospective cohort of children born in Western Australia between 1990–2009 (N = 524,534) using de-identified linked-administrative data.MethodsMultivariate Cox regression determined the adjusted and unadjusted hazard ratios for child maltreatment allegation in children with a mother hospitalised for assault. Models were adjusted for a range of sociodemographic characteristics.ResultsOne in five children had a maltreatment allegation following their mother's hospitalisation for assault. This increased to two in five children when the mother was assaulted in the prenatal period. Aboriginal children accounted for 57.6% of all allegations despite representing only 7.8% of the population.Children whose mother had a hospitalisation for assault were nine-times (HR = 9.20, 95%CI: 8.98–9.43) more likely to have a subsequent maltreatment allegation than children whose mother did not have a hospitalisation for assault. Following adjustment for confounding factors, both Aboriginal and non-Aboriginal children had an almost two-fold increased risk of maltreatment allegation (HR = 1.56, 95%CI: 1.43–1.70; HR = 1.93 95%CI:1.80–2.07).ConclusionsOur study shows that child maltreatment allegation is common in children following a maternal hospitalisation for assault. Targeted early intervention is required for families with young children, and pregnant women experiencing violence. Importantly service staff need awareness of the impact of violence on families and the appropriate services to refer families to.  相似文献   

2.
The transition from maternity services to community child health services on discharge from hospital occurs at a potentially vulnerable time for women in their transition through the childbearing/early parenting continuum. Their experiences contribute to their developing maternal efficacy and parenting skill. The ideal attributes of services that aim to support women and their families during this time include continuity of care, service integration, and birth in accessible, community-based contexts. The purpose of this study was to investigate aspects of maternal experience of mothers attending with their infants a publicly funded drop-in postnatal health-care service, as well as their reasons for attending and their perceptions of its usefulness to them as a mechanism of continuity and a source of support.  相似文献   

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4.
BackgroundAn important obstacle for family reunification following child placement in residential care and other temporary out-of-home care services is the lack of engagement among parents.ObjectiveThe aim of this meta-analysis is to identify the most effective interventions to promote parental engagement and family reunification.Method and participantsEight studies, for a total of 2996 families, were used to conduct two series of meta-analyses. Each study examined the effectiveness of a goal-oriented parental engagement intervention, relative to a control group made up of parents who received standard services. Six moderators were analyzed: type of clinical modality, number of clinical strategies, sources of motivation for intervention, focus on the child care staff-parent relationship, child care staff training, and strategies to promote access to intervention.ResultsResults indicate that parents exposed to goal-oriented engagement interventions showed greater engagement (effect size d = 0.71, CI: 0.35–1.07, p < 0.001) and likelihood of reunification (effect size OR = 2.49, CI: 1.22–5.10, p < 0.05) than parents who received standard services. In particular, moderator analysis showed that parents who specifically participated in a family-focused intervention showed the highest engagement in comparison to parents involved in other types of interventions or who received standard services (effect size d = 1.08, CI: 0.58–1.59, p < 0.001). No moderators significantly explained heterogeneity of studies on family reunification.ConclusionOverall, the results underline the effectiveness of family-focused interventions to promote parental engagement. Nevertheless, greater knowledge on the mechanisms by which interventions can increase parents’ engagement and family reunification is still needed.  相似文献   

5.
Despite mounting evidence on the importance of fathers in children’s development, evidence-based perinatal home visitation programs have largely overlooked fathers in the design and delivery of services. This paper describes the design, development, and pilot testing of the “Dads Matter” enhancement to standard home visiting services. Dads Matter is a manualized intervention package designed to fully incorporate fathers into perinatal home visiting services. Twenty-four families were enrolled in a pilot study to assess the feasibility, acceptability, and preliminary outcomes of the intervention. Using a quasi-experimental time-lagged design, 12 families received standard home visiting services and completed baseline and four-month post-tests. Home visitor staff were then trained and supervised to implement the Dads Matter enhancement in addition to standard services. Twelve additional families were then enrolled and completed baseline and four-month post-tests. Implementation data indicated that Dads Matter was implemented as planned. Cohen’s d scores on outcome measures indicate positive trends associated with Dads Matter in the quality of the mother-father relationship, perceived stress reported by both parents, fathers’ involvement with the child, maltreatment indicators, and fathers’ verbalizations toward the infant. Effect sizes generally ranged from moderate to large in magnitude and were larger than overall effect sizes of home visitation services alone reported in prior meta-analyses. Dads Matter appears to be a feasible, acceptable, and promising approach to improving fathers’ engagement in home visiting services and promoting family and child well-being.  相似文献   

6.
This study examines the influence of child custody loss on drug use and crime among a sample of African American mothers. Two types of custody loss are examined: informal custody loss (child living apart from mother but courts not involved), and official loss (child removed from mother’s care by authorities).MethodsUsing data from 339 African American women, longitudinal random coefficient models analyzed the effects of each type of custody loss on subsequent drug use and crime.Resultsindicated that both informal and official custody loss predicted increased drug use, and informal loss predicted increased criminal involvement. Findings demonstrate that child custody loss has negative health implications for African American mothers, potentially reducing their likelihood of regaining or retaining custody of their children.ConclusionsThis study highlights the need to integrate drug treatment and other types of assistance into family case plans to improve reunification rates and outcomes among mothers, children, and families. Additionally, the finding that informal loss predicts increased drug use suggests that community-based efforts within the mother’s social network could be implemented to intervene before child welfare system involvement becomes necessary.  相似文献   

7.

Objectives

Although a high level of involvement with the child protection system has been identified in families where parental substance use is a feature, not all such parents abuse or neglect their children or have contact with the child protection system. Identifying parents with substance-use histories who are able to care for their children without intervention by the child protection system, and being able to target interventions to the families who need them the most is important. This study interviewed a relatively large sample of mothers about their histories, their children and their involvement with the child protection system. We hypothesized that mothers in opioid pharmacological treatment who are involved with child protection services are different in characteristics to those mothers who are not involved.

Methods

One hundred and seventy-one women, with at least one child aged under 16 years, were interviewed at nine treatment clinics providing pharmacological treatment for opioid dependence across Sydney, Australia.

Results

Just over one-third of the women were involved with child protection services at the time of interview, mostly with children in out-of-home care. Logistic regression analyses revealed that factors which significantly increased the likelihood of the mother being involved with the child protection system were: (1) having a greater number of children, (2) being on psychiatric medication, and (3) having less than daily contact with her own parents.

Conclusions

This study replicates and extends the work of Grella, Hser, and Huang (2006) and the limited literature published to date examining the factors which contribute to some substance-using mothers becoming involved with the child protection system while others do not. The finding that mental health problems and parental supports (along with the number of children) were significantly associated with child protection system involvement in this study, indicates a need for improved interventions and the provision of treatment and support services if we are to reduce the involvement of the child protection system with these families.  相似文献   

8.
Home visitation programs: Critical Issues and Future Directions   总被引:1,自引:0,他引:1  
As support for intervening early in the lives of vulnerable children has risen in the United States in recent years, so has interest in home-visitation programs. Home visitation is increasingly recognized for its potential to foster early child development and competent parenting, as well as to reduce risk for child abuse and neglect and other poor outcomes for vulnerable families.This paper provides a discussion of several aspects of home-visitation programs that warrant further development and evaluation, including the powerful role of context in determining program outcomes, as well as the impact of other factors, including service dosage, levels of family engagement, and characteristics of home visitors. The importance of more accurately understanding and measuring risk and engaging family members beyond the mother-child dyad is also discussed. Recommendations are made for making improvements in all of these areas, in order to strengthen home-visitation programs and produce better outcomes for the children and families they serve. Aspects of Nurse Family Partnership and Early Head Start, two widely replicated and rigorously evaluated programs, are highlighted to demonstrate how the issues discussed here are likely to affect service delivery and program outcomes. The multiple challenges inherent in replicating and evaluating home-visitation programs that are truly responsive to the needs of a wide array of families with young children are examined. This discussion concludes with a call to expand and improve methods for evaluating these programs, and to view home visitation as a component of a comprehensive system of child and family supports, rather than as a stand-alone model of intervention.  相似文献   

9.
This article explores service use broadly by examining the mix of educational, health, and psychosocial services that preschool children received in the fifth year of life. The sample included 869 children who participated in the Infant Health and Development Program, an early intervention program designed to evaluate the efficacy of a comprehensive early intervention for low-birth-weight, premature infants during the first 3 years of life and who were followed until age 5. Cluster analyses of services at age 5 yielded 4 service groups--basic health only (doctor visits; n = 114); basic health and educational services (doctor visits and school/preschool; n = 444); basic health, educational, and psychosocial services (or multiple services; doctor visits, school/preschool, and psychosocial services; n = 129); and specialized health and educational services (doctor visits, school/preschool, emergency room visits and special medical visits [ear and/or eye examinations]; n = 182). Results suggest that neonatal health conditions, maternal education at the time of the child's birth, child developmental status at age 3, and maternal health, family income, and insurance status at age 5 were associated with patterns of services at age 5. Patterns of use are consistent over time (the first 3 years of life to the 5th year of life). After covarying the correlates of the service patterns, participation in the early intervention was not associated with patterns of services at age 5, and service patterns were associated with child well-being (health, school readiness, mental health), but results differed by intervention status. Findings are discussed in terms of preventive, responsive, and deficit models of service use.  相似文献   

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OBJECTIVE: Building on a previous model of recurrence, this study examined the relationship of services on the hazard of child maltreatment 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 434 subject families who met study eligibility requirements from 1181 families randomly selected from the 2902 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 the Cox Proportional Regression Model. RESULTS: Case characteristics that predicted recurrence were: child vulnerability, family stress, partner abuse, and social support deficits. After examining the potential effect of nine service-related variables only attendance at services predicted recurrence while controlling for other variables in the model. Families who were noted to attend the services identified in their service plans were 33% less likely to experience a recurrence of child maltreatment while their case was active with CPS. CONCLUSIONS: Implications of this and other research suggests that actively engaging families in a helping alliance and helping them accept and receive services may reduce the likelihood of future maltreatment.  相似文献   

12.
Meeting Needs of Young Children at Risk for or Having a Disability   总被引:1,自引:0,他引:1  
Poverty-related factors place children at higher risk for disabilities and also serve as barriers to families accessing services for their children and themselves. Early childhood practitioners can play a critical role in supporting families by providing services to overcome these obstacles and by working in partnership with specialized early intervention programs to assure the families and children receive those services. Families (N = 3,001) enrolled in the Early Head Start (EHS) Research and Evaluation Project were randomly assigned to the program group (who received EHS services) or the control group in a rigorous, experimental design study in order to evaluate program impacts. All participating families were living in poverty, included a pregnant woman or a child below age 1, and were eligible for EHS. The majority of children enrolled in the EHS Research and Evaluation Project was identified as having at least one of a great variety of disability indicators (e.g., family received Part C services, child has been diagnosed as having asthma). There was a very small number of families, however, actually enrolled in Part C services. Enrollment in EHS was associated with children being less likely to have cognitive or language delays and their families being more likely to receive early intervention (Part C) services and have Individualized Family Service Plans (IFSPs) when they needed them.  相似文献   

13.
Seven hundred thirty-one income-eligible families in 3 geographical regions who were enrolled in a national food supplement program were screened and randomized to a brief family intervention. At child ages 2 and 3, the intervention group caregivers were offered the Family Check-Up and linked parenting support services. Latent growth models on caregiver reports at child ages 2, 3, and 4 revealed decreased behavior problems when compared with the control group. Intervention effects occurred predominantly among families reporting high levels of problem behavior at child age 2. Families in the intervention condition improved on direct observation measures of caregivers' positive behavior support at child ages 2 and 3; improvements in positive behavior support mediated improvements in children's early problem behavior.  相似文献   

14.
Supporting child welfare (CW) workers’ ability to accurately assess substance abuse needs and link families to appropriate services is critical given the high prevalence of parental substance use disorders (SUD) among CW-involved cases. Several barriers hinder this process, including CW workers’ lack of expertise for identifying SUD needs and scarcity of treatment resources. Drawing from theories and emergent literature on interagency collaboration, this study examined the role of collaboration in increasing the availability of resources for identifying and treating SUDs in CW agencies. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, study findings highlight a lack of SUD resources available to CW workers. On the other hand, the availability of SUD resources was increased when CW agencies had a memorandum of understanding, co-location of staff, and more intense collaboration with drug and alcohol service (DAS) providers. These results provide evidence to support efforts to improve collaboration between CW and DAS providers and showcase specific collaboration strategies to implement in order to improve service delivery.  相似文献   

15.
This study examined the impact of the Family Check-Up (FCU) and linked intervention services on reducing health-risk behaviors and promoting social adaptation among middle school youth. A total of 593 students and their families were randomly assigned to receive either the intervention or middle school services as usual. Forty-two percent of intervention families engaged in the service and received the FCU. Using complier average causal effect analyses, engagement in the intervention moderated intervention outcomes. Families who engaged in the intervention had youth who reported lower rates of antisocial behavior and substance use over time than did a matched control sample. Results extend previous research indicating that a family-centered approach to supporting youth in the public school setting reduced the growth of antisocial behavior, alcohol use, tobacco use, and marijuana use throughout the middle school years.  相似文献   

16.
BackgroundNeglect is the most common form of child maltreatment with consequences that appear to be as serious as for abuse. Despite this, the problem has received less than its due attention.ObjectiveTo examine the relationship between the timing and chronicity of neglect during childhood and substance use in early adulthood.Participants and settingThe sample consisted of a subset of 475 participants from the prospective Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) consortium from five geographic areas around the U.S.MethodNeglect was assessed using abstracted information from CPS reports (birth-18) and self-reports of neglect (12–18). Participants completed a follow-up online survey (mean age of 24 years) that probed their use of substances.ResultsThe prevalence of substance use during the past year was comparable in this high-risk sample to the general population. Latent class analysis supported the presence of three groups related to the presence and timing of neglect: Chronic Neglect, Late Neglect and Limited Neglect. Late Neglect was the pattern most strongly linked to substance use in early adulthood.ConclusionsHigh-risk youth experiencing neglect beginning in mid- adolescence are especially vulnerable to later substance use. Those working with such youth and their families can play a valuable role helping ensure their basic needs are adequately met, and recognizing early signs of substance use and abuse.  相似文献   

17.
In this investigation we examine the relation between intensity, duration, and comprehensiveness of early intervention (EI) services and changes in three aspects of maternal well-being: parenting stress, social support, and family cohesion. Data on the hours, length, and types of services received by a sample of 133 children and families from EI programs in Massachusetts and New Hampshire were gathered from the point of entry into EI to the point of discharge around the child's third birthday. Hierarchical regression analyses were used to determine which measure of EI service intervention contributed significantly to the explained variance in changes in maternal well-being, over and above aspects of the child's functioning and prior levels of maternal well-being. Results indicated that, although greater service intensity was associated with improved family cohesion overall, mothers of children without motor impairment reported greater increases than mothers of children with motor impairment. Service intensity and comprehensiveness predicted significant increases in social support levels. EI services did not have a significant impact on parenting stress. Three practice and policy implications are discussed: building flexibility into EI service provision to be responsive to individual family needs; attending to the accommodations required of families raising a child with a motor impairment; and incorporating other aspects of family functioning into future studies of EI effectiveness.  相似文献   

18.
OBJECTIVES: To assess the impact of a home visiting program in reducing malleable parental risk factors for child abuse in families of newborns identified, through population-based screening, as at-risk of child abuse. METHODS: This randomized trial focused on Healthy Start Program (HSP) sites operated by three community-based organizations on Oahu, HI, USA. From 11/94 to 12/95, 643 families were enrolled and randomly assigned to intervention and control groups. Mothers in both groups were interviewed annually for 3 years (88% follow-up each year) to measure mental health, substance use, and partner violence. HSP records were reviewed to measure home visiting services provided. Home visitors were surveyed annually to measure their perceived competence. RESULTS: Malleable parental risks for child abuse were common at baseline. There was no significant overall program effect on any risk or on at-risk mothers' desire for and use of community services to address risks. There was a significant reduction in one measure of poor mental health at one agency and a significant reduction in maternal problem alcohol use and repeated incidents of physical partner violence for families receiving > or =75% of visits called for in the model. Home visitors often failed to recognize parental risks and seldom linked families with community resources. HSP training programs were under-developed in preparing staff to address risks and to link families with community resources. CONCLUSIONS: Overall, the home visiting program did not reduce major risk factors for child abuse that made families eligible for service. Research is needed to develop and test strategies to improve home visiting effectiveness in reducing parental risks for child abuse.  相似文献   

19.
ObjectiveInterorganizational relationships (IORs) between child welfare agencies and mental health service providers may facilitate mental health treatment access for vulnerable children. This study investigates whether IORs are associated with greater use of mental health services and improvement in mental health status for children served by the child welfare system.MethodsThis was a longitudinal analysis of data from a 36-month period in the National Survey of Child and Adolescent Well-Being (NSCAW). The sample consisted of 1,613 children within 75 child welfare agencies who were 2 years or older and had mental health problems at baseline. IOR intensity was measured as the number of coordination approaches between each child welfare agency and mental health service providers. Separate weighted multilevel logistic regression models tested associations between IORs and service use and outcomes, respectively.ResultsAgency-level factors accounted for 9% of the variance in the probability of service use and 12% of mental health improvement. Greater intensity of IORs was associated with higher likelihood of both service use and mental health improvement.ConclusionsHaving greater numbers of ties with mental health providers may help child welfare agencies improve children's mental health service access and outcomes.Practice implicationsPolicymakers should develop policies and initiatives to encourage a combination of different types of organizational ties between child welfare and mental health systems. For instance, information sharing at the agency level in addition to coordination at the case level may improve the coordination necessary to serve these vulnerable children.  相似文献   

20.
Evaluations of early intervention for children facing biological and/or socioeconomic risk have tended to focus most directly on change in the child, treating family variables primarily as mediators of change. In contrast, the current study used developmental theory to articulate hypotheses that address one way in which a focus on the relationship between mother and child may be related to intervention efficacy. This study examined maternal control strategy and child compliance as a function of early intervention beginning at birth for low birth weight, preterm infants and their families and related these aspects of mother–child interaction to behavioral outcomes at age 3 (n=645). Overall, mothers receiving early intervention were no more likely to use a preferred control strategy, guidance orientation, in a structured compliance task than were mothers participating in a follow-up only condition. However, an association between early intervention and maternal guidance was observed among mothers of children who were consistently noncompliant during the task. As a result, maternal guidance as observed in the compliance interaction was associated with reduced externalizing and internalizing behavior at program end for children participating in the intervention but not the follow-up only condition. Findings highlight the value of focusing on the mother–child dyad and illustrate one way in which developmental theory can assist in the specification of treatment effects.  相似文献   

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