Child protection training for professionals to improve reporting of child abuse and neglect

Knowledge and experience of pediatricians and pedodontists in identifying and managing child abuse and neglect cases

Child abuse, by definition parents and other family members, caregivers, or any adult he does not know culturally inappropriate, harmful to the child described, inhibiting growth and development, or exposure to a restrictive behavior. This study aims to evaluate the capabilities of pediatricians and pedodontists in identifying and managing child abuse and neglect within healthcare settings, a crucial responsibility for professionals across various medical disciplines. Questionnaire was performed on 53 pediatricians and 89 pedodontists. Utilizing a 28-item expert-designed electronic questionnaire, the study solicited responses from pediatricians and pedodontists to assess their demographic characteristics, professional experience, and self-perceived competence in this critical area. The results indicate that 42% of the participating healthcare providers have encountered at least one case of child abuse and neglect. Notably, pedodontists displayed a higher level of uncertainty in identifying abuse and neglect cases compared to pediatricians. Furthermore, participants who had a higher level of self-perceived competence were significantly more willing to identify and manage cases, although this self-assessment did not correlate with their actual skills or level of willingness to intervene effectively. The study concludes that there is a pressing need for specialized training programs tailored to enhance the skill sets of healthcare providers in identifying and managing child abuse and neglect. These programs should encompass not only academic knowledge but also practical applications and psychosocial support techniques to ensure a holistic approach to combating this serious issue.

Interprofessional Education in Child Protection for Preservice Health and Allied Health Professionals: A Scoping Review

Health and allied health professionals are uniquely positioned to collaborate in prevention, early intervention and responses to child maltreatment. Effective collaboration requires comprehensive interprofessional education (IPE), and inadequate collaboration across sectors and professions continually contributes to poor outcomes for children. Little is known about what interprofessional preparation health and allied health professionals receive before initial qualification (preservice) that equips them for interprofessional collaboration and provision of culturally safe care in child protection. This scoping review aimed to identify what is known internationally about IPE in child protection for preservice health and allied health professionals. Thirteen manuscripts reporting 12 studies met the inclusion criteria and were included in the synthesis. Key characteristics of the educational interventions are presented, including target disciplines, core content and their learning objectives and activities. Findings demonstrated primarily low-quality methodologies and educational interventions that had not been replicated beyond their initial context. Many educational interventions did not provide comprehensive content covering the spectrum of prevention, early intervention and responses for all types of child maltreatment, and/or did not clearly indicate how IPE was achieved. Key challenges to delivering comprehensive interprofessional child protection include lack of institutional support and competing priorities across disciplines who must meet requirements of separate regulatory bodies. Consequently, there is a need for further development and robust evaluation of educational interventions to explore how interprofessional collaborative skills for child protection can be developed and delivered in preservice health and allied health professional education.

Prevention of child sexual abuse in the USA: a scoping review protocol of US legislative policies

INTRODUCTION

Child sexual abuse (CSA) poses a significant threat to the health and well-being of children in the USA and globally. Many states have introduced or implemented policies to address and prevent CSA, but little research has linked the effects of this legislation on the reduction of adult-perpetrated CSA. The objective of this scoping review is to identify US policies which aim to prevent CSA, explain the components of these types of legislation, review evidence of effectiveness, describe the populations included in the literature, and identify barriers and facilitators to the implementation of said policies.

METHODS AND ANALYSIS

This scoping review will follow Joanna Briggs Institute methodology for scoping reviews and will use the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. Sources of peer-reviewed evidence from January 2000 to July 2023 will be included. Relevant publications will first be searched in PubMed/MEDLINE database, then 25 other databases. The reference lists of included studies and high-yield journals will be hand searched. Articles which focus on the types of CSA prevention policies and their effects will be included. Studies must clearly demonstrate a connection between policies and CSA outcomes. Title, abstract, full-text screening and extraction will be completed by a team of three researchers. Critical appraisal of the included studies will be performed. Extracted data will be displayed in tabular form and a narrative summary will describe the results of the review.

ETHICS AND DISSEMINATION

This scoping review will provide an extensive overview of legislative policies which aim to prevent CSA in the USA. Results of this review will inform future CSA prevention policies in the USA, particularly regarding policy development, evaluation and implementation. Results will be disseminated through a peer-reviewed publication.

An E-Learning Program for Continuing Midwifery Education on Handling High-Risk Abuse Cases: A Pretest-Posttest Design

It is essential to equip midwives and nurses working in the perinatal period with comprehensive knowledge and awareness regarding child abuse prevention. However, most midwives and nurses in Japan do not have the opportunity to learn about abuse prevention during their basic education. We aimed to develop an e-learning program to assist obstetric midwives and nurses in acquiring the knowledge needed to provide support and handle cases with a high risk of abuse, as well as to assess the program's usefulness. This study employed a single-group pre-post design; e-learning served as the intervention. Seventy-one obstetric midwives and nurses were recruited. The program's usefulness was the difference between the participants' pretest and post-test knowledge and efficacy scores. The score data were analyzed using the t-test. A paired t-test revealed that the post-test scores of knowledge and efficacy were significantly higher than those of the pretest, with a large effect size (d = 1.71). Platforms where basic knowledge on how to respond to high-risk abuse cases are lacking in nursing education; thus, this e-learning program is recommended for nurses working in the perinatal field throughout Japan. This educational opportunity for perinatal midwives and nurses will increase awareness and contribute to abuse prevention.

How Do Survivor and Mandatory Reporter Status Correlate with Program Outcomes for an Adult-Focused Child Sexual Abuse Prevention Program?

This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming.

Childhood abuse and association with adult depressive symptoms among people with cardiovascular disease

Background

To study the association between the total/different types of childhood abuse and adult depressive symptoms in people with cardiovascular disease (CVD).

Methods

The subjects were people with CVD who continuously participated in the China Health and Retirement Longitudinal Study (CHARLS) life history survey and the 2018 wave of the CHARLS national baseline Survey. Multi-level logistic regression models were used to analyze the relationship between emotional neglect, physical neglect, physical abuse and adult depressive symptoms.

Results

A total of 4,823 respondents were included in this study. The incidence of childhood abuse (existed emotional neglect, physical neglect or physical abuse) was 43.58% among people over 45 years old with CVD, which was higher than that of the general population (36.62%, p < 0.05). Adjusted model showed that overall childhood abuse was associated with adult depressive symptoms (OR = 1.230, 95%CI:1.094-1.383). Among different types of childhood abuse, only physical abuse was associated with depressive symptoms in adulthood (OR = 1.345, 95%CI:1.184-1.528).

Conclusion

Compared with that of the general population, the incidence of childhood abuse in CVD population is higher. Physical abuse in childhood increased the risk of depressive symptoms in adulthood. It suggested that the occurrence of depressive symptoms was the result of related factors in the whole life course. In order to prevent the depressive symptoms, childhood abuse also needs to be considered. It is very important to identify and prevent the continuation of childhood abuse in time.

Teachers' Responses to Child Maltreatment

Purpose

Teachers play an important role in detecting and reporting child maltreatment by virtue of their extensive contact with children. Current research, while limited, shows a tendency among teachers to under-detect and under-report various forms of child abuse and neglect. Methods: Using data from a pilot evaluation of child maltreatment training for teachers, we examined teachers' self-reported behaviours for different forms of maltreatment. Participants included 45 experienced teachers from a large urban centre in the province of Ontario (Canada) who rated their likelihood of, and rationale for, detecting and reporting maltreatment based on four case vignettes.

Results

Accuracy rates for detection and reporting were highest for sexual abuse (95% and 93%), followed by neglect (87% and 75%), emotional abuse (86% and 70%), and physical abuse (58% and 27%). Differences in detection and reporting rates were only significant between physical abuse and other maltreatment types (sexual abuse and neglect for detection; sexual abuse, neglect, and emotional abuse for reporting), with accurate detection and reporting rates being significantly lower for physical abuse. Teachers stated that the physical abuse vignette lacked convincing evidence of child maltreatment. Further, many teachers indicated that additional information was needed to determine whether the vignette represented physical abuse and, as such, was reportable.

Conclusion

Our findings suggest the need for more targeted interventions to improve teachers' decision-making with potential child maltreatment scenarios, especially for physical abuse, so that children who are experiencing maltreatment may be more accurately detected and reported to child protection.

Creation and evaluation of a participatory child abuse and neglect workshop for medical students

BACKGROUND

Since child abuse and neglect (CAN) is prevalent worldwide, medical students should acquire basic knowledge, skills, and confidence in identifying and addressing CAN. Although significant educational efforts have been previously described, none has focused on using participatory methods to teach medical students CAN.

PURPOSE

To: 1) develop a participatory educational workshop in CAN for medical students, 2) gather, train, and establish a peer-to-peer teaching group, and 3) assess the effectiveness of the workshop in gain of knowledge and improvement of self-confidence for participants.

METHODS

A two-hour workshop was created with role-playing, the use of mannikins and peer-to-peer teaching. A 15-item knowledge and a 9-item self-confidence questionnaire were used before, right after, and six months after each workshop.

RESULTS

Nine workshops in two academic pediatric departments with a total attendance of 300 6th year medical students were conducted. For the 69 students who completed the questionnaires at all three times, there were statistically significant gains in knowledge right after (p < .001) and six months after (p < .0001) the workshops. Similarly, self-confidence increased right after (p < .0001) and six months after (p < .001) the workshops. Self-selection bias testing indicated that these 69 students who completed all three questionnaires were representative of those who completed the pre-testing and the testing right after.

CONCLUSIONS

We successfully established a peer-to-peer teaching group to conduct nine participatory workshops that improved the participants' knowledge and self-confidence in CAN. This feasible and novel active learning approach may help address inadequacies in medical curricula.