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Hornor G, Anderson AM, Baumeyer S, Daniels A, Doughty K, Hollar J, Prince C, Skeens M, Wilkinson K. Multidisciplinary Approach to Emergent Sexual Abuse in a Pediatric Emergency Department: A Simulated Child Advocacy Center Model of Care. JOURNAL OF FORENSIC NURSING 2022; 18:164-173. [PMID: 35045046 DOI: 10.1097/jfn.0000000000000365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The purpose of this study was to compare child sexual abuse interview disclosures and judicial outcomes for cases of child and adolescent sexual abuse/assault seen in a pediatric emergency department (PED) before and after the implementation of a simulated child advocacy center (CAC) multidisciplinary model of care. METHOD A retrospective chart and legal records review was conducted from both the PED model of care group and the simulated CAC multidisciplinary model of care for judicial outcomes, child sexual abuse interview disclosures, and sexual abuse case characteristics. RESULTS The simulated CAC multidisciplinary model of care did not result in increased indictments, pleas, trials, or disclosure of sexual abuse in the sexual abuse interview when compared with the PED model of care. The simulated CAC multidisciplinary model of care did result in a significantly higher rate of sexual abuse interview completion. DISCUSSION Demographic risk factors for sexual abuse victimization as well as perpetration have been identified in the literature and were supported by this study. Law enforcement and child protective services were more frequently present in the PED under the simulated CAC multidisciplinary model allowing for improved protection of children.
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Affiliation(s)
- Gail Hornor
- Author Affiliations: International Association of Forensic Nurses
| | | | | | - Alicia Daniels
- Center for Family Safety and Healing, Nationwide Children's Hospital
| | - Katharine Doughty
- Center for Family Safety and Healing, Nationwide Children's Hospital
| | - Jessica Hollar
- Center for Family Safety and Healing, Nationwide Children's Hospital
| | - Celeste Prince
- Center for Family Safety and Healing, Nationwide Children's Hospital
| | - Micah Skeens
- Center for Family Safety and Healing, Nationwide Children's Hospital
| | - Kerri Wilkinson
- Center for Family Safety and Healing, Nationwide Children's Hospital
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Jones LM, Mitchell KJ. Predictors of Multidisciplinary Team Sustainability in Work With Child Sex Trafficking Cases. VIOLENCE AND VICTIMS 2022; 37:222-243. [PMID: 35264454 DOI: 10.1891/vv-d-19-00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A coordinated response by a trained multidisciplinary team (MDT) can help support child sex trafficking (CST) victims, but little is known about factors that influence the development and sustainability of MDTs in this work. An online survey was conducted with 171 professionals who attended a Multidisciplinary Team Child Sex Trafficking (MDT-CST) training to identify factors related to team growth. Increased MDT success was related to: (1) the presence of a CST-specific advocacy organization in the community; (2) other community agencies active in supporting CST victims (e.g., SANE nurses, faith-based organizations, and runaway shelters); (3) a greater breadth of professional representation on the MDT; and (4) agency leadership support for the CST action plan. Most of the MDTs sustained and increased their coordination with other community agencies over time, but the study identified that growth is improved when administrators support team efforts and there are resources and supports for CST victims elsewhere in the community.
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Affiliation(s)
- Lisa M Jones
- Crimes Against Children Research Center, University of New Hampshire
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Taylor EK, Tener D, Silovsky JF, Newman A. Comparison of children's advocacy center responses to harmful sexual behavior among siblings: An international perspective. CHILD ABUSE & NEGLECT 2021; 122:105371. [PMID: 34731673 DOI: 10.1016/j.chiabu.2021.105371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Harmful sexual behavior (HSB) is sexual behavior exhibited by children and adolescents that is developmentally inappropriate and/or harmful or abusive towards themselves or others. Victims of children with HSB are commonly siblings. Multiple professionals may be involved in cases of youth HSB involving siblings, which places Children's Advocacy Centers (CACs) in a key position to directly address intrafamilial HSB. Approximately 25% of all cases seen at CACs in the U.S. are youth-initiated HSB. However, no known research has examined how CAC professionals approach decision-making and response to intrafamilial and sibling HSB, particularly across regions and cultures. OBJECTIVES To examine the perspectives of professionals from three separate CACs in Israel, eastern U.S., and southwestern U.S. regarding their decision-making and response process for sibling HSB. PARTICIPANTS AND SETTING Thirty-seven multidisciplinary team members from the three CACs, including representatives from child welfare, law enforcement, family advocacy, mental health, and the court system, among others, participated in the study. METHODS Participants completed focus groups that asked them to discuss how their system would respond to a vignette case. Dedoose was used for thematic analysis. RESULTS Using qualitative thematic analysis, results indicate all sites perceived sibling HSB as a family crisis, and they prioritized establishing safety and providing therapeutic interventions. Differences across sites were on how to establish safety and when to use legal actions. CONCLUSIONS The study draws attention to the influences that formal policy and community contexts have on CAC decision-making, particularly around the availability of evidence-based treatments and caregiver engagement.
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Affiliation(s)
- Erin K Taylor
- Center on Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13(th) St Suite 4900, Oklahoma City, OK 73104, USA.
| | - Dafna Tener
- Paul Baerwald School of Social Work and Social Welfare at The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jane F Silovsky
- Center on Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13(th) St Suite 4900, Oklahoma City, OK 73104, USA
| | - Abbie Newman
- Mission Kids Child Advocacy Center, 180 W. Germantown Pike, Suite 1, East Norriton, PA 19401, USA
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Abstract
Human trafficking and child sex trafficking and sexual exploitation in particular are global public health issues with widespread, lasting impacts on children, families, and communities. Traditionally, human trafficking has been treated as a law enforcement problem with an emphasis on the arrest and prosecution of traffickers. However, use of a public health approach focuses efforts on those impacted by exploitation: trafficked persons, their families, and the population at large. It promotes strategies to build a solid scientific evidence base that allows development, implementation, and evaluation of prevention and intervention efforts, informs policy and program development, and guides international efforts at eradication. This article uses the public health approach to address human trafficking, with a focus on child sex trafficking and exploitation. Recommendations are made for public health professionals to contribute to antitrafficking efforts globally.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, Virginia 22314, USA; .,Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, Georgia 30342, USA
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Antwi WK, Reeves PJ, Ferris C, Aziato L. Exploration of Ghanaian radiographers' reporting of suspected physical abuse amongst children. Radiography (Lond) 2021; 27:817-822. [PMID: 33468409 DOI: 10.1016/j.radi.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/25/2020] [Accepted: 12/27/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The success of the child protection process is dependent on rapid actions by healthcare professionals who encounter a child in possible need of protection and make appropriate referrals to statutory agencies. Clear rules that promote inter-professional working among health professionals is necessary to enhance child protection. AIM To explore the internal factors leading to bystander attitude towards reporting of suspected physical abuse amongst Ghanaian radiographers. METHODS Twenty radiographers across Ghana who have encountered suspected child physical abuse during practice interviewed. Data was collected using qualitative methodology using semi-structured interviews. Participants were radiographers who were selected using purposive sampling. Data was thematically analysed and managed with NVivo version 10. Themes developed formed the basis of the discussion. RESULTS Participants reported barriers such as training deficits, lack of knowledge in reporting regulations, and the absence of a framework or structures in place to guide suspected physical abuse (SPA) management. The results showed that the majority of participants were ignorant of the role of the social worker in identified cases of SPA. Additionally, there was no teamwork in the majority of the hospitals in the management of suspected physical abuse. CONCLUSIONS Participants' behaviour towards child protection was congruent with the situation where an individual would assess the consequences of an action. Fear, lack of direction and collaboration characterised the management of suspected physical abuse. IMPLICATION FOR PRACTICE The timely identification of child abuse is key to providing the necessary intervention for the child. However, the mere identification of abuse would be of no use to the child when no action was taken by radiographers handling the case as a result of impediments on their way.
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Affiliation(s)
- W K Antwi
- Dept. of Radiography, School of Biomedical & Allied Health Sciences, University of Ghana, Ghana.
| | - P J Reeves
- Sheffield Hallam University, Sheffield, UK.
| | - C Ferris
- Clinical Hypnotherapy, Todwick, Sheffield, UK.
| | - L Aziato
- School of Nursing, University of Ghana, Ghana.
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Westphaln KK, Regoeczi W, Masotya M, Vazquez-Westphaln B, Lounsbury K, McDavid L, Lee H, Johnson J, Ronis S. Outcomes and outputs affiliated with Children's Advocacy Centers in the United States: A scoping review. CHILD ABUSE & NEGLECT 2021; 111:104828. [PMID: 33339637 DOI: 10.1016/j.chiabu.2020.104828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/15/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The Children's Advocacy Center (CAC) model is the predominant multidisciplinary model that responds to child sexual abuse (CSA) in the United States (US). While the CAC model has made important contributions in case coordination and referrals for specialty services, little is known about child- or family-oriented outcomes. OBJECTIVE Explore the trends and gaps involving outcome and output measures affiliated with CACs in the US. PARTICIPANTS & SETTING A scoping review of the literature was conducted on English language articles published between 1985-2019 that involved CACs and children less than 18 years of age. METHODS An electronic database search using the terms "Children's Advocacy Center(s)," "Child Advocacy Center(s)," and "CAC(s)" identified titles and abstracts. Data from articles selected for full text review were evaluated by a multidisciplinary team using a mixed methods approach. RESULTS Measures of CAC impact frequently focus on service and programmatic outputs with person-centered outcomes left often reported. The most prevalent output measures related to case prosecution and forensic interviews. Person-centered outcomes most commonly emphasized child mental health and caregiver satisfaction. The majority of articles were limited by weak or unspecified study designs. CONCLUSION The current literature on CACs suggests that while they are successful in coordinating services and facilitating referrals, little is known about how engagement with CACs impacts short- and long-term outcomes for children and families. Further research beyond cross sectional or quasi-experimental designs is necessary to better understand how variability in CAC structure, function, and resources can be optimized to meet the needs of the diverse communities that they serve. This is especially salient given the national dissemination of the CAC model. Without such additional studies, knowledge will remain limited regarding the enduring impacts of CACs on the lives of those impacted by CSA.
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Affiliation(s)
- Kristi K Westphaln
- Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland, OH, USA; UH Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
| | - Wendy Regoeczi
- College of Liberal Arts and Social Sciences, Cleveland State University, Cleveland, OH, USA.
| | - Marie Masotya
- UH Rainbow Center for Child Health and Policy, Cleveland, OH, USA.
| | | | | | - Lolita McDavid
- UH Rainbow Babies and Children's Hospital, Cleveland, OH, USA; Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - HaeNim Lee
- Department of Social Welfare and Counseling, Dongguk University, South Korea.
| | | | - Sarah Ronis
- UH Rainbow Babies and Children's Hospital, Cleveland, OH, USA; UH Rainbow Center for Child Health and Policy, Cleveland, OH, USA; Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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Tener D, Newman A, Yates P, Tarshish N. Child Advocacy Center intervention with sibling sexual abuse cases: Cross-cultural comparison of professionals' perspectives and experiences. CHILD ABUSE & NEGLECT 2020; 105:104259. [PMID: 31744636 DOI: 10.1016/j.chiabu.2019.104259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/08/2019] [Accepted: 11/03/2019] [Indexed: 05/14/2023]
Abstract
BACKGROUND Despite being a complex phenomenon with potentially significant short- and long-term consequences for all involved including siblings, parents and the family as a whole, sibling sexual abuse (SSA) has not received sufficient empirical and clinical attention. Practitioners are often left to cope without appropriate guidance. OBJECTIVE This study aimed to compare staff perspectives and experiences of working with sibling sexual abuse cases across two Child Advocacy Centers (CACs) within different countries and different cultural and legal contexts. PARTICIPANTS AND SETTING Participants were staff members from two Child Advocacy Centers: one in Jerusalem, Israel, and the other in Montgomery County, Pennsylvania, United States of America. METHODS This qualitative cross-cultural comparative study analyzes staff experiences of sibling sexual abuse cases based upon 14 focus groups, in Jerusalem (N = 7) and Montgomery County (N = 7). RESULTS Findings reveal that both CACs focused on parents, the parents' negative emotional responses to SSA, and the impossible nature of their predicament. The Montgomery County CAC tended to emphasize the needs of the victim while being attuned to the legal proceedings, whereas the Jerusalem CAC emphasized supportive therapeutic responses for the whole family. CONCLUSIONS The differences across the two Child Advocacy Centers are related to the different legal and cultural contexts of the two CACs and underscore the need to review what may be the most appropriate policy and practice response to SSA that does not itself cause further harm.
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Affiliation(s)
- Dafna Tener
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mt Scopus, Jerusalem 91905, Israel; The Haruv Institute, Jerusalem, Israel.
| | - Abbie Newman
- Mission Kids Child Advocacy Center, Montgomery County, PA, United States
| | - Peter Yates
- Edinburgh Napier University, Edinburgh, Scotland, United Kingdom
| | - Noam Tarshish
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mt Scopus, Jerusalem 91905, Israel
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Albright K, Greenbaum J, Edwards SA, Tsai C. Systematic review of facilitators of, barriers to, and recommendations for healthcare services for child survivors of human trafficking globally. CHILD ABUSE & NEGLECT 2020; 100:104289. [PMID: 31787336 DOI: 10.1016/j.chiabu.2019.104289] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/12/2019] [Accepted: 11/16/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Child trafficking is associated with multiple physical and mental health problems, yet relatively little is known about the factors that facilitate or hamper delivery of high-quality health care services to trafficked children. OBJECTIVE To summarize information about identified facilitators of, barriers to, and recommendations for medical and mental health service provision to trafficked children. PARTICIPANTS AND SETTING A systematic review was conducted of the English-language, peer-reviewed literature on medical and mental healthcare of trafficked children published since 2010. METHODS Inclusion criteria were: (1) the study population or focus included, wholly or in part, individuals under the age of 18 years; (2) the study focus was clearly defined as human trafficking or commercial sexual exploitation; (3) a main focus included health services or barriers to care, and (4) the article contained original data. RESULTS Of the 29 articles meeting inclusion criteria, 19 included facilitators of health service provision to trafficked populations, 22 included barriers to that provision, and 25 included explicit recommendations for service improvement. 45 distinct facilitators were identified a total of 140 times, 118 distinct barriers were identified a total of 174 times, and 52 distinct recommendations were identified a total of 100 times. The majority of facilitators, barriers, and recommendations fell under the locus of the healthcare provider and healthcare organization. CONCLUSIONS Existing research reveals abundant areas of opportunity for healthcare professionals and healthcare administrators to improve access to, and quality of, medical and mental health care for trafficked children.
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Affiliation(s)
- Karen Albright
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA, USA; Institute on Healthcare and Human Trafficking, SVB Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | | | - Carmelle Tsai
- Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
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Miller AJ, Arnold-Clark J, Brown KW, Ackerman-Brimberg M, Guymon M. Featured counter trafficking program: The law enforcement first responder protocol. CHILD ABUSE & NEGLECT 2020; 100:104173. [PMID: 31542279 DOI: 10.1016/j.chiabu.2019.104173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 08/27/2019] [Accepted: 09/01/2019] [Indexed: 06/10/2023]
Abstract
This invited article is one of several comprising part of a special issue of Child Abuse and Neglect focused on child trafficking and health. The purpose of each invited article is to describe a specific program serving trafficking children. Featuring these programs is intended to raise awareness of innovative counter-trafficking strategies emerging worldwide and facilitate collaboration on program development and outcomes research. This article describes the Law Enforcement First Responder Protocol, which trained law enforcement to recognize youth engaged in sex work as survivors of commercial sexual exploitation, rather than as "prostitutes", and to connect these survivors immediately with social services, advocates, timely medical care and ongoing follow-up.
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Affiliation(s)
- Aaron J Miller
- New York City Health and Hospitals, 125 Worth Street Suite 500, New York, NY 10013, United States.
| | - Janet Arnold-Clark
- Los Angeles County Department of Health Services, Martin Luther King Jr. Hub Clinic, 1670 East 120thStreet, Los Angeles, CA 90059, United States
| | - Kate Walker Brown
- National Center for Youth Law, 405 14th Street, Suite 1500, Oakland, CA 94612, United States
| | - Mae Ackerman-Brimberg
- National Center for Youth Law, 405 14th Street, Suite 1500, Oakland, CA 94612, United States
| | - Michelle Guymon
- Los Angeles County Department of Probation, Child Trafficking Unit, 1660 W. Mission Ave, Pomona, CA 91766, United States
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Herbert JL, Bromfield L. Better Together? A Review of Evidence for Multi-Disciplinary Teams Responding to Physical and Sexual Child Abuse. TRAUMA, VIOLENCE & ABUSE 2019; 20:214-228. [PMID: 29334012 DOI: 10.1177/1524838017697268] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Multi-Disciplinary teams (MDTs) have often been presented as the key to dealing with a number of intractable problems associated with responding to allegations of physical and sexual child abuse. While these approaches have proliferated internationally, researchers have complained of the lack of a specific evidence base identifying the processes and structures supporting multi-disciplinary work and how these contribute to high-level outcomes. This systematic search of the literature aims to synthesize the existing state of knowledge on the effectiveness of MDTs. This review found that overall there is reasonable evidence to support the idea that MDTs are effective in improving criminal justice and mental health responses compared to standard agency practices. The next step toward developing a viable evidence base to inform these types of approaches seems to be to more clearly identify the mechanisms associated with effective MDTs in order to better inform how they are planned and implemented.
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Affiliation(s)
- James Leslie Herbert
- 1 Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia
| | - Leah Bromfield
- 1 Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia
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Mulambia Y, Miller AJ, MacDonald G, Kennedy N. Are one-stop centres an appropriate model to deliver services to sexually abused children in urban Malawi? BMC Pediatr 2018; 18:145. [PMID: 29712552 PMCID: PMC5925825 DOI: 10.1186/s12887-018-1121-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 04/22/2018] [Indexed: 11/16/2022] Open
Abstract
Background The Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as ‘Chikwanekwanes’ - ‘everything under one roof’) to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. No formal evaluation of the utility of such services has ever been undertaken. This study focused on the experiences of the families served at the country’s first Chikwanekwane in the large, urban city of Blantyre. Methods One hundred seven families were surveyed in their home three months after their initial evaluation for sexual abuse at the Blantyre One Stop Centre, and 25 families received a longer interview. The survey was designed to inquire what types of initial evaluation and follow-up services the children received from the medical, legal and social welfare services. Results All 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29% had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12% returned for further treatment; 95.3% had an initial police report and 27.1% ended in a criminal conviction for child sexual abuse. Most of the families were satisfied with the service they received, but a quarter of the families were not satisfied with the law enforcement response, and 2% were not happy with the medical assessment. Conclusions: Although a perception of corruption or negligence by police may discourage use of service, we believe that the One-Stop model is an appropriate means to deliver high quality care to survivors of abuse in Malawi. Electronic supplementary material The online version of this article (10.1186/s12887-018-1121-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yabwile Mulambia
- The College of Medicine, University of Malawi, Chichiri, Blantyre, 3, Malawi.
| | - Aaron J Miller
- Building Regional Alliances to Nurture Child Health, 2 Gold St, New York, NY, 10038, USA
| | - Geraldine MacDonald
- Institute of Child Care Research, Queen's University, University Rd, Belfast, BT7 1NN, UK
| | - Neil Kennedy
- The College of Medicine, University of Malawi, Chichiri, Blantyre, 3, Malawi.,Centre for Medical Education, Queens's University Belfast, University Rd, Belfast, BT7 1NN, UK
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Greenbaum J, Bodrick N, Flaherty EG, Idzerda SM, Laskey A“T, Legano LA, Leventhal JM, Gavril AR, Suchdev PS, Chan KJ, Howard CR, McGann PT, St. Clair NE, Yun K. Global Human Trafficking and Child Victimization. Pediatrics 2017; 140:peds.2017-3138. [PMID: 29180462 DOI: 10.1542/peds.2017-3138] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Trafficking of children for labor and sexual exploitation violates basic human rights and constitutes a major global public health problem. Pediatricians and other health care professionals may encounter victims who present with infections, injuries, posttraumatic stress disorder, suicidality, or a variety of other physical or behavioral health conditions. Preventing child trafficking, recognizing victimization, and intervening appropriately require a public health approach that incorporates rigorous research on the risk factors, health impact, and effective treatment options for child exploitation as well as implementation and evaluation of primary prevention programs. Health care professionals need training to recognize possible signs of exploitation and to intervene appropriately. They need to adopt a multidisciplinary, outward-focused approach to service provision, working with nonmedical professionals in the community to assist victims. Pediatricians also need to advocate for legislation and policies that promote child rights and victim services as well as those that address the social determinants of health, which influence the vulnerability to human trafficking. This policy statement outlines major issues regarding public policy, medical education, research, and collaboration in the area of child labor and sex trafficking and provides recommendations for future work.
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Affiliation(s)
- Jordan Greenbaum
- Stephanie V. Blank Center for Safe and Healthy Children at Children’s Healthcare of Atlanta, Atlanta, Georgia
- International Centre for Missing and Exploited Children, Alexandria, Virginia; and
| | - Nia Bodrick
- Unity Health Care, Inc, Washington, District of Columbia
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Herbert JL, Bromfield L. Evidence for the Efficacy of the Child Advocacy Center Model: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2016; 17:341-357. [PMID: 25971710 DOI: 10.1177/1524838015585319] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Child Advocacy Center (CAC) model has been presented as the solution to many of the problems inherent in responses by authorities to child sexual abuse. The lack of referral to therapeutic services and support, procedurally flawed and potentially traumatic investigation practices, and conflict between the different statutory agencies involved are all thought to contribute to low conviction rates for abuse and poor outcomes for children. The CAC model aims to address these problems through a combination of multidisciplinary teams, joint investigations, and services, all provided in a single child friendly environment. Using a systematic search strategy, this research aimed to identify and review all studies that have evaluated the effectiveness of the approach as a whole, recognizing that a separate evidence base exists for parts of the approach (e.g., victim advocacy and therapeutic responses). The review found that while the criminal justice outcomes of the model have been well studied, there was a lack of research on the effect of the model on child and family outcomes. Although some modest outcomes were clear, the lack of empirical research, and overreliance on measuring program outputs, rather than outcomes, suggests that some clarification of the goals of the CAC model is needed.
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Affiliation(s)
- James Leslie Herbert
- Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia
| | - Leah Bromfield
- Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia
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Nwogu NN, Agrawal L, Chambers S, Buagas AB, Daniele RM, Singleton JK. Effectiveness of Child Advocacy Centers and the multidisciplinary team approach on prosecution rates of alleged sex offenders and satisfaction of non-offending caregivers with allegations of child sexual abuse: a systematic review. ACTA ACUST UNITED AC 2016; 13:93-129. [PMID: 26767818 DOI: 10.11124/jbisrir-2015-2113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 08/30/2015] [Accepted: 09/11/2015] [Indexed: 10/31/2022]
Abstract
BACKGROUND Child sexual abuse is a multifaceted issue that negatively affects the lives of millions of children worldwide. These children suffer numerous medical and psychological long-term adverse effects both in childhood and adulthood. It is imperative to implement evidence- based interventions for the investigation of this crime. The use of Child Advocacy Centers and the multidisciplinary team approach may improve the investigation of child sexual abuse. OBJECTIVE To evaluate the effectiveness of Child Advocacy Centers and the multidisciplinary team approach on prosecution rates of alleged sex offenders and satisfaction of non-offending caregivers of children less than 18 years of age, with allegations of child sexual abuse. INCLUSION CRITERIA TYPES OF PARTICIPANTS Children under 18 years, of any race, ethnicity or gender with allegations of child sexual abuse. Other participants included in this review are non-offending caregivers of children with allegations of child sexual abuse, and alleged sex offenders. Type of intervention : The use of Child Advocacy Centers and the multidisciplinary team approach on child sexual abuse investigations. Types of outcomes : Prosecution rates of alleged sex offenders and the satisfaction of non-offending caregivers of children with allegations of child sexual abuse. Types of studies: This review includes quasi-experimental and descriptive studies. SEARCH STRATEGY The search strategy aimed to find published and unpublished articles in the English language published from 1985 through April 2015 for inclusion. The databases searched include: PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Health Source: Nursing/Academic Edition, Criminal Justice Periodicals, ProQuest Dissertations & Theses and Criminal Justice Collections. An additional grey literature search was conducted. METHODOLOGICAL QUALITY Two reviewers evaluated the included studies for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute. DATA EXTRACTION Data were extracted using standardized data extraction instruments from the Joanna Briggs Institute. DATA SYNTHESIS Due to heterogeneity between the included studies, statistical meta-analysis was not possible. Results are presented in a narrative form. CONCLUSIONS The use of Child Advocacy Centers and the multidisciplinary team approach in child sexual abuse investigation may have positive benefits in increasing non-offending caregivers' satisfaction and prosecution rates of alleged sex offenders. IMPLICATIONS FOR PRACTICE Utilization of Child Advocacy Centers and the multidisciplinary team approach for child sexual abuse investigations may be beneficial in improving prosecution rates and the experiences of families involved. The use of satisfaction surveys for non-offending caregivers may be an effective tool to evaluate the satisfaction with services rendered by Child Advocacy Centers. Findings from this review may help to guide reforms. It is hoped that client satisfaction may lead to or improve utilization of services important for the healing process of victims of abuse. Child Advocacy Center multidisciplinary team interventions may improve prosecution rates and satisfaction of non-offending caregiver’ in children less than 18 years of age with allegations of child sexual abuse (Grade B). When available, children with allegations of child sexual abuse should be referred to Child Advocacy Centers for evaluation (Grade B). The use of non-offending caregiver satisfaction survey is recommended to evaluate the ongoing effectiveness of the Child Advocacy Centers multidisciplinary team approach. The quality improvement process will help measure the quality of care rendered by a Child Advocacy Centers and identify areas in need of improvement so a Child Advocacy Centers can continue to provide optimal care in the investigation of child sexual abuse while improving the utilization of services important for the healing process for victims of abuse (Grade B). IMPLICATIONS FOR RESEARCH Future studies may consider interventions that include greater sample size and more diverse ethnic groups to promote generalizability of findings.
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Affiliation(s)
- Ngozi N Nwogu
- College of Health Professions, Pace University, New York, NY, USA
| | - Lynet Agrawal
- College of Health Professions, Pace University, New York, NY, USA
| | | | - Archiel B Buagas
- College of Health Professions, Pace University, New York, NY, USA
| | - Rose Mary Daniele
- The Northeast Institute for Evidence Synthesis and Translation (NEST): a Collaborating Center of the Joanna Briggs Institute
| | - Joanne K Singleton
- The Northeast Institute for Evidence Synthesis and Translation (NEST): a Collaborating Center of the Joanna Briggs Institute
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15
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Johnson JL, Shelley AE. Effects of child interview tactics on prospective jurors' decisions. BEHAVIORAL SCIENCES & THE LAW 2014; 32:846-866. [PMID: 25470811 DOI: 10.1002/bsl.2152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Although decisions in child sexual abuse (CSA) cases are influenced by many factors (e.g., child age, juror gender), case and trial characteristics (e.g., interview quality) can strongly influence legal outcomes. In the present study, 319 prospective jurors read about a CSA investigation in which the alleged victim was interviewed at a child advocacy center (CAC) or traditional police setting. The prospective jurors then provided legally relevant ratings (e.g., child credibility, interview quality, defendant guilt). Structural equation modeling techniques revealed that child credibility predicted greater confidence in guilt decisions and also mediated all associations with such decisions. Having fewer negative prior opinions and rating the interview as of better quality were associated with higher child credibility ratings. Mitigating factors (e.g., interview quality), as opposed to proxy indicators (e.g., participant gender), better predicted CSA case outcomes. Similar associations across groups (e.g., CAC interviews did not make child victims more or less credible) permit a tentative conclusion that CACs do not positively or negatively affect decisions made in hypothetical CSA cases. Ideas for future studies examining factors influencing decisions in CSA cases are discussed.
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Affiliation(s)
- Jonni L Johnson
- Department of Psychology, University of California, 1 Shields Avenue, Davis, CA, 95616, U.S.A
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16
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Dubowitz H, Christian CW, Hymel K, Kellogg ND. Forensic medical evaluations of child maltreatment: a proposed research agenda. CHILD ABUSE & NEGLECT 2014; 38:1734-1746. [PMID: 25224781 DOI: 10.1016/j.chiabu.2014.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 07/18/2014] [Accepted: 07/22/2014] [Indexed: 06/03/2023]
Abstract
Physicians play an important role in the forensic evaluation of suspected child abuse and neglect. There has been considerable progress in the medical field, helping distinguish findings related to maltreatment from other conditions or circumstances. Nevertheless, important questions remain. This article covers several of these questions and proposes a research agenda concerning five main topics: sexual abuse, neglect, fractures, abusive head trauma, and physicians work in interdisciplinary settings. The suggestions are hardly inclusive, but offer suggestions the authors think are priorities, and ones that research could reasonably address. By providing some background to gaps in our knowledge, this paper should be of interest to a broader audience than just medical professionals.
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Affiliation(s)
| | - Cindy W Christian
- The Perelman School of Medicine at the University of Pennsylvania, USA
| | | | - Nancy D Kellogg
- University of Texas Health Science Center at San Antonio, USA
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17
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Molyneux EM, Kennedy N, Dano A, Mulambia Y. Sexual abuse of children in low-income settings: time for action. Paediatr Int Child Health 2013; 33:239-46. [PMID: 24070539 DOI: 10.1179/2046905513y.0000000087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
In this article, child sexual abuse in low-income settings is reviewed, including the extent of the problem, the way children present, and how they should be managed. Liaising with other agencies, training in all aspects of sexual abuse and creating an environment that is conducive to good care by all groups involved is essential. Technical details of medical examination are not covered as appropriate guidelines are accessible.
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18
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Lippert T, Cross TP, Jones L, Walsh W. Suspect confession of child sexual abuse to investigators. CHILD MALTREATMENT 2010; 15:161-170. [PMID: 20410024 DOI: 10.1177/1077559509360251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Increasing the number of suspects who give true confessions of sexual abuse serves justice and reduces the burden of the criminal justice process on child victims. With data from four communities, this study examined confession rates and predictors of confession of child sexual abuse over the course of criminal investigations (final N = 282). Overall, 30% of suspects confessed partially or fully to the crime. This rate was consistent across the communities and is very similar to the rates of suspect confession of child sexual abuse found by previous research, although lower than that from a study focused on a community with a vigorous practice of polygraph testing. In a multivariate analysis, confession was more likely when suspects were younger and when more evidence of abuse was available, particularly child disclosure and corroborative evidence. These results suggest the difficulty of obtaining confession but also the value of methods that facilitate child disclosure and seek corroborative evidence, for increasing the odds of confession.
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