Neighborhood-level social processes and substantiated cases of child maltreatment

Understanding forms of childhood adversities and associations with adult health outcomes: A regression tree analysis

BACKGROUND

Empirical studies have demonstrated associations between ten original adverse childhood experiences (ACEs) and multiple health outcomes. Identifying expanded ACEs can capture the burden of other childhood adversities that may have important health implications.

OBJECTIVE

We sought to identify childhood adversities that warrant consideration as expanded ACEs. We hypothesized that experiencing expanded and original ACEs would be associated with poorer adult health outcomes compared to experiencing original ACEs alone.

PARTICIPANTS

The 11,545 respondents of the National Longitudinal Surveys (NLS) and Child and Young Adult Survey were 48.9 % female, 22.7 % Black, 15.8 % Hispanic, 36.1 % White, 1.7 % Asian/Native Hawaiian/Pacific Islander/Native American/Native Alaskan, and 7.5 % Other.

METHODS

This study used regression trees and generalized linear models to identify if/which expanded ACEs interacted with original ACEs in association with six health outcomes.

RESULTS

Four expanded ACEs-basic needs instability, lack of parental love and affection, community stressors, and mother's experience with physical abuse during childhood -significantly interacted with general health, depressive symptom severity, anxiety symptom severity, and violent crime victimization in adulthood (all p-values <0.005). Basic needs instability and/or lack of parental love and affection emerged as correlates across multiple outcomes. Experiencing lack of parental love and affection and original ACEs was associated with greater anxiety symptoms (p = 0.022).

CONCLUSIONS

This is the first study to use supervised machine learning to investigate interaction effects among original ACEs and expanded ACEs. Two expanded ACEs emerged as predictors for three adult health outcomes and warrant further consideration in ACEs assessments.

Application of geospatial analysis in health research: A systematic review of methodological aspects of studies on violence against children and young people

BACKGROUND

Geographical variation exists in violence experienced by children and young people; however, there is limited research applying geospatial techniques to study this variation, and the methodological quality of this body of work is unclear.

OBJECTIVE

This study aimed to review the application of geospatial analysis in research on violence against children (VAC) and evaluate how essential methodological aspects are reported.

METHODS

Twelve databases were searched for studies on VAC using geospatial techniques. Two independent reviewers screened the papers for eligibility. Findings were narratively synthesised.

RESULTS

Sixty studies were included. Six studies estimated the prevalence of VAC and 54 investigated the associations between VAC and covariates. Most studies were conducted in the US (68 %), and the broad definition of 'child maltreatment' (53 %) was the most common form of violence explored. Most studies (83 %) used administrative data, whereas 23 % used an ecological study design to estimate the associations between risk factors and official reports of VAC. Frequentist modelling approaches were used in 54 % of the studies, and 47 % investigated VAC at census tract level. Model fit metrics were reported in 69 % of studies.

CONCLUSIONS

Current knowledge of the geographical distribution of VAC is severely limited because of the reliance on administrative data, which vastly underestimates the prevalence of VAC compared with self-reports and poor reporting of quality characteristics. There is a huge opportunity for applying geospatial methods in VAC research in diverse geographic contexts. Future research must adopt rigorous and standardised approaches to model fitting and validation and make better use of self-reported data.

The importance of community resources for breastfeeding

BACKGROUND

Breastfeeding has long-lasting effects on children's cognition, behavioral, mental and physical health. Previous research shows parental characteristics (e.g., education, race/ethnicity, income level) are associated with breastfeeding initiation and duration. Further, research shows significant variation in access to community resources by race/ethnicity. It is unclear how community resources may impact breastfeeding practices and how this might intersect with maternal race/ethnicity.

METHODS

This study combined nationally-representative data from the Study of Attitudes and Factors Effecting Infant Care (SAFE), which surveyed US mothers immediately after the infant's birth and at two to six months of infant age, with the Child Opportunity Index (COI) 2.0, a census tract measure of community resources associated with child development, to explore the association between community resources and breastfeeding initiation and whether this varies based on maternal race/ethnicity and country of birth. The SAFE Study used a stratified, two-stage, clustered design to obtain a nationally representative sample of mothers of infants, while oversampling Hispanic and non-Hispanic (NH) Black mothers. The SAFE study enrolled mothers who spoke English or Spanish across 32 US birth hospitals between January 2011 and March 2014.

RESULTS

After accounting for individual characteristics, mothers residing in the highest-resourced communities (compared to the lowest) had significantly greater likelihood of breastfeeding. Representation in higher-resourced communities differed by race/ethnicity. Race/ethnicity did not significantly moderate the association between community resources and breastfeeding. In examining within race/ethnic groups, however, community resources were not associated with non-US born Black and Hispanic mothers' rates of breastfeeding, while they were with US born Black and Hispanic mothers.

CONCLUSIONS

Findings suggest that even health behaviors like breastfeeding, which we often associate with individual choice, are connected to the community resources within which they are made. Study implications point to the importance of considering the impact of the contextual factors that shape health and as a potential contributor to understanding the observed race/ethnicity gap.

LAND-USE FILTERING FOR NONSTATIONARY SPATIAL PREDICTION OF COLLECTIVE EFFICACY IN AN URBAN ENVIRONMENT

Collective efficacy-the capacity of communities to exert social control toward the realization of their shared goals-is a foundational concept in the urban sociology and neighborhood effects literature. Traditionally, empirical studies of collective efficacy use large sample surveys to estimate collective efficacy of different neighborhoods within an urban setting. Such studies have demonstrated an association between collective efficacy and local variation in community violence, educational achievement, and health. Unlike traditional collective efficacy measurement strategies, the Adolescent Health and Development in Context (AHDC) Study implemented a new approach, obtaining spatially-referenced, place-based ratings of collective efficacy from a representative sample of individuals residing in Columbus, OH. In this paper we introduce a novel nonstationary spatial model for interpolation of the AHDC collective efficacy ratings across the study area, which leverages administrative data on land use. Our constructive model specification strategy involves dimension expansion of a latent spatial process and the use of a filter defined by the land-use partition of the study region to connect the latent multivariate spatial process to the observed ordinal ratings of collective efficacy. Careful consideration is given to the issues of parameter identifiability, computational efficiency of an MCMC algorithm for model fitting, and fine-scale spatial prediction of collective efficacy.

The neighborhood deprivation gradient and child physical abuse and neglect: A Bayesian spatial model

BACKGROUND

Child abuse and neglect is a public health priority due to its long-term maladaptive consequences. No study in the USA has assessed the nature and magnitude of the social deprivation effect on substantiated child maltreatment risk.

OBJECTIVES

To examine linear and non-linear relationships between area level deprivation and the log-risk of both substantiated physical abuse and neglect while accounting for spatial and heterogeneous random effects.

METHODS

Substantiated child maltreatment and population data (2008-2015) were aggregated to neighborhoods in Bernalillo County, New Mexico. The contribution of area level deprivation to the geographical variation in the log-risks of substantiated child physical abuse and neglect was modeled using Bayesian spatial regression.

RESULTS

Forty-three percent and 46.4 % of the 153 neighborhoods recorded greater risk for either substantiated physical abuse or neglect compared to the county average. The most deprived 20 % of neighborhoods had 71 % and 72 % more cases of substantiated physical abuse and neglect, respectively, than would be expected if the substantiations were randomly distributed throughout the county. Area level deprivation explained 47 % of the variation in substantiated physical abuse and 51 % of the variation in substantiated neglect after controlling for both spatial autocorrelation and heterogeneity.

CONCLUSIONS

Implications from this study can be used to quantify disparities in substantiated child maltreatment attributed to regional differences in social deprivation and to identify priority areas for intervention.

Systematic braiding of Smoke-Free Home SafeCare to address child maltreatment risk and secondhand smoke exposure: findings from a pilot study

BACKGROUND

Exposure to secondhand tobacco smoke (SHS) and child maltreatment are preventable threats to child health. Few evidence-based interventions target both SHS and child maltreatment risk. The purpose of this paper is to describe the systematic braiding process of two evidence-based programs to address child SHS in the home and maltreatment perpetration risk, and present results from the formative work and pilot study.

METHODS

The first 4 steps of the systematic braiding process were completed, including the following: (1) the identification of core elements of both programs, (2) the development of an initial draft of the braided curriculum (Smoke-Free Home SafeCare - SFH-SC), (3) an acceptability and feasibility pilot of SFH-SC with caregivers of young children who reported a smoker living in the home (N = 8), and (4) feedback collection on the braided curriculum from SafeCare Providers (N = 9).

RESULTS

Experts identified common pedagogical and theoretical underpinnings for the two programs and braided Smoke-Free Homes: Some Things Are Better Outside into two SafeCare modules. Caregiver feedback from the pilot demonstrated that participants were engaged with SFH-SC and felt supported and comfortable discussing SHS intervention content with the SFH-SC Provider. Caregiver self-reports indicated a slight increase in smoke-free home rules from baseline to follow-up and a notable reduction in parent stress on the Parent Stress Index of 5.9 points (SD = 10.2). SafeCare Provider feedback following intensive review of the curriculum indicated high feasibility for SFH-SC delivery.

CONCLUSIONS

Parent and Provider findings suggest SFH-SC is a viable intervention that has potential to reduce the public health impact of SHS and child maltreatment for at-risk families.

PROTOCOL

The protocol for the pilot is not published elsewhere; however, the full protocol for the hybrid trial can be found here: https://clinicaltrials.gov/ct2/show/NCT05000632 .

TRIAL REGISTRATION

NCT, NCT05000632. Registered 14 July 2021, there is not a separate registration number for the pilot.

Child Maltreatment During COVID-19: Key Conclusions and Future Directions Based on a Systematic Literature Review

The COVID-19 pandemic has had a far-ranging impact. As societies struggled to minimize infection, questions arose regarding the consequences for children. Initial research reported the urgent need for child protective services worldwide to adapt existing policies and practices to protect children from maltreatment during this time, which is the rationale for the current systematic literature review. This review examined studies published in peer-reviewed journals from March 2020 to October 2020 on child maltreatment (CM) in the context of COVID-19. Twenty-five manuscripts met the inclusion criteria and were predominantly from the United States, with three international studies. The majority of the studies included CM reports during COVID-19 based on official data. The results clearly demonstrated an increased risk for children alongside a worrisome international decrease in CM reports. Only two studies addressed interventions during the pandemic. The current review highlights that, along with the obligation of scholars to advance the protection of children during COVID-19, there is much that is unknown. Future studies should examine the impact of the pandemic on children and their surrounding systems as well as child protective services' responses, which face enormous challenges during a pandemic. An additional conclusion is that, since children were not identified as a health risk group during the pandemic, their protection rights may have been jeopardized. Furthermore, the variance identified in the policies of different countries pinpoints the urgent need to establish an international protocol for protecting children from maltreatment during COVID-19, a protocol that will hopefully be a basis for policymakers worldwide.

Social capital and the nonprofit infrastructure; an ecological study of child maltreatment

Child maltreatment is a significant social problem that responds to neighborhood conditions, including disorder and support. Using administrative sources with the census response rate and geocoded nonprofit tax forms in a cross-sectional ecological design (N = 443), this article explores two understudied supportive factors in neighborhoods: aggregate social capital and nonprofit organizations. A series of Poisson models show aggregate social capital and nonprofit density are negatively related to child maltreatment rates, while the relationship between social capital and child maltreatment rates varies by the number of nonprofits present in the neighborhood. The results provide new insights into the ecology of child maltreatment and illustrate the importance of norms and formal organizations when addressing collective action problems.

Social Cohesion and Informal Social Control as Mediators Between Neighborhood Poverty and Child Maltreatment

Neighborhoods have profound impacts on children and families. Using structural equation modeling and data from 4,898 children in the Fragile Families and Child Wellbeing Study, the current study examines the direct and indirect effects of neighborhood poverty on the likelihood of being maltreated at age 5. Two neighborhood social processes, social cohesion and informal social control, were examined as mediators. The study found that neighborhood poverty was indirectly related to physical assault and psychological aggression through its impact on social cohesion, and indirectly related to neglect through its impact on informal social control. The results highlight the need to reduce poverty across communities and increase social cohesion and social control as potential pathways for interrupting the impact of neighborhood poverty on maltreatment.

Mechanisms of Inequity: The Impact of Instrumental Biases in the Child Protection System

The structural risk perspective conceptualizes the causes of inequities in child protection system contact as unequal exposure to the structural causes of child abuse risk, combined with biases in the responses of child welfare workers and reporters. This conceptual article proposes a third mechanism of inequity: instrumental biases. It is proposed that instrumental biases operate as a third group of mechanisms that inequitably increase the involvement of some groups and not others. Instrumental biases operate through institutional structures, interpretive concepts and risk proxies that affect how risk is coded and becomes attached to particular people. Against the background of the notify-investigate model that creates poor conditions for decision making, and shapes institutional structures, instrumental biases include the miscalibration of the demand and supply of services (an institutional cause); family-specific surveillance bias and a reliance on prior case histories (a risk proxy cause); widening legal definitions of serious harm (an interpretive concept cause); and complex responses to intimate partner violence that minimize theories of IPV and the social context it occurs within (concept and risk proxy causes). It is argued that within the decision-making context of the child protection system, how services are structured and risk becomes codified has disproportionate impacts on some communities compared to others. Examples from Aotearoa New Zealand, with reference to Māori and people living in high-deprivation areas, are used to illustrate these concepts.

The Association of Low-Income Housing Tax Credit Units and Reports of Child Abuse and Neglect

INTRODUCTION

Poverty broadly and financial stress owing to housing insecurity specifically are associated with an increased risk of child maltreatment. Therefore, it is possible that a program designed to increase access to affordable housing such as the Low-Income Housing Tax Credit program could reduce child maltreatment. The purpose of this study is to examine the association of the availability of housing units through the Low-Income Housing Tax Credit Program with the rates of child maltreatment reports, including reports for physical abuse and neglect, at the state and county levels.

METHODS

Data were from the 2005‒2015 National Child Abuse and Neglect Data System and the Low-Income Housing Tax Credit Program database. Generalized estimating equations were conducted in 2021 to calculate rate ratios and 95% CIs, adjusting for relevant confounders.

RESULTS

At the state level, ≥25 compared with <25 Low-Income Housing Tax Credit Program units per 100,000 population was associated with a lower rate of overall child maltreatment (i.e., neglect and physical abuse; rate ratio=0.96, 95% CI=0.93, 0.99), neglect (rate ratio=0.96, 95% CI=0.94, 0.99), and physical abuse (rate ratio=0.96, 95% CI=0.93, 1.00) reports. Similarly, at the county level, ≥1 compared with 0 Low-Income Housing Tax Credit Program units per 100,000 population was associated with a lower rate of overall child maltreatment (rate ratio=0.94, 95% CI=0.92, 0.97), neglect (rate ratio=0.96, 95% CI=0.93, 0.98), and physical abuse (rate ratio=0.94, 95% CI=0.91, 0.98) reports.

CONCLUSIONS

Increasing access to affordable housing may be an effective strategy to reduce child maltreatment at both the state and county levels.

The Role of Social Cohesion in Preventing Child Abuse Among Rural Chinese Left-Behind Children

Child abuse is a significant public health issue that can affect children's physical and mental health. However, few studies have examined rural Chinese left-behind children. The role of social cohesion of rural Chinese communities in the prevention of child abuse remains understudied. The present study aims to investigate certain factors that could reduce child abuse problems, placing a special focus on the protective role of social cohesion, especially for left-behind rural children. Data were collected from a sample of 1,049 school-aged rural children from the largest middle school in China's Henan Province. It was found that social cohesion directly affected physical abuse and emotional abuse; furthermore, social cohesion was more significantly associated with emotional abuse, whereas sexual abuse was a more significant issue for left-behind children than for those living with their parents. However, the moderating effect of the left-behind status on the association between social cohesion and physical abuse was not significant. Our findings suggest that social cohesion is an important factor for preventing emotional and sexual abuse. Thus, it is necessary to enhance social cohesion in rural Chinese communities with left-behind children to reduce their risk of experiencing child abuse.

Relationships Between Opioid-Related Hospitalizations and Intimate Partner Violence and Child Maltreatment Hospitalizations in Pennsylvania Across Space and Time

Intimate partner violence (IPV) and child maltreatment outcomes are markedly associated with substance abuse disorders. However, few studies have explored these serious family violence outcomes in connection to the opioid epidemic or population-level geographic connections between these variables. This study assesses associations of ZIP code-level IPV and child maltreatment hospitalization outcomes with opioid- and alcohol-related diagnoses as well as economic and demographic neighborhood characteristics. We used 11 years (2004-2014) of ZIP code-level Pennsylvania hospital discharge data and U.S. Census neighborhood characteristics data. As nearby ZIP codes are more likely to be similar than those that are distant, we incorporated spatial autocorrelation using conditionally autoregressive Bayesian hierarchical space-time models. There was a positive relationship between ZIP code-level opioid-related diagnoses and both IPV (relative risk 1.061; 95% credible interval [1.015, 1.106]) and child maltreatment (relative risk 1.055; 95% credible interval [1.035, 1.070]) hospitalizations. There was a positive relationship between alcohol-related diagnoses and IPV but not child maltreatment. Higher median household incomes were associated with lower counts of both IPV and child maltreatment hospitalizations. To illustrate geographic heterogeneity of model estimates, posterior distributions were used to compare variability of effects across ZIP codes. Our findings emphasize the secondary implications of the opioid epidemic in the form of family violence within communities.

The Effect of Home Foreclosures on Child Maltreatment Rates: A Longitudinal Examination of Neighborhoods in Cleveland, Ohio

Foreclosure rates have been linked to increased levels of neighborhood stress. Neighborhood stressors can impact a number of interpersonal and familial dynamics, including child maltreatment. Despite this, little research has examined the relationship between neighborhood foreclosure rates and aggregate trends in child maltreatment. Using substantiated child maltreatment cases, foreclosure, and census data at the neighborhood level in Cleveland, Ohio we find that home foreclosures are a significant predictor of neighborhood rates of child maltreatment. Importantly, this effect is durable and is not impacted by the housing crisis. Furthermore, this is a direct effect and is not shaped by other neighborhood conditions like poverty, as found in prior research. From a policy perspective, this suggests that policy makers need to be cognizant of the effect of foreclosures on child maltreatment regardless of the historical and economic contexts of the neighborhood.

Neighborhood influences on early childhood behavioral problems: Child maltreatment as a mediator

BACKGROUND

A sizable number of previous research investigated the influences of untreated behavior problems in children's early age, as well as how different environmental factors affect child behavior problems (King et al., 2004; Vaillancourt et al., 2013). However, few studies focused on the influences of different types of neighborhood factors on early childhood internalizing and externalizing symptoms via adverse childhood experiences.

OBJECTIVE

This study aims to capture the specific pathways from neighborhood structural factors and process factors to early childhood internalizing and externalizing symptoms.

PARTICIPANTS AND SETTING

The restricted version of the Fragile Family Child Wellbeing Study (FFCWS) dataset at ages 3 and 5 were used, and 2722 children were included in the final model.

METHODS

The Structural Equation Model was used to estimate the pathways from neighborhood structural and process factors to early childhood internalizing (INT) and externalizing (EXT) symptoms. Neighborhood structural factors were measured at the census tract level. Neighborhood collective efficacy, child maltreatment experiences, and early childhood internalizing, and externalizing symptoms were reported by the focal child's mother.

RESULTS

Neighborhood process factors and structural factors showed both direct and indirect effects on early childhood EXT and INT differently. Emotional assault and neglect worked as mediators in this relationship.

CONCLUSIONS

Findings emphasize the importance for researchers and practitioners to involve neighborhood context when assisting children with early childhood behavior problems. Implications for research and interventions are further discussed.

How does neighborhood affect child maltreatment among immigrant families?

BACKGROUND

Child maltreatment in immigrant families is understudied, although research suggests that they are at higher risk of child abuse and neglect. While the limited studies on the etiology of child maltreatment among immigrant families have mainly focused on children and their caregivers, this study breaks new ground by examining the neighborhood as an environmental context for child maltreatment among immigrant families.

METHODS

Following social disorganization theory, this study explores the mechanisms by which neighborhood structural characteristics and social processes affect the maltreatment of children in immigrant families, using the Fragile Families and Child Wellbeing Study (N = 372).

RESULTS

Structural equation modeling revealed that negative neighborhood structural characteristics were positively associated with higher physical assault (β = 0.42, p < .001), higher psychological aggression (β = 0.29, p < .001), and higher neglect (β = 0.19, p < .001) among immigrant families. Conversely, positive neighborhood social processes were associated with lower physical assault (β = -0.37, p < .001) and lower psychological aggression (β = -0.31, p < .001) among immigrant families. In addition, neighborhood social processes mediated the relationship between neighborhood structural characteristics and child physical assault (β = -0.09, p < .001) among immigrant families.

CONCLUSIONS

The findings of this study highlighted the positive role of neighborhood social processes in reducing child physical assault among immigrant families, even in neighborhoods with negative structural characteristics.

Rural Child Maltreatment: A Scoping Literature Review

TOPIC OF REVIEW

The current study sought to review the state of existing knowledge on rural maltreatment.

METHOD OF REVIEW

We conducted a scoping literature review to answer two research questions: (1) Is maltreatment higher in rural areas compared to urban areas? and 2) Are there unique correlates of maltreatment in rural areas?

NUMBER OF RESEARCH STUDIES MEETING THE CRITERIA FOR REVIEW

This review included studies that compared child maltreatment in rural and urban areas in the United States (9) and predictors of maltreatment in rural areas (7).

CRITERIA FOR INCLUSION

Studies that compared child maltreatment in rural and urban areas in the United States were included. For our second research question, related to understanding maltreatment in rural areas, we included those studies that exclusively examined rural areas, when maltreatment was the outcome variable.

HOW RESEARCH STUDIES WERE IDENTIFIED

Studies were reviewed from relevant databases (Annual Reviews, PsychINFO, PubMed, Web of Science) between 1975 and 2019.

MAJOR FINDINGS

Findings were mixed on whether rates of maltreatment were higher or lower in rural areas. While five studies reported higher rates of maltreatment in rural areas, four reported higher rates in urban areas. Overall, child maltreatment rates tended to be higher in urban areas among people of color and higher in rural areas among White people. One study found that community economic factors were not related to maltreatment in a rural area, in stark contrast to robust findings from urban areas.

Older Neighbors and The Neighborhood Context of Child Well-Being: Pathways to Enhancing Social Capital for Children

Drawing on Coleman's concept of social capital, researchers have investigated how the quality of neighborhood social networks influences child development and well-being. The role of non-kin older neighbors in advancing child well-being through the enhancement of social capital, however, has been under-studied. Our objective was to delineate specific pathways through which non-kin older neighbors contribute to neighborhood quality for children and families and potentially advance child well-being. We examined open-ended interview data from 400 parents who cared for at least one child under 18 years of age and resided in 20 neighborhoods in Cleveland, Ohio. A subsample of 113 parents connected older neighbors to neighborhood quality for families and children in their narratives. Our analysis identified three primary pathways through which parents positively linked older neighbors to neighborhood quality: older neighbors support parents and children, promote neighborhood safety, and contribute to neighborhood residential stability. These contributions are evidence of intergenerational closure, reciprocated exchange, and informal social control working together to create social capital in neighborhoods for children. It is by enhancing social capital that older neighbors potentially improve child well-being. We discuss the implications of our findings for neighborhood research and practice.

The Protective Effect of Neighbourhood Collective Efficacy On Family Violence and Youth Antisocial Behaviour in Two South Korean Prospective Longitudinal Cohorts

Neighbourhood collective efficacy has been proposed as a protective factor against family violence and youth antisocial behaviour. However, little is known about its impact on parent and child behaviour in non-Western countries. Using data from two population-based prospective cohorts from South Korea, including primary school students aged 10–12 years (N = 2844) and secondary school students aged 15–17 years (N = 3449), we examined the interplay between collective efficacy, family violence, and youth antisocial behaviour, and whether effects vary by SES. In a first series of models, in both samples, higher levels of collective efficacy were associated with lower levels of family violence, whereas higher levels of family violence were associated with higher levels of youth antisocial behaviour. There was no direct effect of collective efficacy on youth antisocial behaviour; however, there was an indirect effect via family violence. Although these effects were more pronounced in low SES children, there was no evidence of moderation by SES. In a second series of models, in primary school students, collective efficacy was not associated with youth antisocial behaviour. However, there was a direct effect of collective efficacy on family violence, even after adjusting for youth antisocial behaviour. Again, there was no evidence of moderation by SES. In secondary school students, the pattern of results was less consistent, however, again, suggesting more pronounced effects of collective efficacy in low SES children. The findings suggest that collective efficacy may influence family violence more directly, whereas youth antisocial behaviour may be affected more indirectly through the family environment.

"Hurt people hurt people": Relations between adverse experiences and patterns of cyber and in-person aggression and victimization among urban adolescents

This study identified subgroups of adolescents with distinct patterns of involvement with overt and relational in-person and cyber aggression and victimization. We also assessed subgroup similarities and differences in exposure to adverse childhood experiences (ACEs), exposure to community violence, and trauma symptoms. Using latent class analysis, we identified three subgroups among 265 adolescents (Mage  = 14.3 years; 57% female; 96% African American) residing in three urban high-burden communities that included youth who reported: (a) combined (cyber and in-person) aggression and victimization (17%), (b) in-person aggression and victimization (51%), and (c) adolescents with limited involvement (32%). Youth in the combined aggressive-victims subgroup had the highest probability of endorsing exposure to community violence, trauma symptoms, and a higher number of ACEs overall as well as higher rates of both verbal and physical abuse compared to the other subgroups. Our results indicated that the adolescents who reported the highest frequencies of aggressive behavior were also the most victimized and traumatized. These findings provide context to aggressive behavior among adolescents living in high-burden, urban communities and underscore the need for trauma-informed prevention interventions.

Community-Engaged and Informed Violence Prevention Interventions

Strategies for the prevention of violence against children have evolved over the last 3 decades to incorporate community-engaged approaches. These promising approaches involve mobilizing key stakeholders within communities from a variety of different sectors, and engaging adult bystanders to take action when violence is suspected. However, there are many challenges associated with funding and evaluating such programs, which are often barriers in the development of an evidence base that includes metrics of effectiveness and cost benefits. This article discusses specific interventions developed to target physical abuse and neglect, sexual violence, community and gang violence, and bullying within the community setting.

Public Health Nurses' Professional Practices to Prevent, Recognize, and Respond to Suspected Child Maltreatment in Home Visiting: An Interpretive Descriptive Study

The purpose of this analysis was to understand public health nurses’ experiences in preventing and addressing suspected child maltreatment within the context of home visiting. The principles of interpretive description guided study decisions and data were generated from interviews with 47 public health nurses. Data were analyzed using reflexive thematic analysis. The findings highlighted that public health nurses have an important role in the primary prevention of child maltreatment. These nurses described a six-step process for managing their duty to report suspected child maltreatment within the context of nurse-client relationships. When indicators of suspected child maltreatment were present, examination of experiential practice revealed that nurses developed reporting processes that maximized child safety, highlighted maternal strengths, and created opportunities to maintain the nurse-client relationship. Even with child protection involvement, public health nurses have a central role in continuing to work with families to develop safe and competent parenting skills.

The influence of neighborhood violent crime on child-rearing: Integrating neighborhood ecologies and stratified reproduction approaches

While relationships between neighborhood violent crime and adverse child outcomes are well-established, less is known about how neighborhood violent crime influences child-rearing strategies. To address this gap, we blend neighborhood ecologies and stratified reproduction frameworks and examine interview data collected in 2014-2015 from 107 adult caregivers residing in three low and three elevated violent crime neighborhoods in Cleveland, Ohio. Our objective is to examine how perceptions of neighborhood violent crime and its relationship to self-reported child-rearing practices vary by level of neighborhood violence. We find that, although caregivers in low and elevated violent crime neighborhoods shared the perception of neighborhood violent crime as a concern, their narratives of child-rearing practices differed. Caregivers in elevated violent crime neighborhoods were more likely than their low violent crime counterparts to describe in experience-near terms how violent crime threatened their children's well-being. To protect children, caregivers in elevated violent crime neighborhoods reported engaging in severely constrained child-rearing strategies. These constraints have unintended consequences. While they may protect children in the short-term, they may also reproduce inequities by reducing family quality of life in other ways. These findings advance understanding of how neighborhood violent crime differentially affects child-rearing. We integrate neighborhood ecologies and stratified reproduction frameworks to capture how social inequities interact in neighborhood settings to constrain child-rearing and perpetuate inequities over time.

Community-Level Prevention of Childhood Maltreatment: Next Steps in a World with COVID-19

Maltreatment of children continues to be a major public health concern, with high social, economic and health burdens. Rates vary by a number of factors that can be categorized into different levels of the social ecology. Research and theory in this field point to the importance of community-level factors that can contribute to either risk or prevention of child maltreatment. The COVID-19 pandemic context creates additional risks and concerns related to child maltreatment and exacerbates risk factors that existed before: e.g., families and communities are in much worsened states of poverty, unemployment, and food insecurity; losses and grief are affecting mental health; and limitations and safety concerns are affecting in-person child protection work and more. Central to recovery from this pandemic will be the mobilization of community-level resources and the building back up of the social fabric that can support vulnerable children and caregivers. Key to this mobilization will be a better intersectional understanding of structural inequities in the child welfare system and in our communities. Efforts to dismantle structural biases and discrimination are critical to provide safety and support for families and vital for effective child maltreatment prevention. In this context, we discuss the state of the science of community-level prevention of childhood maltreatment, highlighting evidence-based community-level prevention programs and how these types of efforts may be impacted by the current COVID-19 global pandemic.

Trauma Craniano Violento (TCV): Relação entre Conhecimento de Pais, Potencial de Abuso Infantil e Status Socioeconômico Familiar

Resumo Descreve a relação entre conhecimento sobre Trauma Craniano Violento (TCV), status socioeconômico e potencial de maus-tratos infantis. Dezenove pais e 61 mães responderam aos instrumentos Escala de Atitudes Frente ao Choro do Bebê, Inventário de Potencial de Abuso Infantil e Questionário Socioeconômico. A correlação de Spearman demonstrou resultados significativos entre escolaridade e renda com crenças sobre cuidados com o bebê (r = 0,32, p = 0,004; r = 0,22, p = 0,05, respectivamente), poder aquisitivo e escolaridade com conhecimentos sobre choro infantil (r = -0,40, p<0,001; r = -0,22, p = 0,05, respectivamente), número de filhos com estratégias para lidar com choro (r = -0,29, p = 0,01) e rigidez com consequências de sacudir o bebê e crenças sobre cuidados com o bebê (r = -0,29, p = 0,008; r = -0,359, p = 0,001, respectivamente). Considera importante direcionar intervenções às necessidades de cada população e trabalhar a flexibilidade parental para reduzir o TCV.

Family Structure and Secondary Exposure to Violence in the Context of Varying Neighborhood Risks and Resources

Secondary exposure to violence in the community is a prevalent developmental risk with implications for youths' short- and long-term socioemotional functioning. This study used longitudinal, multilevel data from the Project on Human Development in Chicago Neighborhoods to consider how family structure, including parental instability, is associated with youths' secondary exposure to violence across diverse neighborhood contexts. Results showed that both living in a stable single-parent household and experiencing parental instability were associated with greater secondary exposure to violence compared with living in a stable two-parent household. The associations between having a single parent or experiencing parental instability and secondary exposure to violence were especially strong in neighborhoods with high levels of crime and strong neighborhood ties.

The hallmarks of childhood abuse and neglect: A systematic review

BACKGROUND

Studies on the impacts of child maltreatment (CM) have been conducted in diverse areas. Mechanistic understanding of the complex interplay between factors is lacking. Hallmarking is an approach which identifies common factors across studies and highlights the most robust findings.

OBJECTIVES

In a review of systematic reviews and meta-analyses, we addressed the following questions: 1) What are the hallmarks associated with exposure to CM across the bio-ecological spectrum? 2) What is the strength of evidence to support each hallmark? 3) What are the gaps that future research should address?

METHODS

A comprehensive literature search was carried out to find relevant systematic reviews or meta-analyses. 269 articles were read in full and 178 articles, encompassing more than 6000 original papers, were included in the final synthesis. All reviews were independently rated for quality by at least 2 reviewers using AMSTAR-2.

RESULTS

Of 178 review articles, 6 were rated as high quality (all meta-analyses) and 46 were rated as medium quality. Most were from high income countries.

CONCLUSIONS

Based on the most commonly reported high-quality research findings we propose that the hallmarks of exposure to child maltreatment are: Increased risk of psychopathology; Increased risk of obesity; Increased risk of high- risk sexual behaviours, Increased risk of smoking; and Increased risk of child maltreatment in children with disabilities. Research gaps include a lack of focus on complexity and resilience. Little can be concluded about directions of causality or mechanisms. Adequately powered prospective studies are required to move the field forward.

Reconstructing the workforce within public health protective systems: Improving resilience, retention, service responsiveness and outcomes

BACKGROUND

Unacceptably high staff turnover has plagued traditional approaches to child protection, seemingly forever. Around the globe, numerous studies, reports and inquiries have highlighted how statutory agencies, focusing on risk-oriented investigations of suspected maltreatment, experience significant issues with worker stress and its occupational and organisational consequences. Yet, promoting staff resilience within child protection agencies' workforces has proved to be quite elusive at a systems level. While concern about child protection services often centers on the children and families agencies they intend to assist, the experiences of workers within the system provide further evidence that the system is itself failing. As a result, governments around the world are increasingly embracing system reforms that promote public health approaches focusing on early intervention and prevention to build child, family and neighbourhood support capacity and resilience and thereby reduce child maltreatment.

OBJECTIVE

We review the workforce issues affecting traditional child protection approaches and its impacts. In light of this, we examine the knowledge to be applied in the development of public health approaches that embrace integrated and coordinated systems of community care. Such reforms, with altered organisational remits that are far broader than narrow tertiary responses of investigation and removal, utilize evidence-based interventions targeted at differentiated risk and service user needs to provide effective supports and reduce maltreatment. This article unpacks the strategies needed to build and properly prepare a re-tooled workforce capable of implementing a public health model of preventive interventions.

PARTICIPANTS AND SETTING

Not applicable.

METHODS

Current public health reforms are examined through the lens of their potential impacts upon contemporary workforce issues. Focusing upon building a stable, resilient and appropriately skilled workforce for a public health model, we examine the implications for key stakeholders including workers, program and organisational leaders, educators, researchers, academics and community members, especially children and vulnerable families.

RESULTS AND CONCLUSIONS

Public health approaches to protecting children seek to provide effective supports and services in timely ways in order to prevent unnecessary statutory interventions, which affect those from cultural and poor communities disproportionately. But remodelling systems to embrace these approaches entails complex practice, program, policy and legislative changes, using evidence to intervene in ways that are primarily voluntary rather than coercive. In doing so they provide potential to recast the basis of the helping relationship to attend better to the relational aspects of changed behaviour. Embedding workforce resilience strategies in reformed systems is necessary to address retention and ensure service effectiveness and responsiveness to the diversity of needs of struggling families and impoverished communities. Thereby, public health approaches are well placed to achieve their true potential.

Neighbourhood collective efficacy and protective effects on child maltreatment: A systematic literature review

Research within the community-based child protection approach has used the neighbourhood collective efficacy theory of social disorganisation to focus on investigating the social conditions and processes that facilitate residents' ability to intervene or protect children from parental maltreatment. However, much of the research into the protective effects of neighbourhood collective efficacy on child maltreatment has yielded mixed results. In a review of empirical studies published between 2008 and 2019, we investigated the sources of these mixed findings and the pathways through which neighbourhood collective efficacy could protect children from parental maltreatment. Following the PRISMA guidelines for systematic literature reviews yielded 21 empirical research articles on the subject that were critically examined in line with the theoretical underpinning and research questions. Evidence suggests both direct and sequential pathways in which increased social cohesion and informal social control (ISC) protect against parents' maltreatment behaviours. Higher levels of neighbourhood social cohesion were found to be a potential primary preventive strategy against risk factors for maltreatment. The use of ISC measures from the traditional collective efficacy scale account for the mixed findings and limited research on the direct and indirect forms of ISC. Moreover, the transactional processes posited by collective efficacy theory that link neighbourhood social cohesion to ISC have yet to be examined and confirmed with respect to child maltreatment. Studies addressing these theoretical and methodological gaps are encouraged, in particular, studies examining ISC dimensions using item measures of specific residents' actions within child maltreatment behaviours. The results provide implications for community-based child protection practice, in terms of promoting cultural norms and values that foster social cohesion and facilitate ISC interventions within neighbourhoods.

Risk and protective factors for child maltreatment: A review

PURPOSE OF REVIEW

The purpose of this review was to synthesize the empirical literature regarding key risk and protective factors for child maltreatment at each level of the socioecological model and to identify directions for future research and practice.

RECENT FINDINGS

Prior research has largely focused on risk and protective factors at the individual and interpersonal levels of the socioecological model. More recently, research has begun to examine risk and protective factors at the community and societal levels, with results suggesting that programmatic and policy interventions that reduce risk and enhance protection at these levels are promising primary prevention strategies for child maltreatment.

SUMMARY

Future research should continue to focus on risk and protective factors at the community and societal levels with the aim of building the evidence base for population-wide prevention strategies. Such strategies have the potential to create contexts in which families and children thrive.

Perceptions of danger, tolerance of delinquency, and economic disadvantage: Examining neighborhood influences on child physical abuse

BACKGROUND

Social disorganization theory posits that both structural and social features of a particular geographic unit are associated with criminal behavior. Despite many tests of social disorganization theory, few studies have assessed its relevance to child abuse.

OBJECTIVE

This study seeks to explain neighborhood variation in child maltreatment. The goal of the current study is to fill this gap by investigating whether or not child physical abuse is related to neighborhood economic disadvantage, perceptions of the dangerousness of the neighborhood, and norms regarding delinquency.

PARTICIPANTS AND SETTING

Data were drawn from the Project on Human Development in Chicago Neighborhoods (PHDCN) and included 2364 respondents from 79 neighborhoods. The dependent variable, the variety or number of acts of severe child physical abuse, was reported by caregivers, while neighborhood characteristics were based on information from the U.S. Census Data and adult respondents living in Chicago neighborhoods.

METHODS

A multilevel, over-dispersed, Poisson regression models were utilized to predict the variety of acts of severe physical abuse that a child living within a given neighborhood would experience.

RESULTS

Neighborhood economic disadvantage was not significantly associated with greater variety of physical abuse. However, neighborhoods perceived as dangerous had greater variety of physical abuse (b = .25, p < .05), while those with a greater tolerance for deviance had somewhat lower variety of physical abuse (b= -.69, p ≤ .10).

CONCLUSIONS

These results suggest that some contextual factors may help explain child maltreatment and should be subject to additional research.

Trajectories of maternal aggression in early childhood: Associations with parenting stress, family resources, and neighborhood cohesion

BACKGROUND

The effects of family risk on parenting can be ameliorated or exacerbated depending on factors internal (e.g., appraisals, regulation) and external (e.g., resources, social support) to the role of parenting. Therefore, it is important to distinguish between sources of stress when exploring associations with parenting behaviors.

OBJECTIVE

We aimed to identify trajectories of maternal aggression among families across various levels of risk, and explore associations with factors internal and external to parenting.

PARTICIPANTS AND SETTING

Participants included children in large U.S. cities born between 1998 and 2000, followed through age 9, in the Fragile Families and Child Well-being Study with medical records data available (N = 3529).

METHOD

Latent growth curve modeling was conducted to identify trajectories of maternal aggression measured through a survey at child age 3, 5, and 9. Correlates of maternal aggression (i.e., family risk for maltreatment, income-to-poverty ratios, maternal education, parenting stress, and neighborhood cohesion) were measured through medical records and maternal surveys at birth, age 1, and age 3.

RESULTS

Maternal aggression similarly declined between child age 3 and 9 across low-, moderate-, and high-risk families. Across all families, neighborhood social cohesion was significantly, negatively associated with maternal aggression, (β's = -.20 to -.28, p's < .001) and increases in parenting stress were significant predictors among Low Risk (β = .12, p = .006) and High Risk (β = .10, p = .02) families.

CONCLUSION

The results suggest that families could benefit from supportive neighborhood environments or parenting stress reduction techniques, regardless of level of risk at birth.

Neighborhood Effects on Children's Development in Experimental and Nonexperimental Research

Children's neighborhood contexts are defined by rising socioeconomic inequality and segregation. This article reviews several decades of research on how neighborhood socioeconomic conditions are associated with children's development. The nonexperimental literature suggests that the most salient neighborhood socioeconomic condition depends on the outcome—disadvantage for social, emotional, and behavioral outcomes and advantage for achievement-related outcomes. Moreover, children's cumulative exposure to neighborhood socioeconomic conditions over the first two decades of life, and possibly especially in childhood, may matter most for later development. These findings are partially supported by the few experimental studies available, and across study designs, neighborhood effects are typically modest. In order to improve our understanding of this topic, we recommend methodologically rigorous designs—experimental and nonexperimental—and comparative approaches, particularly ones addressing the complexities of development in neighborhood contexts. To guide this research, we provide an integrated framework that captures a broad and dynamic perspective including macro forces, neighborhood social processes and resources, physical features, spatial dynamics, and individual differences.

Safe and sound? Exploring parents' perceptions of neighborhood safety at the nexus of race and socioeconomic status

Racial and socioeconomic achievement gaps appear in early childhood, persist into adolescence, and undermine long-term well-being. Scholarship typically examines whether family socioeconomic inequality explains racial skills gaps; however, increasing research indicates that the academic returns to socioeconomic status (SES) differ for Black and White children and that the size of Black-White achievement gaps vary by SES, with the largest disparities evident among the highest-SES students. The processes underlying the development of within-SES racial gaps remain unclear, though growing evidence suggests that racial disparities in proximity to (dis)advantage shape family life in critical ways. In particular, Black-White differences in proximity to spatial (dis)advantage may have serious implications for young children's health and well-being. Yet, little research has directly explored how race and family economic status shape children's family and neighborhood contexts. This chapter presents a mixed-methods study that integrated semi-structured interview, neighborhood observation, and neighborhood crime data from a socioeconomically-diverse sample of Black and White families to explore how the interplay between race and family economic status shapes parents' perceptions of neighborhood safety. Findings revealed that race intersects with SES to produce complex patterns of inequality in community life and neighborhood conditions. Although economic disadvantage places limits on all parents, irrespective of race, dangerous conditions and stressors at the neighborhood level tended to be more pronounced and take a more pernicious form among low-income Black parents. Higher income granted parents escape from the most serious threats to their children's well-being, but the returns to increases in SES were not equivalent for middle-income Black and White families, and only among the most affluent families did race differences diminish considerably or disappear altogether.

The Relationship between Parental Perception of Neighborhood Collective Efficacy and Physical Violence by Parents against Preschool Children: A Cross-Sectional Study in a County of China

Children exposed to negative neighborhood environments are at high risk of experiencing violence. This study aimed to explore the effects of parental perception of neighborhood collective efficacy on parental physical violence (PV) to their preschool children in a county of China. A total of 1337 parents from nine kindergartens were recruited by the stratified random cluster sampling method. Data about parental PV behavior toward children during the past three months, parental perception of neighborhood collective efficacy, together with their attitudes towards the use of corporal punishment to discipline children, and demographic characteristics were collected. Their relationships were investigated by applying multivariable logistic regression models. Overall, 67.5% of the parents reported at least one form of PV during the past three months. The rates of minor PV (MPV) and severe PV (SPV) were 67% and 22.8%, respectively. The results of multivariate logistic regression showed that only social cohesion was associated with lower odds of parental PV and MPV behavior after controlling for covariates. The results suggest that neighborhood collective efficacy is associated with parental PV behavior against their children to some extent, but the effects differ according to the severity level of PV. Neighborhood social cohesion may have a positive role in reducing parental PV behavior in the county surveyed at present study.

Social determinants of health and maxillofacial injuries in children and adolescents victims of violence: A novel GIS-based modelling application

BACKGROUND

Physical violence against children and adolescents comprises a serious public health problem and often results in oral and maxillofacial traumas. Social determinants may favour the occurrence of these events, but few studies have critically evaluated the interaction between social and geographical risk factors.

AIMS

To investigate the spatiotemporal distribution of oral and maxillofacial traumas resulting from violence against children and adolescents through geostatistical techniques.

METHODS

This study was an ecological analysis of cases of trauma caused by violence against Brazilian children and adolescents using aggregated data from victims attended at a Center of Forensic Medicine and Forensic Dentistry between January 2012 and December 2015. Data were analysed through modelling based on geographic information system (GIS).

RESULTS

Two distinct patterns of longitudinal trajectory of oral and maxillofacial trauma related to violence against children and adolescents were identified (TP1 and TP2, P < 0.05). The spatial regression analysis revealed a statistically significant association between higher incidence of cases and areas with worse socioeconomic conditions (β = 0.047, SE = 0.020, P < 0.05).

CONCLUSION

Neighbourhoods with considerable socio-spatial vulnerability for violence against children and adolescents and maxillofacial traumas were identified.

Differential Response and Children Re-Reported to Child Protective Services: County Data From the National Child Abuse and Neglect Data System (NCANDS)

Child protection systems that implement differential response (DR) systems screen to route referrals to an investigation response (IR) or alternative response (AR). AR responses emphasize family engagement, assessment of family needs, and service linkage. Usually, AR state-level policy does not require child welfare staff to make a maltreatment determination. Jurisdictions implement DR systems differently, leading to variations in the proportion of AR cases, risk levels of cases served, and the ways families access and use services. County data from the National Child Abuse and Neglect Data System were analyzed for six states from 2004 to 2013 that implemented DR. Variation in county-level AR rates were associated with county-level re-report rates using regression models with risk adjustments for socioeconomic and other county characteristics. Counties had 3% fewer re-reports overall for each percentage increase in AR use; higher levels of AR use are related to lower levels of re-reporting. When county AR and IR cases were analyzed separately, increasing rates of AR were associated with lower re-report rates for IR cases, but higher re-report rates for AR cases. Findings for the AR and IR subgroup must be interpreted with caution as a number of technical factors may be driving these results.

Neighborhood inequality in the prevalence of reported and substantiated child maltreatment

BACKGROUND

Prior research documents spatial concentration in the incidence of child maltreatment reported to and confirmed by Child Protective Services (CPS), but without estimates of the prevalence of such reports, the extent of CPS contact in different communities is unknown.

OBJECTIVE

To estimate the prevalence of CPS reports during early childhood and substantiated investigations during childhood for children living in different types of neighborhoods.

PARTICIPANTS AND SETTING

Children who experienced CPS reports and substantiated investigations in Connecticut.

METHODS

This study uses synthetic cohort life tables to estimate the cumulative risk of CPS reports before age five and substantiated CPS investigations before age 18, by neighborhood poverty rate and neighborhood racial composition.

RESULTS

The analysis reveals substantial stratification in the prevalence of CPS contact by the demographic characteristics of children's residential neighborhoods. For example, while 7% of children in low-poverty neighborhoods (under 10% poor) experience a substantiated CPS investigation at some point during childhood at 2014 and 2015 rates, this risk more than doubles to 17% for their peers in moderate-poverty neighborhoods (10-20% poor) and more than triples to 26% for their peers in high-poverty neighborhoods (over 20% poor). Similar trends emerge when examining CPS reports in early childhood as well as when comparing neighborhoods with different proportions of White residents.

CONCLUSIONS

CPS reports and substantiated investigations are a widespread and disproportionately experienced life event for children in poor neighborhoods and children in non-White neighborhoods.

Socioeconomic variation in injury hospitalisations in Australian children ≤ 16 years: a 10-year population-based cohort study

BACKGROUND

Childhood injury remains a significant public health problem responsible for significant morbidity and mortality. However, injury has been found to increase with socioeconomic disadvantage for some injuries. The current study examines the 10-year epidemiological profile of injury hospitalisations of children ≤16 years by socioeconomic status for different age group and select types of injury.

METHOD

A retrospective analysis of injury hospitalisations of children aged ≤16 years using linked hospitalisation and mortality records during 1 July 2002 to 30 June 2012 was conducted. Negative binomial regression was used to calculate incidence rate ratios (IRRs) for injury hospitalisation rates by socioeconomic disadvantage quintile.

RESULTS

There were 679,171 injury hospitalisations for children aged 0-16 years in Australia. Children in more disadvantaged socioeconomic quintiles were more likely to be hospitalised for an injury sustained by: assault (IRR range 1.40 to 3.64), poisoning (IRR range 1.29 to 1.36), heat and hot substances (IRR range 1.07 to 1.34), and pedestrian collisions (IRR range 1.06 to 1.54) than children in advantaged socioeconomic quintiles.

CONCLUSIONS

Findings support the notion that the risk of injury hospitalisation among children differs according to socioeconomic gradient and has implications for childhood injury prevention. Policy makers should consider socioeconomic differences in the design of injury prevention measures, particularly measures directed at modifying the built environment and home-based interventions.

Community-level social capital, parental psychological distress, and child physical abuse: a multilevel mediation analysis

PURPOSE

The purpose of this study was to investigate the association between community-level social capital and physical abuse towards children, and the mediating effect of parental psychological distress by multilevel mediation analyses.

METHODS

We analyzed data from a population-based study of first-grade elementary school children (6-7 years old) in Adachi City, Tokyo, Japan. The caregivers of first-grade students from all elementary schools in Adachi City (N = 5355) were asked to respond to a questionnaire assessing parents' self-reported physical abuse (beating and hitting) and neighborhood social capital. Among them, 4291 parents returned valid responses (response rate 80.1%). We performed multilevel analyses to determine the relationships between community-level parental social capital and physical abuse, and further multilevel mediation analyses were performed to determine whether parental psychological distress mediated the association.

RESULTS

Low community-level social capital was positively associated with physical abuse (both beating and hitting) after adjustment for other individual covariates (beating: middle, OR = 1.54, 95% CI 1.11-2.13; low, OR = 1.33, 95% CI 0.94-1.88; and hitting: middle, OR = 1.35, 95% CI 1.02-1.80; low, OR = 1.16, 95% CI 0.86-1.57). Multilevel mediation analyses revealed that community-level parental psychological distress did not mediate the association (indirect effect ß = 0.10, 95% CI - 0.10 to 0.29, p = 0.34 for beating; ß = 0.03, 95% CI - 0.16 to 0.23, p = 0.74 for hitting).

CONCLUSIONS

Fostering community-level social capital might be important for developing a strategy to prevent child maltreatment, which may have a direct impact on abusive behavior towards children.

Intergenerational Continuity in Adverse Childhood Experiences and Rural Community Environments

OBJECTIVES

To understand the role of the community environment on intergenerational continuity in adverse childhood experiences (ACEs) among a rural White sample.

METHODS

Parents in 12 counties in rural Iowa reported retrospectively on their own ACEs in 1989. We measured their child's ACEs retrospectively and prospectively across adolescence (n = 451 families). We measured structural and social process-related measures of community environment (i.e., community socioeconomic status, parents' perception of community services, perceived community social cohesion, and neighborhood alcohol vendor density) on multiple occasions during the child's adolescence.

RESULTS

The 4 measures of community environment were all correlated with the child's ACEs, but only alcohol vendor density predicted ACEs after inclusion of covariates. Intergenerational continuity in ACEs was moderated by both social cohesion (b = -0.11; SE = 0.04) and alcohol vendor density (b = -0.11; SE = 0.05).

CONCLUSIONS

Efforts to increase community social cohesion and manage alcohol vendor density may assist families in breaking the cycle of maltreatment across generations.

How might neighborhood built environment influence child maltreatment? Caregiver perceptions

RATIONALE

Child maltreatment remains a serious but potentially preventable public health concern in the United States. Although research has examined factors associated with child maltreatment at the neighborhood level, few studies have explicitly focused on the role of the neighborhood built environment in maltreatment.

OBJECTIVE

We begin to address these gaps by investigating caregivers' own perceptions of mechanisms by which neighborhood built environments may affect child maltreatment.

METHOD

Utilizing a grounded theory approach, we examined open-ended interview data from 400 adult residents residing in 20 different Cleveland, Ohio neighborhoods (census tracts) and caring for at least one child under 18 years of age.

RESULTS

Our analysis revealed three primary pathways through which caregivers linked the neighborhood built environment to potential child maltreatment: housing density, physical neighborhood space as shaping family relations, and the internalization of the surrounding neighborhood-built environment.

CONCLUSIONS

Our findings suggest that aspects of the neighborhood built environment, such as the presence of abandoned houses or the lack of recreational centers, can be stressors themselves and may also critically alter families' thresholds for navigating other everyday pressures. Conversely, aspects of the neighborhood built environment, such as housing density, may work to mitigate the risk of maltreatment, either by promoting social support or by increasing the likelihood that maltreatment is reported to authorities. Additional research, both qualitative and quantitative, is integral to building and testing models of these separate but related pathways by which the neighborhood built environment may link to child maltreatment.

Child maltreatment reporting in the general population: Examining the roles of community, collective efficacy, and adverse childhood experiences

According to bystander theory, factors such as the community environment, collective efficacy, and history of adverse childhood experiences could be related to likelihood of reporting or intervening against maltreatment. An online survey was conducted with 946 general population Californians obtained through mixed-mode random probability and quota-based recruitment methods. Using an experimental vignette design, participants were randomly assigned to two scenarios: a) potential child abuse occurring in their neighborhood; b) potential child abuse in an unfamiliar neighborhood. Weighted multivariate logistic regression models assessed relationships between the vignette condition, collective efficacy, appraisal of the behavior, and likelihood of reporting or intervening. The results suggested that perceiving the vignette as occurring in your own neighborhood was associated with lower odds of viewing the behavior as appropriate and considering it abusive. Higher collective efficacy scores were associated with lower odds of viewing the incident as inappropriate but higher odds of personally intervening. Adverse childhood experiences were positively related to reporting the incident to child protective services and intervening. Bystanders may be more likely to give parents in their own neighborhood "the benefit of the doubt" by viewing their abusive behaviors as less severe, potentially leading to underreporting. Neighborhood collective efficacy might increase willingness to personally intervene, but not contact systems such as child protective services or police, suggesting that enhanced trust in communities does not extend to these institutions. Our findings have implications for neighborhood and education interventions to enhance understanding of and willingness to intervene on behalf of children.

Neighborhood characteristics and violence behind closed doors: The spatial overlap of child maltreatment and intimate partner violence

In this study, we analyze first whether there is a common spatial distribution of child maltreatment (CM) and intimate partner violence (IPV), and second, whether the risks of CM and IPV are influenced by the same neighborhood characteristics, and if these risks spatially overlap. To this end we used geocoded data of CM referrals (N = 588) and IPV incidents (N = 1450) in the city of Valencia (Spain). As neighborhood proxies, we used 552 census block groups. Neighborhood characteristics analyzed at the aggregated level (census block groups) were: Neighborhood concentrated disadvantage (neighborhood economic status, neighborhood education level, and policing activity), immigrant concentration, and residential instability. A Bayesian joint modeling approach was used to examine the spatial distribution of CM and IPV, and a Bayesian random-effects modeling approach was used to analyze the influence of neighborhood-level characteristics on small-area variations of CM and IPV risks. For CM, 98% of the total between-area variation in risk was captured by a shared spatial component, while for IPV the shared component was 77%. The risks of CM and IPV were higher in neighborhoods characterized by lower levels of economic status and education, and higher levels of policing activity, immigrant concentration, and residential instability. The correlation between the log relative risk of CM and IPV was .85. Most census block groups had either low or high risks in both outcomes (with only 10.5% of the areas with mismatched risks). These results show that certain neighborhood characteristics are associated with an increase in the risk of family violence, regardless of whether this violence is against children or against intimate partners. Identifying these high-risk areas can inform a more integrated community-level response to both types of family violence. Future research should consider a community-level approach to address both types of family violence, as opposed to individual-level intervention addressing each type of violence separately.

Neighborhood collective efficacy, parental spanking, and subsequent risk of household child protective services involvement

Children exposed to negative neighborhood conditions and parental spanking are at higher risk of experiencing maltreatment. We conducted prospective analyses of secondary data to determine the effects of neighborhood collective efficacy and parental spanking on household Child Protective Services (CPS) involvement, and whether spanking mediates the relationship between neighborhood collective efficacy and CPS involvement. The sample (N = 2,267) was drawn from the Fragile Families and Child Wellbeing Study (FFCWS), a stratified random sample of 4,789 births between 1998-2000 in 20 large U.S. cities. Logistic regression models were employed to test the effects of neighborhood collective efficacy and spanking at child age 3 on mother's report of CPS contact during the subsequent two years. The product-of-coefficient approach was used to test the mediation hypothesis. One aspect of neighborhood collective efficacy (i.e., Social Cohesion/Trust) is associated with lower odds of CPS involvement (OR = .80, 95% CI 0.670-0.951) after controlling for Informal Social Control, parental spanking, and the covariates. Parental spanking predicts increased odds of CPS involvement during the next two years (OR = 1.38, 95% CI 1.001-1.898), net of neighborhood collective efficacy and the covariates. The mediation hypothesis is not supported. Promoting both cohesive and trusting relationships between neighbors and non-physical discipline practices is likely to reduce the incidence of household CPS involvement.