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Mathews B, Thomas HJ, Scott JG. A new era in child maltreatment prevention: call to action. Med J Aust 2023; 218 Suppl 6:S47-S51. [PMID: 37004187 PMCID: PMC10952631 DOI: 10.5694/mja2.51872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 04/03/2023]
Affiliation(s)
- Ben Mathews
- Queensland University of TechnologyBrisbaneQLD
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUnited States of America
| | - Hannah J Thomas
- QIMR Berghofer Medical Research InstituteBrisbaneQLD
- Queensland Centre for Mental Health ResearchBrisbaneQLD
| | - James G Scott
- QIMR Berghofer Medical Research InstituteBrisbaneQLD
- Child Health Research Centrethe University of QueenslandBrisbaneQLD
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2
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Anis L, Ross K, Ntanda H, Hart M, Letourneau N. Effect of Attachment and Child Health (ATTACH TM) Parenting Program on Parent-Infant Attachment, Parental Reflective Function, and Parental Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148425. [PMID: 35886276 PMCID: PMC9324434 DOI: 10.3390/ijerph19148425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 02/01/2023]
Abstract
High-risk families exposed to toxic stressors such as family violence, depression, addiction, and poverty, have shown greater difficulty in parenting young children. In this study, we examined the effectiveness of ATTACHTM, a 10−12 session manualized one-on-one parental Reflective Function (RF)-based parenting program designed for high-risk families. Outcomes of parent-child attachment and parental RF were assessed via the Strange Situation Procedure (SSP) and Reflective Function Scale (RFS), respectively. The protective role of ATTACHTM on parental depression was also assessed. Data were available from caregivers and their children < 6 years of age who participated in five pilot randomized control trials (RCTs) and quasi-experimental studies (QES; n = 40). Compared with the control group, caregivers who received the ATTACHTM-program demonstrated a greater likelihood of secure attachment with their children (p = 0.004) and higher parental RF [self (p = 0.004), child (p = 0.001), overall (p = 0.002)] in RCTs. A significant improvement in parental RF (p = 0.000) was also observed in the QES within ATTACHTM group analysis. As attachment security increased, receiving the ATTACHTM program may be protective for depressed caregivers. Results demonstrated the promise of ATTACHTM for high-risk parents and their young children.
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Affiliation(s)
- Lubna Anis
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Kharah Ross
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada;
- Faculty of Humanities and Social Sciences, Athabasca University, Athabasca, AB T9S 3A3, Canada
| | - Henry Ntanda
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada; (H.N.); (M.H.)
| | - Martha Hart
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada; (H.N.); (M.H.)
| | - Nicole Letourneau
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, Departments of Pediatrics, Psychiatry, and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Correspondence:
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Williams VN, Lopez CC, Tung GJ, Olds DL, Allison MA. A case study of care co-ordination between primary care providers and nurse home visitors to serve young families experiencing adversity in the Northwestern United States. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1400-1411. [PMID: 34114696 DOI: 10.1111/hsc.13470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/21/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
Nurse home visitors in Nurse-Family Partnership® (NFP) work with mothers experiencing social and economic adversities to improve their and their children's health. Collaboration between nurse home visitors and primary care providers (PCPs: healthcare providers and social workers embedded within obstetrics, paediatrics and family medicine practices) can improve service delivery for families experiencing the greatest adversities. However, little is known about how and to what extent PCPs collaborate with home visiting nurses. We conducted a single exploratory case study between April 2019 and February 2020 to better understand how PCPs collaborate with home visiting nurses to meet family needs in one NFP site, purposefully selected for strong collaboration. We conducted in-depth qualitative interviews with 22 PCPs, including 5 nurses, 7 physicians, 7 social workers and 3 non-direct care professionals, including patient navigator and hospital executives. Interviews were recorded, transcribed, validated and coded inductively. Codes were grouped into broader categories and thematic memos across provider role were written to triangulate perspectives. Healthcare providers interacted with home visiting nurses mainly during the referral process, while social workers provided more specific examples of service co-ordination. In this case study, we saw mutual awareness, co-operation and collaboration to serve families with high needs. Even in this case, purposefully selected to represent strong collaboration, there were opportunities to enhance co-ordination to improve the health and social needs of young families experiencing adversity.
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Affiliation(s)
- Venice Ng Williams
- Prevention Research Center for Family and Child Health, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Connie Cignetti Lopez
- Prevention Research Center for Family and Child Health, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Gregory Jackson Tung
- Department of Health Systems, Management and Policy, Colorado School of Public Health, Aurora, CO, USA
| | - David Lee Olds
- Prevention Research Center for Family and Child Health, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mandy Atlee Allison
- Prevention Research Center for Family and Child Health, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Child Health Clinic, Children's Hospital Colorado, Aurora, CO, USA
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Wagner RE, Jonson-Reid M, Drake B, Kohl PL, Pons L, Zhang Y, Fitzgerald RT, Laudenslager ML, Constantino JN. Parameterizing Toxic Stress in Early Childhood: Maternal Depression, Maltreatment, and HPA-Axis Variation in a Pilot Intervention Study. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022:10.1007/s11121-022-01366-4. [PMID: 35606570 DOI: 10.1007/s11121-022-01366-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 12/22/2022]
Abstract
Adverse experiences superseding a child's capacity to sustain regulation of emotion and adaptive function are theorized to constitute "toxic stressors" when they induce a deleterious biological response within an individual. We ascertained presumptive parameters of toxic stress among 164 low-income infants and toddlers (ages 4-48 months) from 132 families enrolled in Early Head Start (EHS). We randomized a subset of these families into a pilot intervention arm of parenting education (the Incredible Years, TIY), which supplemented the EHS curriculum. Official report child abuse and neglect (CAN) and child behavior were serially ascertained over the course of the study. We observed relatively low associations among maternal depression, CAN, caregiver-child relationship quality, hair cortisol, and adverse child behavioral outcomes. Moreover, despite poverty and the high prevalence (51%) of CAN in this sample, the frequency of clinical-level internalizing and externalizing behavior among the children did not exceed that of the general population, by their parents' report. The pilot supplementation of EHS with TIY improved attendance in group meetings but did not significantly reduce adverse behavioral outcomes or CAN. This study revealed marked independence of standard indices of toxic stress (child maltreatment, maternal depression, caregiver emotional unavailability) which have been presumed to be risk factors for the development of psychopathology. That they were weakly inter-correlated, and only modestly predictive of child behavioral outcomes in this EHS sample, caution against presumptions about the toxicity of individual stressors, highlight the importance of ascertaining risk (and compensatory influences) comprehensively, suggest buffering effects of programs like EHS, and demonstrate the need for greater understanding of what parameterizes resilience in early childhood.
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Affiliation(s)
- Rachael E Wagner
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Melissa Jonson-Reid
- School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Brett Drake
- School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Patricia L Kohl
- School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Laura Pons
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Yi Zhang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Robert T Fitzgerald
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | | | - John N Constantino
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
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5
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A realist model for home visitation program evaluation. J Pediatr Nurs 2022; 64:e6-e14. [PMID: 35177363 DOI: 10.1016/j.pedn.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 12/28/2021] [Accepted: 01/20/2022] [Indexed: 11/20/2022]
Abstract
Increased attention on home visitation as a strategy to reduce child maltreatment and increased funding to support home visitation programs has led to their rapid and widespread adoption in the United States and internationally. The rapid adoption of home visitation programs has occurred without an adequate understanding of the underlying mechanisms of influence on child maltreatment. Consequently, there is a lack of consistency in structures and processes across programs. The variability in structures and processes within and across programs has contributed to the inconsistent findings related to the effectiveness of home visitation as a strategy to constrain child maltreatment. Identifying the underlying mechanisms that are facilitating or constraining program success or failure is essential for informing policy and practice. We propose the use of realist theory to identify the underlying mechanisms of home visitation programs. While realist theory has been used broadly in the social sciences, its uptake in nursing has been slow. Despite its limited use in nursing, realism's primary function, seeking to identify the underlying mechanisms in complex social programs, makes it suitable for investigating many complex phenomena that are of interest to nurse scientists. Here we discuss the theoretical foundations for home visitation programs, the recent evidence for program effectiveness, significant home visitation program components, and we propose a realist model for home visitation program evaluation that may aid in identifying how, for whom, and under what conditions home visitation programs work when these programs are implemented to address child maltreatment.
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Han K, Oh S. The effectiveness of home visiting programs for the prevention of child maltreatment recurrence at home: a systematic review and meta-analysis. CHILD HEALTH NURSING RESEARCH 2022; 28:41-50. [PMID: 35172079 PMCID: PMC8858785 DOI: 10.4094/chnr.2022.28.1.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/21/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose This systematic review aimed to investigate the effectiveness of home visiting programs targeting parents who have maltreated their children on the prevention of child maltreatment recurrence. Methods Major databases were searched (Ovid-Medline, PubMed, Cochrane Library, CINAHL, and RISS). The frequency of maltreatment was measured for the meta-analysis, which was conducted using Review Manager 5.2 software. The effect size was measured using odds ratios (ORs). Results Six studies were included in the analysis, none of which were conducted in South Korea. The meta-analysis demonstrated that the risk of child maltreatment recurrence significantly decreased after a home visiting program was implemented (OR=0.45, 95% confidence interval [CI]=0.29-0.68). Nurses were the most common intervention providers. Conclusion Home visiting programs should be provided for families in which maltreatment has already occurred to prevent the recurrence of maltreatment and foster a home environment in which children can live safely. Since the rate of child maltreatment in Korea is increasing, further research is needed to develop and implement home visiting programs in which nurses play a major role in preventing the recurrence of child maltreatment.
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Affiliation(s)
- Kyeongji Han
- Registered Nurse, Jeju National University Hospital, Jeju ‧ Graduate Student, College of Nursing, Jeju National University, Jeju, Korea
| | - Sumi Oh
- Assistant Professor, College of Nursing · Health and Nursing Research Institute, Jeju National University, Jeju, Korea
- Corresponding author Sumi Oh College of Nursing · Health and Nursing Research Institute, Jeju National University, 102 Jejudaehak-ro, Jeju 63243, Korea TEL: +82-64-754-3756 FAX: +82-64-702-2686 E-MAIL:
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Kohl PL, Gyimah EA, Diaz J, Kuhlmann FM, Dulience SJL, Embaye F, Brown DS, Guo S, Luby JL, Nicholas JL, Turner J, Chapnick M, Pierre JM, Boncy J, St Fleur R, Black MM, Iannotti LL. Grandi Byen-supporting child growth and development through integrated, responsive parenting, nutrition and hygiene: study protocol for a randomized controlled trial. BMC Pediatr 2022; 22:54. [PMID: 35062907 PMCID: PMC8780724 DOI: 10.1186/s12887-021-03089-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/22/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Poor child growth and development outcomes stem from complex relationships encompassing biological, behavioral, social, and environmental conditions. However, there is a dearth of research on integrated approaches targeting these interwoven factors. The Grandi Byen study seeks to fill this research gap through a three-arm longitudinal randomized controlled trial which will evaluate the impact of an integrated nutrition, responsive parenting, and WASH (water, sanitation and hygiene) intervention on holistic child growth and development. METHODS We will recruit 600 mother-infant dyads living in Cap-Haitien, Haiti and randomize them equally into one of the following groups: 1) standard well-baby care; 2) nutritional intervention (one egg per day for 6 months); and 3) multicomponent Grandi Byen intervention (responsive parenting, nutrition, WASH + one egg per day for 6 months). Primary outcomes include child growth as well as cognitive, language, motor, and social-emotional development. The study also assesses other indicators of child health (bone maturation, brain growth, diarrheal morbidity and allergies, dietary intake, nutrient biomarkers) along with responsive parenting as mediating factors influencing the primary outcomes. An economic evaluation will assess the feasibility of large-scale implementation of the interventions. DISCUSSION This study builds on research highlighting the importance of responsive parenting interventions on overall child health, as well as evidence demonstrating that providing an egg daily to infants during the complementary feeding period can prevent stunted growth. The multicomponent Grandi Byen intervention may provide evidence of synergistic or mediating effects of an egg intervention with instruction on psychoeducational parenting and WASH on child growth and development. Grandi Byen presents key innovations with implications for the well-being of children living in poverty globally. TRIAL REGISTRATION NCT04785352 . Registered March 5, 2021 at https://clinicaltrials.gov/.
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Affiliation(s)
- Patricia L Kohl
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Emmanuel A Gyimah
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA.
| | - Jenna Diaz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - F Matthew Kuhlmann
- Division of Infectious Diseases, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Sherlie Jean-Louis Dulience
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Fithi Embaye
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Derek S Brown
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Shenyang Guo
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Jennifer L Nicholas
- Department of Radiology, School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Jay Turner
- McKelvey School of Engineering, Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Melissa Chapnick
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Joseline Marhone Pierre
- Unité de Coordination du Programme National d'Alimentation et de Nutrition, Ministère de la Santé Publique et de la Population, 1, Angle Avenue Maïs Gaté et, Rue Jacques Roumain, Port-au-Prince, Haiti
| | - Jacques Boncy
- Laboratoire National de Santé Publique, Ministère de la Santé Publique et de la Population, 1, Angle Avenue Maïs Gaté et, Rue Jacques Roumain, Port-au-Prince, Haiti
| | | | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
| | - Lora L Iannotti
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
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Stith SM, Topham GL, Spencer C, Jones B, Coburn K, Kelly L, Langston Z. Using systemic interventions to reduce intimate partner violence or child maltreatment: A systematic review of publications between 2010 and 2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:231-250. [PMID: 34697816 DOI: 10.1111/jmft.12566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
This systematic review seeks to understand the effectiveness of systemic interventions to reduce Intimate Partner Violence (IPV) or child maltreatment published between January 2010 and December 2019. We found nine studies reviewing systemic interventions for IPV and 12 studies reviewing systemic interventions for child maltreatment. In our discussion, we added relevant articles published before 2010 to determine the overall state of the evidence for these interventions. We determined that parent training programs with in vivo coaching components for child maltreatment meet the criteria for well-established interventions. Relationship education approaches are probably efficacious. Parent education and family therapy programs to reduce child maltreatment, and cognitive behavioral couples treatment to reduce IPV are possibly efficacious interventions. Programs based on "naturalistic" couples therapy for IPV are experimental interventions. This review also highlights limitations in this research in addressing the needs of marginalized couples and families.
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Affiliation(s)
| | | | | | | | | | - Lorin Kelly
- Kansas State University, Manhattan, Kansas, USA
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Chiang CJ, Yang M, Wittenberg B, Jonson-Reid M. Neglect subtypes in relation to rereport and foster care entry outcomes. CHILD ABUSE & NEGLECT 2022; 123:105433. [PMID: 34902639 PMCID: PMC8763032 DOI: 10.1016/j.chiabu.2021.105433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/03/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND There have been mixed findings on whether neglect increases the risk of re-report and foster care entry compared with other child maltreatment types. Studies suggest that child neglect can be broken into subtypes which, in turn, may lead to different child welfare outcomes. OBJECTIVE The purpose of this study was to examine whether the re-report and foster care entry outcomes varied by child maltreatment type, specifically the subtypes of neglect. PARTICIPANTS AND SETTING Data were derived from a regional longitudinal study with linked CPS and state-level administrative data. Participants (n = 4867) included children with reports of physical abuse, sexual abuse, and six neglect subtypes. Cox regression models were used to assess the probability of recurrence and foster care entry outcomes. RESULTS Most neglect subtypes were more likely to be re-reported than physical abuse and sexual abuse, and physical neglect was more likely to be re-reported than lack of supervision (HR = 1.20). Children reported for physical neglect was more likely to be placed in foster care than children with reports of physical abuse and other subtypes of neglect. CONCLUSIONS This study provides new insight on whether families with child neglect allegations are at increased risk of re-report or foster care entry outcomes compared with other child maltreatment allegations. Given the significant individual, system, and societal costs of neglect, we hope this study facilitates rigorous investigation of child neglect and the potentially modifiable factors or targets for intervening to prevent the re-report of child maltreatment and foster care entry.
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Affiliation(s)
- Chien-Jen Chiang
- School of Social Work, Louisiana State University, United States of America.
| | - Miyoun Yang
- School of Social Work, Louisiana State University, United States of America
| | | | - Melissa Jonson-Reid
- George Warren Brown School of Social Work, Washington University in St. Louis, United States of America
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A Qualitative Study of Mothers' Perspectives on Enrolling and Engaging in an Evidence-Based Nurse Home Visiting Program. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:845-855. [PMID: 34117977 DOI: 10.1007/s11121-021-01260-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 11/27/2022]
Abstract
Prevention programs like Nurse-Family Partnership® (NFP) must enroll and retain clients of the intended population to maximize program impact. NFP is an evidence-based nurse home visitation program shown in randomized trials to improve maternal and child health and life course outcomes for first-time parents experiencing economic adversity, particularly for mothers with limited psychological resources. The purpose of this study was to understand enrollment and engagement experiences of mothers with previous live births referred to NFP in a formative study of the program for this population, but did not enroll or dropped out before program graduation. We used a grounded theory approach and purposively selected three NFP sites with variation in enrollment rates. We conducted telephone interviews with 23 mothers who were either referred to NFP and declined enrollment or former clients who dropped out before graduation. All interviews were conducted in English, recorded, transcribed, and validated. We developed an iterative codebook with multiple coders to analyze our data in NVivo11 and wrote thematic memos to synthesize data across study sites. Mothers described experiencing overlapping risk factors including physical and behavioral health conditions, child welfare involvement, and housing insecurity. Mothers from all sites discussed how they were referred to the NFP program, their experience of the enrollment process, reasons for enrolling or not enrolling, and reasons for dropping out after initial enrollment. Key themes that influenced mothers' decision-making were: perceptions of program value, not needing the program, their living situation or being too busy as a deterrence, and past experiences including a distrust of health care. Reasons for attrition were related to no longer needing the service, being assigned a new nurse, being too tired postpartum, and moving out of the service area. One way to support home visiting nurses in family enrollment and engagement is to build their professional capacity to implement trauma-informed strategies given mothers' life experiences.
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11
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van Berkel SR, Prevoo MJL, Linting M, Pannebakker FD, Alink LRA. Prevalence of child maltreatment in the Netherlands: An update and cross-time comparison. CHILD ABUSE & NEGLECT 2020; 103:104439. [PMID: 32126398 DOI: 10.1016/j.chiabu.2020.104439] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/12/2020] [Accepted: 02/27/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND The third Netherlands' Prevalence study of Maltreatment of children and youth (NPM-2017) continues the tradition of periodically mapping the national prevalence of child maltreatment. OBJECTIVE The NPM-2017 provides an update of the current prevalence rates of child maltreatment and of changes in its prevalence over the last 12 years. In addition, risk factors for child maltreatment and its co-occurrence with domestic violence were investigated. PARTICIPANTS AND SETTING Prevalence data were based on cases reported to 'Safe at Home' organizations (former CPS agencies) and observations of professionals working with children (sentinels). METHODS Sentinels (N = 785) filled out a form for each case of suspected child maltreatment that they observed within their professional sample during a three-month period. RESULTS An overall prevalence estimate of child maltreatment in the Netherlands in 2017 of 26-37 per 1000 children was computed. The most important risk factors for child maltreatment were low parental education (RR=4.95), parental unemployment (RR = 3.64), immigrant status (RR = 3.61), and single parenthood (RR = 2.29). Neither prevalence rates nor risk factors changed significantly between 2005, 2010, and 2017. Finally, in 46 % of the reported families child maltreatment occurred in a context of domestic violence. CONCLUSIONS The prevalence of co-occurring domestic violence may indicate that family violence observed within one dyad could be a marker for dysfunctional functioning of the family system. Child maltreatment remains a considerable problem in the Netherlands with a stable prevalence over the last 12 years and stability in characteristics that make families vulnerable for child maltreatment.
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Affiliation(s)
- Sheila R van Berkel
- Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands.
| | - Mariëlle J L Prevoo
- Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands; Research Support and Development, University Library, Maastricht University, the Netherlands
| | - Mariëlle Linting
- Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands
| | | | - Lenneke R A Alink
- Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands
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12
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Chiang CJ, Jonson-Reid M, Kim H, Drake B, Pons L, Kohl P, Constantino J, Auslander W. Service Engagement and Retention: Lessons from the Early Childhood Connections Program. CHILDREN AND YOUTH SERVICES REVIEW 2018; 88:114-127. [PMID: 30505049 PMCID: PMC6258043 DOI: 10.1016/j.childyouth.2018.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The high attrition rates found in studies of early childhood home visitation create barriers to measuring the effectiveness of such programs. Most studies examine attrition at program completion. This practice may mask important differences in characteristics between families that end participation at various time points. This study helps address this gap by examining factors associated with percent attrition for early drop out (before three months) compared to the program midpoint (nine months or more) and program completion (18 months) using data from the treatment arm of a small feasibility study of enhanced referral to home visitation among child welfare-involved families (n = 64). Caregivers who identified as White tended to leave by the program midpoint and caregivers who had better social support were more likely to stay at the end of the program. This study is the only published study to date of participation in a community-based home visitation program by child welfare-involved families but several trends identified were consistent with prior studies with other populations. Given the very small sample size, both statistically significant and near significant trends are discussed in the context of existing literature. The practical variation found has implications for continuing to build knowledge of attrition in early childhood home visitation.
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