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Neelakantan L, Fry D, Florian L, Silion D, Filip M, Thabeng M, Te K, Sunglao JA, Lu M, Ward CL, Baban A, Jocson RM, Peña Alampay L, Meinck F. "We don't know how to talk": Adolescent meaning making and experiences of participating in research on violence in Romania, South Africa, and the Philippines. CHILD ABUSE & NEGLECT 2024:106931. [PMID: 38972820 DOI: 10.1016/j.chiabu.2024.106931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 06/02/2024] [Accepted: 06/28/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Current evidence on adolescent participation in violence research has primarily measured distress, harm or upset using quantitative methods. There are relatively few studies which have employed qualitative methods to understand adolescent emotional experiences, and to articulate the experiences of participation from their own perspective. OBJECTIVE This study aimed to assess adolescents' experiences of participating in research on violence in different contexts, namely Romania, South Africa, and the Philippines. METHODS A purposive sample of adolescents (N = 53, 51 % female) were recruited from rural, urban, and peri-urban areas in Romania, the Eastern Cape Province of South Africa, and Metro Manila, Philippines. Semi-structured one-on-one in-depth interviews and drawings sought adolescent perspectives on their experiences of participation, including the emotions they felt, and their perceptions of research on violence. RESULTS Drawing on analysis of interviews and drawings, adolescents reported a layered emotional experience, ranging from sadness, anger, apprehension, and upset, to joy, relief, and laughter. Their emotional experiences were driven by participation as a relational encounter, both with the researchers involved, as well as with other children and young people they encountered. Adolescents emphasized participation as enabling disclosure of difficult experiences, and the creation of awareness of violence. CONCLUSIONS Adolescent perspectives of participation in research on violence are nuanced and encompass their lived experience as well as the fundamentally relational nature of participation. Adolescents experienced increased awareness of topics in violence and perceived research participation as enabling disclosure and possible help-seeking. Measures of participation impact developed along with adolescents, which reflect this complexity, are needed.
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Affiliation(s)
- Lakshmi Neelakantan
- Population Mental Health Unit, Centre for Mental Health and Community Wellbeing, School of Population and Global Health, University of Melbourne, Australia.
| | - Deborah Fry
- Childlight - Global Child Safety Institute, Moray House School of Education and Sport, University of Edinburgh, UK.
| | - Lani Florian
- Moray House School of Education and Sport, University of Edinburgh, UK.
| | - Doriana Silion
- Department of Psychology, Babes-Bolyai University, Romania
| | - Madalina Filip
- Department of Psychology, Babes-Bolyai University, Romania
| | | | - Kathlyn Te
- Department of Psychology, Ateneo de Manila University, Philippines
| | | | - Mengyao Lu
- Childlight - Global Child Safety Institute, Moray House School of Education and Sport, University of Edinburgh, UK.
| | - Catherine L Ward
- Department of Psychology & Safety and Violence Initiative, University of Cape Town, South Africa.
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Romania
| | - Rosanne M Jocson
- National Institute of Education, Nanyang Technological University, Singapore.
| | | | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, UK; OPTENTIA, Faculty of Health Sciences, North-West University, Vanderbijlpark, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
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Franchino-Olsen H, Woollett N, Thurston C, Maluleke P, Christofides N, Meinck F. "They should ask me so that they can help me": Patterns of young children's expressed feelings and beliefs when interviewed about violence and difficult experiences. CHILD ABUSE & NEGLECT 2024:106932. [PMID: 38972819 DOI: 10.1016/j.chiabu.2024.106932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/09/2024] [Accepted: 06/28/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Children's participation in research is a rights-based principle. However, young children are often excluded from research on sensitive topics, due to gatekeepers concerns that participation would cause distress/re-traumatization and conflict with the principle of providing adequate protection from harm. OBJECTIVE To provide evidence around young children's feelings, including potential distress, and beliefs in mixed-method interviews about violence and difficult experiences. PARTICIPANTS AND SETTING Data were collected from South African interviewer focus group discussions and young child (age 6-10) interviews, along with observations and fieldnotes from young child (age 6-17) interviews. METHODS We collected and analyzed qualitative data focused on children's displayed and reported emotions and beliefs in violence-focused interviews. RESULTS Findings showed the quantitative interview was frequently a positive experience for young children, and children who became upset or emotional stated their feelings were due to violence they experienced. The interviewer seemed to represent a safe person to whom the child could disclose. The play- and arts-based methods of the interview were useful in building this safety and providing space for children to regulate difficult emotions. CONCLUSIONS In a carefully managed interview environment using developmentally appropriate methods, young children are enthusiastic participants and do not appear to experience undue distress or trauma when asked about violence and other sensitive topics. Findings demonstrate that young children can be safely included in research about violence and issues that impact them and can exercise their right to participation when research methods, environments, and safeguards are appropriately adapted to their needs.
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Affiliation(s)
- Hannabeth Franchino-Olsen
- School of Social and Political Sciences, University of Edinburgh, United Kingdom; College of Public Health, The Ohio State University, United States.
| | - Nataly Woollett
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; Department of Visual Arts, University of Johannesburg, South Africa
| | - Christina Thurston
- School of Social and Political Sciences, University of Edinburgh, United Kingdom
| | - Pamela Maluleke
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Franziska Meinck
- School of Social and Political Sciences, University of Edinburgh, United Kingdom; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; School of Health Sciences, North-West University, Vanderbijlpark, South Africa
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Turner E, Kelly SA, Eldred E, Bouzanis K, Gatuguta A, Balliet M, Lees S, Devries K. What do we know about how children and adolescents conceptualise violence? A systematic review and meta-synthesis of qualitative studies from sub-Saharan Africa. PLoS One 2024; 19:e0304240. [PMID: 38968312 PMCID: PMC11226035 DOI: 10.1371/journal.pone.0304240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 05/07/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Half of the world's children experience violence every year, but the meaning of violence is not universally agreed. We may therefore risk failing to measure, and address, the acts that matter most to children and adolescents. In this paper, we describe and synthesise evidence on how children and adolescents in sub-Saharan Africa conceptualise different behavioural acts which are deemed violence in childhood under WHO and UN CRC definitions. METHODS AND FINDINGS We conducted a systematic review of qualitative studies. We searched PsychINFO, CINAHL, Embase, Global Health, Medline and ERIC for all publications released prior to March 2023. 30 papers met inclusion criteria. We synthesised primary data from children and adolescents and drew upon theoretical and contextual interpretations of authors of included studies. Only 12 of more than 45 sub-Saharan African countries were represented with relevant research. Of the 30 included papers, 25 came from three countries: South Africa, Uganda and Ghana. Only 10 of 30 papers reported data from young children (pre-adolescence), and 18 of 30 papers primarily focused on sexual violence. 14 studies used child friendly and/or participatory methods. From this limited evidence, we identified six overarching themes in how children and adolescents conceptualised their experiences of acts internationally recognised as violence: 1) adults abusing or neglecting responsibility; 2) sexual violence from peers, family and community members; 3) violence in established intimate relationships; 4) emotional violence surrounding sex from peers and community members; 5) fighting and beating between peers; 6) street and community dangers. No studies meeting our inclusion criteria specifically examined children or adolescents' conceptualisations of homophobic or transphobic violence; violence against children with disabilities; boys' experiences of sexual violence from male perpetrators; trafficking, modern slavery or conflict; child labour; or female genital mutilation. We found that three dimensions were important in how children and adolescents constructed conceptualisations of violence: their age, relationship to the perpetrator, and the physical location of acts they had experienced. These dimensions were interrelated and gendered. CONCLUSION The current limited evidence base suggests children and adolescents' conceptualisations of violence overlapped with, but were also distinct from, the WHO and UNCRC definitions of violence. Currently international survey tools focus on measuring types and frequencies of particular acts and neglect to focus on children's understandings of those acts. Relationship to perpetrator, age of child, physical location are all important in how children conceptualise their experiences of acts internationally recognised as violence, and therefore might be important for their health and social outcomes. Those developing measures should account for these dimensions when developing items for testing.
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Affiliation(s)
- Ellen Turner
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
- National Institute of Teaching, Silverstone, United Kingdom
| | - Susan A. Kelly
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute of Medical Research, Mwanza, Tanzania
| | - Emily Eldred
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Katrina Bouzanis
- International Federation on Ageing, Toronto, Canada
- Global Health Office, McMaster University, Hamilton, Canada
| | - Anne Gatuguta
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Manuela Balliet
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shelley Lees
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Karen Devries
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Klapwijk J, Melendez-Torres GJ, Ornellas A, Wambura M, Chetty AN, Baerecke L, Wamoyi J, Cluver LD. A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: statistical analysis plan for a pragmatic cluster randomised controlled trial. Trials 2024; 25:446. [PMID: 38961513 PMCID: PMC11223375 DOI: 10.1186/s13063-024-08292-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/24/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Globally, violence against children poses substantial health and economic challenges, with estimated costs nearing USD 7 trillion. This prompts the urgent call for effective evidence-based interventions in preventing and mitigating violence against children. ParentApp is a mobile, open-source application designed to offer a remote version of the Parenting for Lifelong Health (PLH) programme. ParentApp is the first digital parenting intervention for caregivers of adolescents aged 10-17 years to be tested in low- and middle-income settings. METHODS This study is a pragmatic, two-arm, cluster-randomised trial in Mwanza, Tanzania's urban and peri-urban areas. Assessments are set for baseline, 1 month post-intervention, and 12 months post-intervention. We randomised 80 clusters, each with about 30 caregiver-adolescent dyads, with a 1:1 ratio stratified by urban or peri-urban location. Both arms receive an entry-level smartphone preloaded with Kiswahili apps-ParentApp for intervention and WashApp control. The primary method of analysis will be generalised linear mixed-effects models with adjustment for person-level characteristics and multiple imputation. In three-level models, measurement waves are nested within a person, nested within a sub-ward. Regressions will constrain groups to be equal at baseline and include covariates for stratification, percentage of male caregivers, and individual-level characteristics. DISCUSSIONS Preparations for the trial began in December 2022, including community mobilisation and sensitisation. Rolling recruitment, baseline data collection, and implementation onboarding took place between April and September 2023. One-month post-test data collection began in August 2023 and thus far achieved 97% and 94% retention rates for caregivers and adolescents respectively. Final post-test data collection will begin in September 2024, anticipated to run until April 2025. This SAP was submitted to the journal before the interim analysis to preserve scientific integrity under a superiority hypothesis testing framework. TRIAL REGISTRATION The trial was registered on the Open Science Framework on 14 March 2023: https://doi.org/10.17605/OSF.IO/T9FXZ . The trial protocol was published in Trials 25, 119 (2024): Baerecke, L., Ornellas, A., Wamoyi, J. et al. A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: study protocol for a pragmatic cluster-randomised controlled trial. Trials 25, 119 (2024). https://doi.org/10.1186/s13063-023-07893-x .
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Affiliation(s)
- Jonathan Klapwijk
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
| | | | - Abigail Ornellas
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Mwita Wambura
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Angelique N Chetty
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Lauren Baerecke
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Joyce Wamoyi
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Lucie D Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Luo J, Ma Y, Zhan HW, Jia WH, Zhang JR, Xie SY, Yu SY, Hou SL, Bi X, Wang XQ. Associations between adverse childhood experiences and pain in middle-aged and older adults: findings from the China Health and Retirement Longitudinal Study. BMC Public Health 2024; 24:1760. [PMID: 38956571 PMCID: PMC11218369 DOI: 10.1186/s12889-024-19239-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) have been associated with a range of adverse health outcomes, with pain being potentially one of them. This population-based cross-sectional study aimed to investigate the associations between Adverse Childhood Experiences (ACEs) and pain in Chinese adults and evaluate whether physical activity and demographic and socioeconomic characteristics modify this associations. METHODS Cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS), were utilized in this study. A total of 9923 respondents with information on 12 ACE indicators and 15 self-reported body pains were included. Logistic regression models were used to assess associations of the ACEs and pain. Modification of the associations by physical activity, demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction. RESULTS Among the 9923 individuals included in the primary analyses, 5098 (51.4%) males and the mean (SD) age was 61.18 (10·.44) years. Compared with individuals with 0 ACEs, those who with ≥ 5 ACEs had increased risk of single pains and multiple pain. A dose-response association was found between the number of ACEs and the risk of pain (e.g. neck pain for ≥ 5 ACEs vs. none: OR, 1.107; 95% CI, 0.903-1.356; p < 0.001 for trend). In the associations of each body pain with each ACE indicator, most ACE indicators were associated with an increased risk of pain. In addition, physical activity, sociodemographic and socioeconomic characteristics, such as age, sex, educational level, area of residence, childhood economic hardship, did not demonstrate a significant modify on the associations between ACEs and pain. CONCLUSIONS These findings indicate that cumulative ACE exposure is associated with increased odds of self-reported pain in Chinese adults, regardless of adult physical activity, sociodemographic and socioeconomic characteristics.
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Affiliation(s)
- Jing Luo
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
- Department of Sport Rehabilitation, Xi'an Physical Education University, Xi'an, 710068, China
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Yue Ma
- Department of Sport Rehabilitation, Xi'an Physical Education University, Xi'an, 710068, China
| | - Hao-Wei Zhan
- Department of Sport Rehabilitation, Xi'an Physical Education University, Xi'an, 710068, China
| | - Wang-Hu Jia
- Department of Sport Rehabilitation, Xi'an Physical Education University, Xi'an, 710068, China
| | - Jia-Rui Zhang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, 200438, China
| | - Shi-Yu Xie
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, 200438, China
| | - Si-Yin Yu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, 200438, China
| | - Shuang-Long Hou
- Department of Sport Rehabilitation, Xi'an Physical Education University, Xi'an, 710068, China
| | - Xia Bi
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, 200438, China.
| | - Xue-Qiang Wang
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, 200438, China.
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China.
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Bamalan OA, AlSharit MA, Sabbagh KI, Abuzaid AH, Aljubran HJ, Alzahrani WA, Alosaimi NM, Menezes RG. School violence in Saudi Arabia: A scoping review. MEDICINE, SCIENCE, AND THE LAW 2024; 64:224-235. [PMID: 38082558 DOI: 10.1177/00258024231216550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
School violence comprises a broad spectrum of physical, psychological, and sexual acts that impact children and adolescents physically, psychologically, and academically. The aim of this article is to provide a scoping review of school violence in Saudi Arabia. The adversities of school violence and related forensic, legal, and social aspects from a Saudi Arabian perspective are discussed. The articles were extracted through the Medline, Embase, and Web of Science databases in a comprehensive criteria-based search strategy using relevant MeSH terms to identify papers related to school violence in Saudi Arabia from inception to October 6, 2022, and a total of 14 studies have been extracted and discussed. There were indicates that male students tend to engage in physical violence while females tend to engage in verbal violence. The consequences included having a significant impact on students' mental wellbeing, followed by a decrease in academic performance. Therefore, this study will identify the risk factors and present the preventive methods that can guide local institutions to establish new policies to increase awareness and implement culturally acceptable, community-based programs against school violence in Saudi Arabia.
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Affiliation(s)
- Omar Abdulqader Bamalan
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Abdulmohsen AlSharit
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalil Ibrahim Sabbagh
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah Haleem Abuzaid
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hussain Jawad Aljubran
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Waleed Abdullah Alzahrani
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nader Mohammed Alosaimi
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ritesh G Menezes
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Winqust A, Burduli E, Eddy LL, Landis T, Fraser J, Barbosa Leiker C. Associations between nurse characteristics, institutional characteristics and perceived nurse knowledge and self-efficacy of reporting suspected child abuse and neglect. J Clin Nurs 2024; 33:2662-2673. [PMID: 38366766 DOI: 10.1111/jocn.17026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/30/2023] [Accepted: 01/15/2024] [Indexed: 02/18/2024]
Abstract
AIM To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self-efficacy of reporting child abuse and neglect. DESIGN A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. METHODS A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. RESULTS Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self-efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self-efficacy of reporting child abuse and neglect. CONCLUSION This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. IMPACT This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self-efficacy in reporting suspected child abuse and neglect. REPORTING METHODS The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. PATIENT OR PUBLIC CONTRIBUTION There is no patient or public contribution as the study only looked at nurses.
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Affiliation(s)
- Anna Winqust
- College of Nursing, University of Colorado Anschutz, Aurora, Colorado, USA
| | - Ekaterina Burduli
- College of Nursing, Washington State University, Spokane, Washington, USA
| | - Linda L Eddy
- College of Nursing, Washington State University, Vancouver, Washington, USA
| | - Tullamora Landis
- College of Nursing, Washington State University, Spokane, Washington, USA
| | - Jennifer Fraser
- Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Puno A, Kim J, Bhatia A, Jeong J, Kim R. Violence Against Children, Self-Harm, and Suicidal Behaviors: A Pooled and Country-Specific Analysis of Eight Low- and Middle-Income Countries. J Adolesc Health 2024; 75:60-68. [PMID: 38739049 DOI: 10.1016/j.jadohealth.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 02/14/2024] [Accepted: 02/28/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE This study assessed associations between experiences of physical or sexual violence in childhood and self-harm, suicidal ideation, and suicide attempts among young people in low- and middle-income countries (LMICs) and whether these associations varied by sex and perpetrator identity. METHODS We used nationally representative data from the Violence Against Children and Youth Surveys in eight LMICs (2017-2019). The analytic sample included 33,381 young men and women (ages 13-24 years). Multivariable logistic regressions with country-fixed effects were used to estimate the associations between childhood physical and sexual violence and the three outcomes. Stratified analyses were performed by country, participant's sex, and type of perpetrator (parent/caregiver, other adults, peers, and intimate partner). RESULTS About 40% of the participants reported physical childhood violence, and 10% experienced childhood sexual violence. Childhood violence was associated with increased odds of self-harm (physical violence: adjusted odds ratio [aOR]: 2.2, 95% confidence interval [CI]: 2.0-2.4; sexual violence: aOR: 2.7, 95%, CI: 2.3-3.0), suicidal ideation (physical: aOR: 3.0, 95% CI: 2.7-3.3; sexual: aOR: 4.0, 95%, CI: 3.6-4.5), and suicide attempts (physical: aOR: 3.6, 95% CI: 3.2-4.1; sexual: aOR: 4.9, 95%, CI: 4.3-5.7). Consistent findings were observed in country-specific analyses. The odds of all outcomes were highest among those who experienced childhood physical violence by intimate partners and childhood sexual violence by parents or caregivers. Young women who experienced childhood sexual violence had higher odds for all outcomes than young men. DISCUSSION Violence prevention and mental health programs for young people in LMICs should consider the types of violence experienced, the perpetrator, and the sex of the survivor.
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Affiliation(s)
- Abigail Puno
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; Division of Biological Sciences, University of the Philippines Visayas, Iloilo, Philippines
| | - Jinseo Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Amiya Bhatia
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Joshua Jeong
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
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9
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Kawahara T, Isumi A, Ochi M, Doi SK, Surkan PJ, Fujiwara T. Association between maternal dissatisfaction with oneself at birth and shaking and smothering toward the offspring up to 18 months old. CHILD ABUSE & NEGLECT 2024; 153:106816. [PMID: 38696953 DOI: 10.1016/j.chiabu.2024.106816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND A mother who feels dissatisfaction with herself may resort to abusive behavior such as shaking or smothering toward their offspring. Understanding this association can inform effective prevention strategies. OBJECTIVE This study aimed to investigate the associations between maternal feelings of dissatisfaction with oneself and infant physical abuse. PARTICIPANTS AND SETTING The study included 434 mothers who had recently given birth in two obstetric wards in a relatively wealthy area in Tokyo, Japan. METHODS Adopting a longitudinal design, the study used questionnaires post-childbirth to measure mothers' dissatisfaction with themselves. This involved evaluating perceptions of failing to meet personal standards or self-image. Physical abuse (specifically shaking or smothering) in infants was tracked at 3, 6, 12, and 18 months. Data analysis comprised multilevel analysis, group-based trajectory modeling, and multivariable logistic regression to explore the association between maternal dissatisfaction and child physical abuse. RESULTS Multilevel analysis showed that mothers with middle or high dissatisfaction with themselves were more likely to abuse their infant compared to mothers with low dissatisfaction with themselves (adjusted odds ratios [aOR] 5.71, 95 % confidence interval [CI], 1.06-30.78 and aOR 12.47, 95 % CI: 2.11-73.69, respectively). Trajectory analyses indicated that mothers with middle or high dissatisfaction with themselves were consistently more likely to abuse their infants up to 18 months (aOR 8.08, 95 % CI 1.61-40.53 and aOR 6.42, 95 % CI 1.27-32.43, respectively). CONCLUSIONS Our findings highlight a robust association between mother's dissatisfaction with themselves and a higher risk of infant physical abuse. These insights call for a comprehensive review of preventive measures for childhood physical abuse.
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Affiliation(s)
- Tomoki Kawahara
- Department of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Aya Isumi
- Department of Health Policy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manami Ochi
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Satomi Kato Doi
- Department of Health Policy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Pamela J Surkan
- Department of Public Health, Tokyo Medical and Dental University, Tokyo, Japan; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Takeo Fujiwara
- Department of Public Health, Tokyo Medical and Dental University, Tokyo, Japan; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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10
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Al Azri Z, Al Hashmi I, Al Zaabi O. Development and validation of the intention to report child abuse tool: A psychometric research study. J Pediatr Nurs 2024; 77:e90-e96. [PMID: 38555196 DOI: 10.1016/j.pedn.2024.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/23/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND There is a lack of comprehensive and concisely validated tools to measure schoolteachers' intention to report child abuse and neglect in an Arabic context. This study aims to develop and evaluate the validity and reliability of the Intention to Report Child Abuse Tool (IRCAT) to measure schoolteachers' intentions to report child abuse and neglect. METHODS The framework proposed by Benson and Clark (1982) was used to guide scale development. The theory of planned behavior (TPB) and literature review guided the construction of the IRCAT items. Total of 653 Arab female schoolteachers from 200 cycle 1 education schools in Oman were recruited in the study using convenience sampling technique. The validity of the tool was determined by assessing its face validity, content validity, and construct validity. Psychometric properties were tested using exploratory factor analysis (EFA). Inter-item correlations and internal consistency were used to determine the reliability of the tool. RESULTS The newly developed IRCAT demonstrated excellent face and content validity. Using EFA, four factors (i.e., attitudes, perceived behavioral control, subjective norms, and intention to report) were determined for construct validity (KMO = 0.92). The tool also showed good overall internal consistency (Cronbach's alpha = 0.82) and acceptable inter-item correlations (varied between 0.003 and 0.62, with about 20% of the correlation coefficients below 0.1). CONCLUSION This study suggests that the IRCAT is a valid and reliable tool to assess schoolteachers' intention to report child abuse and neglect in an Arabic context. IMPLICATIONS TO PRACTICE IRCAT tool can be utilized by researchers and practitioners interested in investigating the phenomenon of child abuse.
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Affiliation(s)
- Z Al Azri
- College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | - I Al Hashmi
- Maternal and Child Health Department, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | - O Al Zaabi
- College of Nursing, Sultan Qaboos University, Muscat, Oman.
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11
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Wang W, Zhang H. A Scoping Review of Parenting Programs for Preventing Violence Against Children in Low- and Middle-Income Countries. TRAUMA, VIOLENCE & ABUSE 2024; 25:2173-2188. [PMID: 37947081 DOI: 10.1177/15248380231207887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Violence against children affects their well-being globally, with a greater burden in low-and middle-income countries (LMICs). This scoping review aimed to summarize the available evidence on parenting programs for reducing violence against children in LMICs and identify knowledge gaps in this area. Six English databases and gray literature were systematically searched to identify studies in LMICs that examined the efficacy of parenting programs to prevent violence against children, before April 15, 2023. A total of 4,183 independent studies were identified, of which 31 met the inclusion criteria. The majority were conducted in Africa and Asia, delivered by trained local community/childcare workers and lay workers, and targeted younger children aged <10 years. Although the core modules varied in terms of number of group sessions and age of the children, the majority emphasized the importance of building a positive relationship with children and nonviolent discipline strategies. The vast majority demonstrated intervention efficacy in reducing general maltreatment and physical and emotional abuse, and improving positive parenting. Ineffective programs for violence tended to be characterized by self-designed programs, small sample sizes, and low corporal punishment levels in the baseline assessment. In conclusion, parenting programs are promising for preventing and reducing the risk factors for violence in LMICs. Future intervention studies should expand to low-income countries outside Eastern Africa with more trials targeting older children, utilizing direct observational assessments, designing core modules relevant to child neglect, involving more male caregivers, and conducting long-term follow-up assessments.
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12
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Satinsky EN, Kakuhikire B, Baguma C, Cooper-Vince CE, Rasmussen JD, Ashaba S, Perkins JM, Ahereza P, Ayebare P, Kim AW, Puffer ES, Tsai AC. Caregiver preferences for physically harsh discipline of children in rural Uganda. JOURNAL OF FAMILY VIOLENCE 2024; 39:861-874. [PMID: 38962696 PMCID: PMC11218336 DOI: 10.1007/s10896-023-00536-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 07/05/2024]
Abstract
Purpose Physically harsh discipline is associated with poor developmental outcomes among children. These practices are more prevalent in areas experiencing poverty and resource scarcity, including in low- and middle-income countries. Designed to limit social desirability bias, this cross-sectional study in rural Uganda estimated caregiver preferences for physically harsh discipline; differences by caregiver sex, child sex, and setting; and associations with indicators of household economic stress and insecurity. Method Three-hundred-fifty adult caregivers were shown six hypothetical pictographic scenarios depicting children whining, spilling a drink, and kicking a caregiver. Girls and boys were depicted engaging in each of the three behaviors. Approximately half of the participants were shown scenes from a market setting and half were shown scenes from a household setting. For each scenario, caregivers reported the discipline strategy they would use (time out, beating, discussing, yelling, ignoring, slapping). Results Two thirds of the participants selected a physically harsh discipline strategy (beating, slapping) at least once. Women selected more physically harsh discipline strategies than men (b = 0.40; 95% confidence interval [CI], 0.26 to 0.54). Participants shown scenes from the market selected fewer physically harsh discipline strategies than participants shown scenes from the household (b = -0.51; 95% CI, -0.69 to -0.33). Finally, caregivers selected more physically harsh discipline strategies in response to boys than girls. Indicators of economic insecurity were inconsistently associated with preferences for physically harsh discipline. Conclusions The high prevalence of physically harsh discipline preferences warrant interventions aimed at reframing caregivers' approaches to discipline.
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Affiliation(s)
- Emily N. Satinsky
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | | | - Charles Baguma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | | | | | - Phionah Ahereza
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Andrew W. Kim
- Department of Anthropology, University of California, Berkeley, CA, USA
| | - Eve S. Puffer
- Department of Psychology, Duke University, Durham, NC, USA
| | - Alexander C. Tsai
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
- Harvard Medical School, Boston, MA, USA
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13
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Samms-Vaughan M, Coore-Desai C, Reece JA, Pellington S. Epidemiology of violence against young children in Jamaica. PSYCHOL HEALTH MED 2024; 29:1155-1164. [PMID: 38776979 DOI: 10.1080/13548506.2024.2342585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/04/2024] [Indexed: 05/25/2024]
Abstract
Violence against young children is known to have detrimental short and long-term effects. Yet, few studies investigate the prevalence of violence against young children, particularly very young children under the age of 2 years. This paper reports on the prevalence of violence against young children in Jamaica using data obtained from the JA KIDS birth cohort study that undertook pre-enrolment of pregnant mothers in the antenatal period and followed full or sub-samples of parents and children at 9-12 months, 18-22 months and 4-5 years. Violence in pregnancy was experienced by 6.1% of pre-enrolled mothers. As many as 43.1% of Jamaican children ages 9-12 months were shouted at, and almost 30% were slapped. Physical and emotional violence increased with age, and by 4-5 years, approximately 90% of children experienced physical and emotional violence. Non-violent methods, primarily explaining and reasoning with children, were also reported by more than 95% of parents at 4-5 years. Corporal punishment was the most common form of violence experienced, but young children also witnessed hurtful physical and emotional violence between mothers and their partners and lived in communities in which there were violent events. Strategies to reduce young children's experiences as victims and witnesses of violence are discussed.
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Affiliation(s)
- Maureen Samms-Vaughan
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Charlene Coore-Desai
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Jody-Ann Reece
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Sydonnie Pellington
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
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Abrahams N, Mhlongo S, Chirwa E, Dekel B, Ketelo A, Lombard C, Shai N, Ramsoomar L, Mathews S, Labuschagne G, Matzopoulos R, Prinsloo M, Martin LJ, Jewkes R. Child abuse and neglect-related murders in South Africa: a comparison of two national surveys in 2009 and 2017. THE LANCET. CHILD & ADOLESCENT HEALTH 2024:S2352-4642(24)00110-X. [PMID: 38944051 DOI: 10.1016/s2352-4642(24)00110-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Population-based statistics on deaths from child abuse and neglect are only routinely available in countries that have reliable national statistics on child murder. For low-income and middle-income countries, relatively little is known about prevalence trends of child murder. South Africa is an exception, having conducted dedicated national studies on child murders for 2009 and 2017 to provide data on child murders overall and on child abuse and neglect-related murders. We aimed to compare child abuse and neglect-related murders in South Africa across two surveys to determine any change between 2009 and 2017. METHODS We conducted two retrospective national mortuary-based surveys on murder of children aged 0-17 years for 2009 and 2017 from a proportionate random sample of medico-legal laboratories in South Africa. A sampling frame of medico-legal laboratories for each study year was prepared with stratification by medico-legal laboratory size. A minimum of 2 years after the crime was allowed before data collection to enable progression of the investigation process. Child abuse and neglect-related murders were identified using both medico-legal laboratory post-mortem autopsy reports and police data. To identify a child abuse and neglect-related murder, we primarily used the framework of abuse happening within the context of responsibility of care arrangements but broadened this to include all perpetrators and abuse identified from the data. We stratified age into 0-4, 5-9, 10-14, and 15-17 years and further stratified children younger than 5 years into early neonates (newborns killed within 6 days of birth), 7 days to 11 months, and 1-4 years. We calculated incidence rate ratios (IRR) with 95% CIs to compare rates between 2009 and 2017. FINDINGS An estimated 458 (95% CI 377-539) children in 2009 and 213 (179-247) children in 2017 were murdered in circumstances of child abuse and neglect. The percentage of all child murders that were child abuse and neglect-related declined from 2009 to 2017 (458 [45·0%] of 1018 in 2009 vs 213 [25·0%] of 851 in 2017), with the overall age-standardised rate decreasing from 2·6 to 1·1 per 100 000 children aged 0-17 years (IRR 0·43 [95% CI 0·35-0·54]). Girls represented 276 (60·3%) of 458 murders in 2009, which declined to 96 (45·1%) of 213 murders in 2017, and boys represented 178 (38·9%) of 458 murders in 2009 and 109 (51·4%) of 213 murders in 2017. The decrease was statistically significant for girls in the 0-4 year (IRR 0·33 [0·22-0·49]) and 5-9 year (0·33 [0·15-0·73]) age groups and for boys in the 0-4 year age group (0·49 [0·33-0·71]). Among early neonates (within 6 days of birth), the decrease in child abuse and neglect-related murders was more pronounced among girls than among boys (IRR 0·33 [95% CI 0·19-0·56] vs 0·46 [0·28-0·77]). INTERPRETATION Child abuse and neglect-related murders are common in South Africa but our study shows that they can be reduced. The high rate of these murders points to the need to continue research and monitoring to inform priority targeted interventions and to better understand the impact of child support policies. FUNDING Ford Foundation and South African Medical Research Council.
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Affiliation(s)
- Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa.
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Esnat Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Bianca Dekel
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Asiphe Ketelo
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa; Stellenbosch University, Cape Town, South Africa
| | - Nwabisa Shai
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Leane Ramsoomar
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Shanaaz Mathews
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Gérard Labuschagne
- Department of Forensic Medicine & Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Matzopoulos
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Megan Prinsloo
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health, University of Cape Town, Cape Town, South Africa; University of Greenwich, London, UK
| | - Lorna J Martin
- Division of Forensic Medicine, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa; Wits School of Public Health, Wits University, Johannesburg, South Africa
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Negre P, Alonso RS, González-Briones A, Prieto J, Rodríguez-González S. Literature Review of Deep-Learning-Based Detection of Violence in Video. SENSORS (BASEL, SWITZERLAND) 2024; 24:4016. [PMID: 38931796 PMCID: PMC11207446 DOI: 10.3390/s24124016] [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: 05/17/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Abstract
Physical aggression is a serious and widespread problem in society, affecting people worldwide. It impacts nearly every aspect of life. While some studies explore the root causes of violent behavior, others focus on urban planning in high-crime areas. Real-time violence detection, powered by artificial intelligence, offers a direct and efficient solution, reducing the need for extensive human supervision and saving lives. This paper is a continuation of a systematic mapping study and its objective is to provide a comprehensive and up-to-date review of AI-based video violence detection, specifically in physical assaults. Regarding violence detection, the following have been grouped and categorized from the review of the selected papers: 21 challenges that remain to be solved, 28 datasets that have been created in recent years, 21 keyframe extraction methods, 16 types of algorithm inputs, as well as a wide variety of algorithm combinations and their corresponding accuracy results. Given the lack of recent reviews dealing with the detection of violence in video, this study is considered necessary and relevant.
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Affiliation(s)
- Pablo Negre
- BISITE Research Group, Universidad de Salamanca, Patio de Escuelas, 37008 Salamanca, Spain; (A.G.-B.); (S.R.-G.)
| | - Ricardo S. Alonso
- AIR Institute, Av. Santiago Madrigal, 37008 Salamanca, Spain;
- UNIR (International University of La Rioja), Av. de la Paz, 137, 26006 Logroño, Spain
| | - Alfonso González-Briones
- BISITE Research Group, Universidad de Salamanca, Patio de Escuelas, 37008 Salamanca, Spain; (A.G.-B.); (S.R.-G.)
| | - Javier Prieto
- BISITE Research Group, Universidad de Salamanca, Patio de Escuelas, 37008 Salamanca, Spain; (A.G.-B.); (S.R.-G.)
| | - Sara Rodríguez-González
- BISITE Research Group, Universidad de Salamanca, Patio de Escuelas, 37008 Salamanca, Spain; (A.G.-B.); (S.R.-G.)
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Adriaens K, Verhelle H, Peters GJY, Haerens L, Vertommen T. The Safe Sport Allies bystander training: developing a multi-layered program for youth sport participants and their coaches to prevent harassment and abuse in local sport clubs. Front Psychol 2024; 15:1389280. [PMID: 38966731 PMCID: PMC11223523 DOI: 10.3389/fpsyg.2024.1389280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/04/2024] [Indexed: 07/06/2024] Open
Abstract
Harassment and abuse represent a pervasive and critical problem in sport with far-reaching consequences. Survivors' testimonials underscore the profound and enduring impact of these experiences at individual, interpersonal, organizational and community level. Many of their stories reveal painful inaction from responsible adults in the sport organization, aggravating the harm. Other contributing factors to the harm inflicted include a culture of silence, lack of knowledge and understanding of what constitutes abuse, unawareness of reporting and supporting mechanisms, and fear of potential consequences. While effective bystander interventions have been developed outside the sport context, particularly targeting students in higher education, such initiatives have yet to be extensively adapted and assessed within the sport context. To address this gap, the Safe Sport Allies Erasmus+ collaborative partnership relied on the intervention mapping approach as a guiding framework to systematically develop a bystander training program (i.e., Safe Sport Allies) to train youth sport participants and youth sport coaches to act as effective bystanders. The current paper describes the comprehensive development process and provides an overview of implementation and evaluation possibilities. Throughout the paper, it is explained how each step of the Intervention Mapping approach shaped the Safe Sport Allies bystander training program. The program development, and the developed plans for implementation and evaluation are presented, shedding light on challenges encountered. The bystander training program developed in this paper and the implementation and evaluation plans can serve as an outline to build future interventions within this critical domain of safeguarding in sport.
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Affiliation(s)
- Karolien Adriaens
- Safeguarding Sport and Society, Centre of Expertise Care and Well-being, Thomas More University of Applied Sciences, Antwerp, Belgium
| | - Helena Verhelle
- Safeguarding Sport and Society, Centre of Expertise Care and Well-being, Thomas More University of Applied Sciences, Antwerp, Belgium
| | | | - Leen Haerens
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Tine Vertommen
- Safeguarding Sport and Society, Centre of Expertise Care and Well-being, Thomas More University of Applied Sciences, Antwerp, Belgium
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Social Epidemiology and Health Policy (SEHPO), University of Antwerp, Antwerp, Belgium
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Knight L, Atuhaire L, Bhatia A, Allen E, Namy S, Anton-Erxleben K, Nakuti J, Mirembe A, Nakiboneka M, Seeley J, Weiss HA, Parkes J, Bonell C, Naker D, Devries K. Violence outcomes in later adolescence with the Good School Toolkit-Primary: a nonrandomized controlled trial in Uganda. BMC Public Health 2024; 24:1532. [PMID: 38849782 PMCID: PMC11157797 DOI: 10.1186/s12889-024-19024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/31/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND We sought to determine whether the Good School Toolkit-Primary violence prevention intervention was associated with reduced victimisation and perpetration of peer and intimate partner violence four years later, and if any associations were moderated by sex and early adolescent: family connectedness, socio-economic status, and experience of violence outside of school. METHODS Drawing on schools involved in a randomised controlled trial of the intervention, we used a quasi-experimental design to compare violence outcomes between those who received the intervention during our trial (n = 1388), and those who did not receive the intervention during or after the trial (n = 522). Data were collected in 2014 (mean age 13.4, SD 1.5 years) from participants in 42 schools in Luwero District, Uganda, and 2018/19 from the same participants both in and out of school (mean age 18, SD: 1.77 years). We compared children who received the Good School Toolkit-Primary, a whole school violence prevention intervention, during a randomised controlled trial, to those who did not receive the intervention during or after the trial. Outcomes were measured using items adapted from the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. We used mixed-effect multivariable logistic regression, with school fitted as a random-effect to account for clustering. RESULTS 1910 adolescents aged about 16-19 years old were included in our analysis. We found no evidence of an average long-term intervention effect on our primary outcome, peer violence victimization at follow-up (aOR = 0.81, 95%CI = 0.59-1.11); or for any secondary outcome. However, exposure to the intervention was associated with: later reductions in peer violence, for adolescents with high family connectedness (aOR = 0.70, 95% CI 0.49 to 0.99), but not for those with low family connectedness (aOR = 1.07, 95% CI 0.69 to 1.6; p-interaction = 0.06); and reduced later intimate partner violence perpetration among males with high socio-economic status (aOR = 0.32, 95%CI 0.11 to 0.90), but not low socio-economic status (aOR = 1.01 95%CI 0.37 to 2.76, p-interaction = 0.05). CONCLUSIONS Young adolescents in connected families and with higher socio-economic status may be better equipped to transfer violence prevention skills from primary school to new relationships as they get older. TRIAL REGISTRATION Clinicaltrials.gov, NCT01678846, registration date 24 August 2012. Protocol for this paper: https://www.researchprotocols.org/2020/12/e20940 .
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Affiliation(s)
- Louise Knight
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Lydia Atuhaire
- Medical Research Council/Uganda, Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Plot 51-59 Nakiwogo Road, Entebbe, Uganda
| | - Amiya Bhatia
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Elizabeth Allen
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Sophie Namy
- Raising Voices, Plot 16, Tufnell Drive, Kamwokya, Kampala, Uganda
| | | | - Janet Nakuti
- Raising Voices, Plot 16, Tufnell Drive, Kamwokya, Kampala, Uganda
| | - Angel Mirembe
- Raising Voices, Plot 16, Tufnell Drive, Kamwokya, Kampala, Uganda
| | | | - Janet Seeley
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
- Medical Research Council/Uganda, Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Plot 51-59 Nakiwogo Road, Entebbe, Uganda
| | - Helen A Weiss
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Jenny Parkes
- UCL Institute of Education, 20 Bedford Way, London, WC1H 0AL, UK
| | - Chris Bonell
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Dipak Naker
- Raising Voices, Plot 16, Tufnell Drive, Kamwokya, Kampala, Uganda
| | - Karen Devries
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
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18
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Niu L, Li Y, Bai R, Pagán JA, Zhang D, Diaz A. Global prevalence of violence against children and adolescents during COVID-19: A meta-analysis. CHILD ABUSE & NEGLECT 2024; 154:106873. [PMID: 38850751 DOI: 10.1016/j.chiabu.2024.106873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Recent studies suggest that children and adolescents are at an increased risk of experiencing violence during the COVID-19 pandemic. However, there is limited knowledge about the prevalence of violence against children and adolescents across different regions in the world. OBJECTIVE To estimate the pooled prevalence of violence against children and adolescents during the COVID-19 pandemic and explore how geographical and methodological factors explain the variation across studies. METHODS We conducted a systematic search of MEDLINE, Embase, and PsycInfo databases for articles published from January 1, 2020 to October 1, 2022. The study protocol was pre-registered with PROSPERO (CRD42022338181). We included published and unpublished studies available in English that reported the prevalence of violence (e.g., physical, emotional, or sexual violence, neglect, bullying) against children and adolescents (age <18 years) during the pandemic. Data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A total of 2740 nonduplicate titles and abstracts were screened, and 217 full-text articles were reviewed for eligibility. RESULTS Twenty-five studies with 66,637 participants met inclusion criteria. Based on random-effects meta-analysis, the pooled prevalence of violence against children and adolescents was 24 % (95%CI 18 %-30 %). The reported prevalence was higher in studies conducted in low- and middle-income countries compared to high-income countries. CONCLUSIONS Over one in five children and adolescents globally reported ever experiencing violence during the COVID-19 pandemic. Our findings highlight the urgent need for effective child protection policies and interventions, as well as multisectoral collaboration, to reduce violence against children and adolescents.
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Affiliation(s)
- Li Niu
- Faculty of Psychology, Beijing Normal University, Beijing, China; Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Ruhai Bai
- School of Public Affairs, Nanjing University of Science and Technology, Nanjing, Jiangsu, China
| | - José A Pagán
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, NY, USA
| | - Donglan Zhang
- Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, NY, USA
| | - Angela Diaz
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Tian T, Katz I, Shang X. Unveiling Child Sexual Abuse Disclosure in China: An Ecological Exploration of Survivors' Experiences. CHILDREN (BASEL, SWITZERLAND) 2024; 11:688. [PMID: 38929267 PMCID: PMC11202016 DOI: 10.3390/children11060688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/01/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
Through a thematic analysis of firsthand posts from 258 abuse survivors in online forums from 2016 to 2023, this research examines the barriers that Chinese children encounter when disclosing sexual abuse. The anonymous narratives shed light on the motives behind survivors' reluctance to reveal abuse, the outcomes following disclosure, and the wider implications for survivors and their families under culture. The findings underscore the need for early intervention upon disclosure, aiming to safeguard children from further harm and foster the development of an effective child protection framework.
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Affiliation(s)
- Tian Tian
- School of Counselling, Human Services, and Social Work, Faculty of Education and Social Work, University of Auckland, Auckland 1010, New Zealand;
| | - Ilan Katz
- Social Policy Research Centre, The University of New South Wales, Sydney, NSW 2052, Australia;
| | - Xiaoyuan Shang
- Social Policy Research Centre, The University of New South Wales, Sydney, NSW 2052, Australia;
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Ibrahim H, Goessmann K, Neuner F, Iffland B. Continuous chains: childhood maltreatment and intimate partner violence victimization among displaced women in a war context. BMC Womens Health 2024; 24:319. [PMID: 38824574 PMCID: PMC11143579 DOI: 10.1186/s12905-024-03156-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/24/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Childhood victimization has been associated with long-term psychological effects and an increased risk of being victimized in later life. Previous research has primarily focused on sexual abuse during childhood, and a wide range of consequences have been identified. However, a significant gap remains in our understanding of the complex interaction between different forms of childhood abuse and violence in later life, particularly in the context of broader social stressors such as armed conflict and displacement. METHODS This study examines the association between exposure to different types of childhood maltreatment in the context of family and intimate partner violence (IPV) among displaced women living in refugee camps in northern Iraq. Structured interviews were conducted by trained female psychologists with 332 women aged between 20 and 62 years. RESULTS Results indicated that over one-third of the participating women reported experiencing at least one occurrence of IPV by their husbands within the past year. In addition, participants reported experiences of different types of maltreatment (physical, emotional, and sexual violence and physical and emotional neglect) perpetrated by family members in their childhood. While all forms of childhood maltreatment showed an association with IPV within the past year, only emotional childhood maltreatment was found to be a significant predictor of IPV in a multivariate analysis. CONCLUSION The study highlights the ongoing impact of child maltreatment and its contribution to increased vulnerability to IPV victimization in later life. In addition, this study describes the specific cultural and contextual elements that contribute to IPV in refugee camps.
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Affiliation(s)
- Hawkar Ibrahim
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany.
- vivo international e.V., Konstanz, Germany.
| | - Katharina Goessmann
- Department of Clinical Psychology and Violence Research, Bielefeld University, Bielefeld, Germany
| | - Frank Neuner
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
- vivo international e.V., Konstanz, Germany
| | - Benjamin Iffland
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
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Han Q, Jocson R, Kunovski I, Raleva M, Juhari R, Okop K, Oppler A, Wilson K, Cirovic T, Sacolo Gwebu H, Alampay L, Eagling-Peche S, Calderon F, Vallance I, Muharam F, Chen Y, Lachman J. The bidirectional temporal relationship between parenting stress and child maltreatment: A cross-lagged study based on intervention and cohort data. J Affect Disord 2024; 354:302-308. [PMID: 38479502 DOI: 10.1016/j.jad.2024.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 02/27/2024] [Accepted: 03/09/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Parenting stress has long been proposed as a major risk factor for child maltreatment. However, there is a lack of evidence from existing studies on the temporal sequence to establish a causal relationship. This study aims to examine bidirectional temporal relationships between parenting stress and child maltreatment. METHODS Longitudinal data from two different sources were analysed: a pre-post study of an online parenting programme conducted across six countries - the ePLH Evaluation Study, and a prospective cohort study in the United States - LONGSCAN. Cross-lagged panel model on parenting stress and child maltreatment was used in each dataset. RESULTS Based on repeatedly measured data of 484 caregivers in the ePLH study across five time points (every two weeks), we found that parenting stress at an earlier time point predicted later child maltreatment (IRR = 1.14, 95 % CI: 1.10,1.18). In addition, the occurrence of child maltreatment was associated with higher subsequent short-term parenting stress (IRR = 1.04, 95 % CI: 1.01,1.08) and thus could form a vicious circle. In the LONGSCAN analysis with 772 caregivers who were followed up from child age of 6 to child age of 16, we also found parenting stress at an earlier time point predicted later child maltreatment (β = 0.11, 95 % CI: 0.01,0.20), but did not observe an association between child maltreatment and subsequent long-term parenting stress. LIMITATIONS Potential information bias on the measurements. CONCLUSIONS This study provides evidence for a bidirectional temporal relationship between parenting stress and child maltreatment, which should be considered in parenting intervention programmes.
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Affiliation(s)
| | | | | | - Marija Raleva
- St. Cyril and Methodius University Skopje, North Macedonia
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jamie Lachman
- University of Oxford, UK; University of Cape Town, South Africa.
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22
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Siu G, Nsubuga RN, Lachman JM, Namutebi C, Sekiwunga R, Zalwango F, Riddell J, Wight D. The impact of the parenting for respectability programme on violent parenting and intimate partner relationships in Uganda: A pre-post study. PLoS One 2024; 19:e0299927. [PMID: 38787892 PMCID: PMC11125497 DOI: 10.1371/journal.pone.0299927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/23/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND There is a growing need for interventions that reduce both violence against children and intimate partner violence in low- and middle-income countries. However, few parenting interventions deliberately address this link. We tested the feasibility of a 16-session group-based parenting programme, Parenting for Respectability, in semi-rural Ugandan communities. METHODS This was a pre-post study with parents and their children (N = 484 parents; 212 children). RESULTS Pre-post comparisons found large effects for parent-reported reduced harsh parenting (Cohen's f2 = 0.41 overall; f2 = 0.47 (among session attendees); with an overall reduction of 26% for harsh parenting. Session attendees reported higher reductions than non-attendees (p = 0.014), and male caregivers reported higher reductions than female caregivers (p<0.001). Children also reported reduced harsh parenting by attending fathers (f2 = 0.64 overall; f2 = 0.60) and attending mothers (f2 = 0.56 overall; f2 = 0.51); with reduction in harsh parenting ranging between 27% to 29% in the various categories. Overall, spousal violence reduced by 27% (f2 = 0.19 overall; f2 = 0.26 (among session attendees). Both parents and children reported reduced dysfunctional parent relationships; parents: f2 = 0.19 overall; f2 = 0.26 (among session attendees); and children: f2 = 0.35 overall; f2 = 0.32 (for attending parents); with reductions ranging between 22% to 28%. Parents who attended more than 50% of the program reported greater effects on reduced dysfunctional relationships than those who attended less than half of the program (B = -0.74, p = 0.013). All secondary outcomes were improved with f2 ranging between 0.08 and 0.39; and improvements ranging between 6% and 28%. CONCLUSION Results suggest the importance of more rigorous testing to determine program effectiveness.
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Affiliation(s)
- Godfrey Siu
- Child Health and Development Centre, School of Medicine Makerere University College of Health Sciences, Kampala, Uganda
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Global Health, LSHTM, London, United Kingdom
| | | | - Jamie M. Lachman
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- University of Cape Town, Cape Town, South Africa
| | - Carol Namutebi
- Child Health and Development Centre, School of Medicine Makerere University College of Health Sciences, Kampala, Uganda
| | - Richard Sekiwunga
- Child Health and Development Centre, School of Medicine Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Daniel Wight
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
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Hutchings J, Ferdinandi I, Janowski R, Ward CL, McCoy A, Lachman J, Gardner F, Williams ME. Parenting for Lifelong Health for Young Children in Montenegro: Preliminary Outcomes, Dissemination, and Broader Embedding of the Program. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024:10.1007/s11121-024-01682-x. [PMID: 38758458 DOI: 10.1007/s11121-024-01682-x] [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: 05/05/2024] [Indexed: 05/18/2024]
Abstract
The quality of parenting program implementation significantly affects the extent to which a program is delivered effectively as well as the likelihood of it becoming embedded in everyday services. The group based Parenting for Lifelong Health for Young Children (PLH-YC) program for parents of children aged 2-9 years was developed specifically for implementation in low- and middle-income contexts, has been tested in five randomized trials, and incorporates a number of strategies to encourage fidelity of delivery. This paper reports on the introduction of PLH-YC to Montenegro, including initial work to engage government agencies and service providers, adapt the program and, following initial evidence of effectiveness, implement strategies to promote effective delivery and embed the program. Following program adaptation and initial facilitator training, eight groups were run, supported with resources and supervision and independently evaluated. The successful pilot led to program training accreditation by national professional agencies and a series of steps to successfully further embed it into routine settings in Montenegro, including by recognizing the program in national policy documents. This led to further facilitator trainings, now numbering 97 facilitators and the certification of ten coaches and two trainers. By the end of 2023, 1278 parents, across 13 municipalities (half of all municipalities in Montenegro) and a range of service providers, have received the program. The paper describes the project phases and key fidelity components that underpinned the successful introduction and embedding of the program in Montenegro. The plan has resulted in Montenegro having its own domestic resources to continue to implement the program effectively and further plan for widespread dissemination.
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Affiliation(s)
- Judy Hutchings
- Centre for Evidence-Based Early Intervention, Bangor University, Bangor, UK.
| | - Ida Ferdinandi
- UNICEF Country Office in Montenegro, Podgorica, Montenegro
| | - Roselinde Janowski
- Department of Psychology, and Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Catherine L Ward
- Department of Psychology, and Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa
| | | | - Jamie Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
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Håkstad K, Fegran L, Hovden E, Köpp UMS. Orofacial signs of child or adolescent maltreatment identified by dentists and dental hygienists: A scoping review. Int J Paediatr Dent 2024; 34:285-301. [PMID: 38050876 DOI: 10.1111/ipd.13139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/02/2023] [Accepted: 11/02/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Child maltreatment, the abuse or neglect of children aged 0-18 years, is a severe and underreported global problem. Compared with other body parts, the orofacial region displays more signs of child maltreatment. Dentists and dental hygienists are therefore well situated to identify orofacial signs of child maltreatment. AIM To map the current literature on orofacial signs of child maltreatment identified by dentists or dental hygienists. DESIGN A scoping review was conducted based on systematic searches of Medline (Ovid), Embase (Ovid), and CINAHL (EBSCOhost) for primary qualitative and quantitative studies through June 6, 2022. RESULTS Twenty-nine studies were included in this scoping review. Though all child maltreatment types were identified in dental settings, physical abuse and dental neglect were most commonly identified. Reports of caries dominated the orofacial signs, followed by bruises (intra- and extraoral), poor oral hygiene, dental trauma, and lacerations (intra- and extraoral). Case reports were used most commonly to describe orofacial signs of child maltreatment. CONCLUSION Dental clinicians identify orofacial signs of all child maltreatment types intraorally. Dentists identify the same extraoral signs as do other healthcare professionals, with bruising being the most common.
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Affiliation(s)
- Katrine Håkstad
- Department of Health- and Sport Science, University of Agder, Kristiansand, Norway
- Agder County Municipality, Public Dental Service, Kristiansand, Norway
| | - Liv Fegran
- Department of Health- and Sport Science, University of Agder, Kristiansand, Norway
- Department of Peadiatrics, Sørlandet Hospital HF, Kristiansand, Norway
| | - Ewa Hovden
- The Oral Health Centre of Expertise in East of (TkØ), Kristiansand, Norway
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McCoy DC, Dormal M, Cuartas J, Carreira Dos Santos A, Fink G, Brentani A. The acute effects of community violence on young children's regulatory, behavioral, and developmental outcomes in a low-income urban sample in Brazil. J Child Psychol Psychiatry 2024; 65:620-630. [PMID: 37011945 DOI: 10.1111/jcpp.13799] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Existing research on the impacts of adversity on young children's psychological well-being has largely focused on household-level risk factors using observational methods in high-income countries. This study leverages natural variation in the timing and location of community homicides to estimate their acute effects on the regulatory, behavioral, and developmental outcomes of Brazilian 3-year-olds. METHODS We compared the outcomes of children who were assessed soon after a recent neighborhood homicide to those of children from the same residential neighborhoods who had not recently experienced community violence. Our sample included 3,241 3-year-olds (Mage = 41.05 months; 53% female; 45% caregiver education less than middle school; 26% receiving a public assistance program) from seven neighborhoods in São Paulo, Brazil. Child outcome measures included parent reports of effortful control and behavior problems as well as direct assessments of children's developmental (cognitive, language, and motor) skills. Community homicides were measured using police records. RESULTS Recent exposure to community homicides was associated with lower effortful control, higher behavior problems, and lower overall developmental performance for children (d = .05-.20 standard deviations; p = ns - <.001). Effects were consistent across subgroups based on sociodemographic characteristics and environmental supports, but generally largest when community violence exposure was geographically proximal (within 600 m of home) and recent (within 2 weeks prior to assessment). CONCLUSIONS Results highlight the pervasive effects that community violence can have on young children as well as the need to expand support to mitigate these effects and prevent inequities early in life.
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Affiliation(s)
- Dana C McCoy
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Marta Dormal
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Jorge Cuartas
- Harvard Graduate School of Education, Cambridge, MA, USA
- Centro de Estudios sobre Seguridad y Drogas (CESED), Universidad de los Andes, Bogota, Colombia
| | | | - Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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26
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Shinyemba TW, Shiode S, Devries K. Application of geospatial analysis in health research: A systematic review of methodological aspects of studies on violence against children and young people. CHILD ABUSE & NEGLECT 2024; 151:106730. [PMID: 38461708 DOI: 10.1016/j.chiabu.2024.106730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/20/2024] [Accepted: 03/02/2024] [Indexed: 03/12/2024]
Abstract
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.
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Affiliation(s)
- Tobias Willem Shinyemba
- Department of Geography, Birkbeck, University of London, London, UK; Department of Computing, Mathematical and Statistical Sciences, University of Namibia, Windhoek, Namibia.
| | - Shino Shiode
- Department of Geography, Birkbeck, University of London, London, UK
| | - Karen Devries
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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27
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Abrahamyan A, Soares S, Fraga S, Barros H. Prevalence of Parental Violent Discipline Toward Children: Findings From A Portuguese Population. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1881-1904. [PMID: 38348947 PMCID: PMC10993632 DOI: 10.1177/08862605241230552] [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] [Indexed: 04/04/2024]
Abstract
Despite recognizing the detrimental impact of parental violence on children's mental and physical health throughout their lives, violence remains an all-too-real part of life for many children around the globe. However, data on the child-reported prevalence of experienced family violence are scarce and primarily based on parental reports. This study aimed to broaden the body of evidence and measure the lifetime prevalence of child-reported experience of violent disciplinary practices perpetrated by parents and to identify its associated sociodemographic and economic factors. We conducted a cross-sectional study using data from 5,281 Generation XXI participants recruited from 2005 to 2006 in Porto, Portugal. Parental disciplinary practices were reported by 7-year-old children using the Parent-Child Conflict Tactics Scale. Pearson's Chi-squared test was used to compare differences in child-reported frequencies of violent disciplinary practices by sociodemographic variables. We observed statistically significant differences in rates of violent disciplinary practices according to the child's and parent's gender. Specifically, fathers exhibited a higher likelihood than mothers to engage in psychological aggression and corporal punishment, while mothers were more prone to engage in severe and very severe physical assault. When fathers were the perpetrators, boys were more inclined than girls to report all forms of violent disciplinary measures, and when mothers were the perpetrators, boys were particularly susceptible to severe and very severe physical assault compared to girls. In our study, children reported being frequently subjected to violent parental disciplinary practices, independently of family socioeconomic background. Children were more likely to experience psychological aggression and corporal punishment if they were born into high-income families, while severe and very severe physical assaults were more common among children whose parents had lower educational levels. National public awareness of the negative effects of violent disciplinary practices is urgently needed, promoting child-friendly and nonviolent approaches to discipline.
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Affiliation(s)
- Armine Abrahamyan
- EPIUnit—Instituto de Saúde Pública da Universidade do Porto, Portugal
- ITR-Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
| | - Sara Soares
- EPIUnit—Instituto de Saúde Pública da Universidade do Porto, Portugal
- ITR-Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
| | - Sílvia Fraga
- EPIUnit—Instituto de Saúde Pública da Universidade do Porto, Portugal
- ITR-Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
| | - Henrique Barros
- EPIUnit—Instituto de Saúde Pública da Universidade do Porto, Portugal
- ITR-Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
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Eimer C, Buschmann C, Deeken J, Kerner T. Mechanical trauma in children and adolescents in Berlin. Forensic Sci Med Pathol 2024:10.1007/s12024-024-00814-7. [PMID: 38625460 DOI: 10.1007/s12024-024-00814-7] [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: 04/08/2024] [Indexed: 04/17/2024]
Abstract
Management of severe pediatric trauma remains challenging. Injury patterns vary according to patient age and trauma mechanism. This study analyzes trauma mechanisms in deceased pediatric patients. Fatal pediatric trauma cases aged 0-18 years who underwent forensic autopsy in the Federal State of Berlin, Germany, between 2008 until 2018 were enrolled in this retrospective study. Autopsy protocols were analyzed regarding demographic characteristics, trauma mechanisms, injury patterns, resuscitation measures, survival times as well as place, and cause of death. 71 patients (73% male) were included. Traffic accidents (40%) were the leading cause of trauma, followed by falls from height > 3 m (32%), railway accidents (13%), third party violence (11%) and other causes (4%). While children under 14 years of age died mostly due to traumatic brain injury (59%), polytrauma was the leading cause of death in patients > 14 years (55%). Other causes of death were hemorrhage (9%), thoracic trauma (1%) or other (10%). A suicidal background was proven in 24%. In the age group of > 14 years, 40% of all mortalities were suicides. Cardiopulmonary resuscitation was carried out in 39% of all patients. 42% of the patients died at the scene. Children between 0 and 14 years of age died most frequently from traumatic brain injury. In adolescents between 14 and 18 years of age, polytrauma was mostly the cause of death with a high coincidence of suicidal deaths. The frequency of fatal traffic accidents and suicides shows the need to improve accident and suicide prevention for children and adolescents.
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Affiliation(s)
- Christine Eimer
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Kiel, Germany.
| | - Claas Buschmann
- Institute of Legal Medicine, University Hospital Schleswig-Holstein, Kiel / Lübeck, Germany
| | - Jonas Deeken
- Asklepios Medical School GmbH, Lohmühlenstraße 5, Haus P, Hamburg, 20099, Germany
| | - Thoralf Kerner
- Department for Anesthesiology, Intensive Care Medicine, Emergency Medicine, Pain Therapy, Asklepios Medical Centre, Harburg, Germany
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Qiu Y, Li M, Shi H, Zhao C, Du Y, Wang X, Zhang J. Depressive symptoms, parenting attitude, and violent discipline among caregivers of left-behind children in rural China: a cross-sectional study. BMC Public Health 2024; 24:994. [PMID: 38594654 PMCID: PMC11005119 DOI: 10.1186/s12889-024-18394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The situation of mental health and discipline behaviors of left-behind children's caregivers were not optimistic in rural China. Caregivers' depression might increase the risk of using violent discipline. However, the specific ways in which depressive symptoms impact violent discipline have rarely been explored in rural areas. This study aims to assess the prevalence of violent discipline among left-behind children under 6 years of age in rural China and explore the potential mechanisms of how caregivers' depressive symptoms affect violent discipline. METHODS We enrolled a total of 396 pairs of left-behind children and their caregivers in our study, which was conducted in 5 counties of Hebei, Henan, Jiangxi, Guizhou, and Sichuan provinces in China. The depressive symptoms of caregivers were measured by using Zung Self-rating Depression Scale (ZSDS) and violent discipline was assessed by the Child Discipline Module of Multiple Indicator Cluster Surveys (MICS). A self-designed questionnaire was utilized to measure caregiver's parenting attitude. Based on the cross-sectional data, controlling for potential confounders, structural equation modeling (SEM) was used to assess the direct and indirect effects of the mediation models by applying the weighted least squares with mean and variance adjusted (WLSMV) estimate. RESULTS The prevalence of violent discipline, psychological aggression, and physical punishment was 72.7%, 59.3%, and 60.4% respectively of left-behind children under 6 years of age. According to the results of SEM, parenting attitude acted as a suppressor, suppressing the association between caregivers' depressive symptoms and physical punishment/psychological aggression/violent discipline. The caregivers' depressive symptoms positively influenced all the outcome variables by affecting parenting attitudes (p = 0.002, p = 0.013, p = 0.002). CONCLUSIONS The presence of depressive symptoms in caregivers increases the use of violent discipline through negative parenting attitudes. The mental health status of primary caregivers of left-behind children in rural China needed emphasis and improvement.
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Grants
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- 860/A0/05/502/001/032 Grant United Nations Children's Fund, Beijing, China
- United Nations Children’s Fund, Beijing, China
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Affiliation(s)
- Yunfei Qiu
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
| | - Mengshi Li
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
| | - Huifeng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
- Department of Obstetrics and Gynecology, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, PR China
| | - Chunxia Zhao
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
- Child Development Research Center, China Development Research Foundation, 136 Andingmenwai Street, Dongcheng District, 100010, Beijing, PR China
| | - Yufeng Du
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 730000, Lanzhou, PR China
| | - Xiaoli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, 100191, Beijing, PR China
| | - Jingxu Zhang
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, 100191, Beijing, PR China.
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, 100191, Beijing, PR China.
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30
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Birungi N, Berge KG, Åstrøm AN, Brattabø IV. Association of child abuse and neglect training with filing reports of concern to child welfare services: a cross-sectional study. BMC Oral Health 2024; 24:427. [PMID: 38582849 PMCID: PMC10999089 DOI: 10.1186/s12903-024-04222-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/02/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND The aptitude, knowledge, and competence of dental health personnel on child abuse and neglect (CAN) is not optimal for deciding when to file a report of concern to child welfare services (CWS). OBJECTIVES The aim of this study was, firstly, to assess the association of the public dental health personnel 's (PDHP) training on CAN received in the last three work years, i.e., in 2016 through 2018 with filing reports to the CWS in the same period and secondly to assess the association of expressed need of training on CAN with filing reports to the CWS. METHODS This cross-sectional study uses data from an electronic survey census of PDHP from Norway (n = 1791) conducted in 2019. The Pearson chi-square test, non-parametric tests, logistic, and negative binomial regression were used for unadjusted and adjusted analysis. Data was reported with proportions, odds ratios (OR), incidence rate ratios and 95% confidence intervals (CIs). RESULTS From 2016 to 2018, the prevalence estimate of filing reports to CWS was 50%, with a mean (standard deviation) of 1.39 (2.11) reports sent. The logistic regression analysis showed an association between filing reports of concern and CAN training in the last three years. Compared to those that had not received CAN training during the three previous years, the ORs (95% CI) for filing reports to the CWS during the same period was 2.5 (1.6-4.0) for one day CAN work training, 3.2 (2.0-5.1) for 2-4 days CAN training and 4.9 (2.6-9.4) for five or more days CAN training. Compared to workers who did not need training in reporting (routines of CAN), those who expressed the need for a little more and more training were less likely to file a report. The corresponding OR were 0.6 (0.4-0.9) and 0.6 (0.3-0.9), respectively. CONCLUSION CAN training during the last three years is associated with filing reports of concern to CWS in the same period among PDHP in Norway. The likelihood of filing CAN reports increased with the number of days of CAN training received. Secondly, the PDHP with an expressed need for training on CAN routines were less likely to report suspicions to CWS.
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Affiliation(s)
- Nancy Birungi
- Oral Health Centre of Expertise in Vestland County, Bergen, Norway.
| | | | - Anne Nordrehaug Åstrøm
- Oral Health Centre of Expertise in Vestland County, Bergen, Norway
- Institute of Clinical Dentistry, University of Bergen, Bergen, Norway
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Whitten T, Tzoumakis S, Green MJ, Dean K. Global Prevalence of Childhood Exposure to Physical Violence within Domestic and Family Relationships in the General Population: A Systematic Review and Proportional Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1411-1430. [PMID: 37300288 PMCID: PMC10913340 DOI: 10.1177/15248380231179133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Efforts to identify and prevent childhood exposure to physical violence within domestic and family relationships must be underpinned by reliable prevalence estimates to ensure the appropriate allocation of resources and benchmarks for assessing intervention efficacy. We conducted a systematic review and meta-analysis of the global prevalence of childhood exposure to physical domestic and family violence separately as a victim or witness. Searches were conducted in Criminal Justice Abstracts, Embase, Scopus, PubMed, PsychInfo, and Google Scholar. Studies were included if they were peer-reviewed, published in English, had a representative sample, unweighted estimates, and were published between January 2010 and December 2022. One-hundred-and-sixteen studies comprising 56 independent samples were retained. Proportional meta-analysis was conducted to calculate the pooled prevalence for each exposure. Pooled prevalence estimates were also stratified by region and sex. The global pooled prevalence of childhood exposure to physical domestic and family violence as a victim or witness was 17.3% and 16.5%, respectively. Prevalence estimates were highest in West Asia and Africa (victim = 42.8%; witness = 38.3%) and lowest for the Developed Asia Pacific region (victim = 3.7%; witness = 5.4%). Males were 25% more likely than females to be the victim of physical domestic and family violence during childhood, while both were equally likely to have witnessed it. These findings suggest that childhood exposure to domestic and family violence is relatively common, affecting around one-in-six people by 18 years of age globally. Regional variations in prevalence estimates may reflect underlying economic conditions, cultural norms, and service availability.
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Affiliation(s)
- Tyson Whitten
- Center for Law and Justice, Charles Sturt University, Port Macquarie, NSW, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
| | - Stacy Tzoumakis
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
- School of Criminology and Criminal Justice, Griffith University, Southport, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Melissa J. Green
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
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Kanagasabai U, Thorsen V, Zhu L, Annor FB, Chiang L, McOwen J, Augusto A, Manuel P, Kambona C, Coomer R, Kamagate F, Ramphalla P, Denhard L, Cain M, Hegle J, de Barros RB, Saenz S, Kamami M, Patel P. Adverse childhood experiences, HIV and sexual risk behaviors - Five sub-Saharan countries, 2018-2020. CHILD ABUSE & NEGLECT 2024; 150:106541. [PMID: 38114359 DOI: 10.1016/j.chiabu.2023.106541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been shown to have negative, lasting effects on health including increasing the likelihood of engaging in sexual risk behaviors. OBJECTIVE This study aimed to identify associations between exposures to ACEs and sexual risk behaviors and HIV service utilization among young people. PARTICIPANTS AND SETTING A sample of 8023 sexually active young people (19-24 year olds) from five sub-Saharan African countries participated Violence Against Children and Youth Surveys (VACS). METHODS Descriptive analysis of demographic variables, individual ACEs, cumulative ACEs, sexual risk behaviors, HIV testing, antiretroviral treatment (ART) and Antenatal Care (ANC) attendance were completed. Bivariate and multivariable logistic regression analyses were conducted to assess the associations between both individual and cumulative ACEs, sexual HIV risk behaviors, and service utilization while controlling for important covariates such as demographic, having ever been pregnant, had an STI, and used contraception. RESULTS Exposure to three or more ACEs was higher among males (26.1 %) compared to females (21.3 %); p = 0.003. The most prominent sexual risk behavior for females was having sexual partners who were at least 5 years older (45.7 % compared to males 3.7 %; p < 0.0001) whereas in males it was no or infrequent condom use (45.3 % compared to females 30.1 %; p < 0.0001). Males and females exposed to childhood sexual violence had seven and four times the odds of engaging in transactional sex (aOR = 7.34, 95 % CI: [3.5-15.0]) and (aOR =3.75, 95 % CI: [2.3-6.2], respectively. Females exposed to three or more ACEs were four times more likely to engage in transactional sex (aOR = 4.85, 95 %, CI: [1.6-14.4]) compared to those who did not experience any ACEs. Males exposed to three or more ACEs were two times more likely to engage in early sexual debut (aOR = 2.2, 95 % CI: [1.3-3.4]),]) compared to those who did not experience any ACEs. Females who had witnessed IPV or violence in the community had significantly higher odds of getting tested for HIV (aOR = 2.16, 95 % CI: [1.63-2.87]) and (aOR = 1.36, 95 % CI: [1.03-1.81]), respectively. CONCLUSIONS This study demonstrated that experiencing ACEs during childhood is associated with higher HIV risk behaviors in sub-Saharan Africa (SSA) with unique differences between males and females.
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Affiliation(s)
| | - Viva Thorsen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Liping Zhu
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Laura Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jordan McOwen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | - Caroline Kambona
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Kenya
| | - Rachel Coomer
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Namibia
| | - Fathim Kamagate
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Puleng Ramphalla
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lesotho
| | - Langan Denhard
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Meagan Cain
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jennifer Hegle
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Shantal Saenz
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Mwikali Kamami
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Pragna Patel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
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Miedema SS, Stamatakis C, Tracy A, Hegle J, Kamagate MF, McOwen J, Augusto A, Manuel P, Coomer R, Kambona C, Ramphalla P, Niolon P, Patel P, Annor FB. Patterns of adverse childhood experiences and their associations with mental distress, substance use and sexual risk behaviors in Sub-Saharan Africa. CHILD ABUSE & NEGLECT 2024; 150:106494. [PMID: 37806930 DOI: 10.1016/j.chiabu.2023.106494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/02/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Multiple adverse childhood experiences (ACEs) are associated with poor sexual and mental health outcomes in low- and middle-income countries (LMICs). Less well understood is how discrete and gendered clustering of ACEs may influence health. OBJECTIVE To assess how multiple ACEs co-occur and how dominant patterns of co-occurrence are associated with mental distress, substance use, and sexual risk behaviors among young women and men in Sub-Saharan Africa. PARTICIPANTS AND SETTING We used pooled data of young men and women aged 19-24 from comparable, nationally representative Violence Against Children and Youth Surveys (VACS) conducted in Cote d'Ivoire, Kenya, Lesotho, Mozambique, and Namibia (nf = 7183; nm = 2207). METHODS We estimated sex-disaggregated latent classes of six ACEs among young women and men. We ran Bolck-Croon-Hagenaars (BCH) distal outcome analysis to test the sex-stratified relationships between ACEs latent classes and health outcomes. RESULTS A six class solution best fit the female data. Classes included witnessing violence and experiencing physical violence (PV); experiencing PV; high ACEs; witnessing community violence; orphanhood; and low ACEs exposure. Among males, the best-fitting three-class solution included experiencing PV and witnessing community violence; high ACEs; and low ACEs exposure. Membership in the high ACEs class was associated with mental distress among females and males, and substance use among males. No differences in sexual risk behavior were identified by class membership among either females or males. CONCLUSIONS Discrete clusters of co-occurring ACEs are associated with elevated odds of mental distress among females, and mental distress and substance use among males. Preventing ACEs may improve mental health among young women and men in LMICs in Sub-Saharan Africa.
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Affiliation(s)
- Stephanie Spaid Miedema
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Caroline Stamatakis
- Division of Global HIV/TB, Center for Global Health, Centers for Disease Control and Prevention, Rwanda
| | | | - Jennifer Hegle
- Division of Global HIV/TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Jordan McOwen
- Centers for Disease Control and Prevention, Maputo, Mozambique
| | | | - Pedro Manuel
- Centers for Disease Control and Prevention, Maputo, Mozambique
| | - Rachel Coomer
- Centers for Disease Control and Prevention, Windhoek, Namibia
| | | | | | - Phyllis Niolon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pragna Patel
- Division of Global HIV/TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Brown C, Nkemjika S, Ratto J, Dube SR, Gilbert L, Chiang L, Picchetti V, Coomer R, Kambona C, McOwen J, Akani B, Kamagate MF, Low A, Manuel P, Agusto A, Annor FB. Adverse Childhood Experiences and Associations with Mental Health, Substance Use, and Violence Perpetration among Young Adults in sub-Saharan Africa. CHILD ABUSE & NEGLECT 2024; 150:106524. [PMID: 38854869 PMCID: PMC11160582 DOI: 10.1016/j.chiabu.2023.106524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background Adverse childhood experiences (ACEs) can have debilitating effects on child well-being, with consequences persisting into adulthood. Most ACE studies have been conducted in high-income countries and show a graded relationship between multiple ACE exposures and adverse health outcomes. Less is known about the types and burden of ACEs in sub-Saharan Africa (SSA). Objective To estimate the pooled prevalence of six individual and cumulative ACE exposures (physical, sexual, and emotional violence; orphanhood; witnessing interparental and community violence) and assess their association with mental health outcomes, substance use, and violence perpetration among young adults in SSA. Participants and setting Aggregate data from the Violence Against Children and Youth Survey (VACS) in Cote d'Ivoire 2018, Kenya 2019, Lesotho 2018, Mozambique 2019, and Namibia 2019 included a sample of 11,498 young adults aged 18-24 years. Methods Cumulative ACEs were defined by an integer count of the total number of individual ACEs (0 to 6). Weighted prevalence and adjusted odds ratios were estimated. Result ACEs prevalence ranged from 7.8% (emotional violence) to 55.0% (witnessing community violence). Strong graded relationships between cumulative ACE exposure and all study outcomes for both males and females were observed. Among females, witnessing interparental violence was the only individual ACE risk factor significantly associated with increased odds of substance use; among males, emotional violence was significantly associated with all outcomes. Conclusion ACEs are associated with adverse mental health, substance use, and violence perpetration in SSA. Gender-specific and culturally sensitive intervention strategies are needed to effectively mitigate ACEs in this population.
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Affiliation(s)
- Colvette Brown
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Stanley Nkemjika
- Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA
| | - Jeffrey Ratto
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Shanta R. Dube
- Levine College of Health Sciences, Wingate University, Wingate, North Carolina
| | - Leah Gilbert
- National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | - Laura Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Viani Picchetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Rachel Coomer
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Namibia
| | - Caroline Kambona
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Kenya
| | - Jordan McOwen
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | - Bangaman Akani
- Department of Public Health, Felix Houphouet Boigny University, Abidjan, Cote d’ Ivoire
| | - Maman Fathim Kamagate
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d’ Ivoire
| | - Andrea Low
- International Center for AIDS Care and Treatment Program (ICAP)at Columbia University, NY
| | - Pedro Manuel
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | | | - Francis B. Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
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Perry Mohling EW, Recinos M, Kwiringira JN, Phung E, Olwit C, Swahn MH, Massetti G, Self-Brown S. Adverse childhood experiences, mental distress, self-harm and suicidality, and cumulative HIV risk by sex in Lesotho. CHILD ABUSE & NEGLECT 2024; 150:106701. [PMID: 38402043 DOI: 10.1016/j.chiabu.2024.106701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa. OBJECTIVES, PARTICIPANTS, SETTING We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho. METHODS Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (nfemale = 7101; nmale = 1467) data. RESULTS Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females. CONCLUSIONS Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho.
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Affiliation(s)
- Elizabeth W Perry Mohling
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA.
| | - Manderley Recinos
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Erick Phung
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Connie Olwit
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Monica H Swahn
- WellStar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Greta Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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Buffarini R, Coll CV, Esposti MD, Murray J. Unique and shared risk factors for early childhood victimisation and polyvictimisation in a Brazilian population-based birth cohort. LANCET REGIONAL HEALTH. AMERICAS 2024; 32:100715. [PMID: 38510789 PMCID: PMC10950884 DOI: 10.1016/j.lana.2024.100715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 02/02/2024] [Accepted: 03/01/2024] [Indexed: 03/22/2024]
Abstract
Background Identifying modifiable risk factors for child victimisation and polyvictimisation (exposure to multiple types of victimisation) is critical for informing prevention efforts, yet little evidence is available in low- and middle-income countries. The authors aimed to estimate the prevalence of child victimisation and polyvictimisation, and examine unique and shared risk factors in a population-based cohort in Southern Brazil. Methods Lifetime child victimisation was based on maternal report when children were aged 4 years old (N∼3900) and included five types of victimisation (conventional crime, child maltreatment, peer/sibling victimisation, sexual victimisation, and witnessing/indirect victimisation) and polyvictimisation. Based on a socioecological model, possible risk factors were examined in four levels: community, maternal and family, parent, and child. Findings Conventional crime and peer/sibling victimisation were the most common types of victimisation (46.0 and 46.5%, respectively), followed by witnessing/indirect victimisation (27.0%), and child maltreatment (11.3%). Sexual victimisation had the lowest prevalence (1.4%). One in 10 (10.1%) children experienced polyvictimisation. In general, boys had higher victimisation rates than girls. There were few risk factors related only to specific types of victimisation (e.g., child disability was uniquely associated with child maltreatment and peer/sibling victimisation). Instead, most risk factors were shared across nearly all victimisation types and also associated with polyvictimisation. These shared risk factors were: violent neighbourhood and low social cohesion, maternal adverse childhood experiences, younger maternal age, parental antisocial behaviour, intimate partner violence against mothers, and maternal depression. Interpretation These findings reveal a general pattern of accumulative risk effects for different types of victimisation and polyvictimisation, rather than unique risk profiles in children aged four year Prevention efforts should target risk factors at multiple levels (e.g.,: community, maternal and family and parent) during early childhood. Funding Wellcome Trust grant 10735_Z_18_Z.
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Affiliation(s)
- Romina Buffarini
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, RS, Brazil
| | - Carolina V.N. Coll
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, RS, Brazil
| | - Michelle Degli Esposti
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, RS, Brazil
| | - Joseph Murray
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, RS, Brazil
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Wong RS, Tung KTS, Ho FKW, Rao N, Chan KL, Ip P. Longitudinal associations between child discipline methods and physical growth patterns across preschool years. Obesity (Silver Spring) 2024; 32:778-787. [PMID: 38233354 DOI: 10.1002/oby.23977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/16/2023] [Accepted: 12/02/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Research has documented the associations of child maltreatment with a range of physical health problems, but little is known about the physical growth patterns of children who experience maltreatment in early childhood. This study aimed to examine the association between various discipline approaches and physical growth in preschool-aged children. METHODS In the first year of preschool, parents of 661 Chinese preschool-aged children completed a questionnaire with items pertaining to the frequency of using physical maltreatment, psychological aggression, neglect, and nonviolent discipline toward the child. Children's weight and height were assessed annually using direct assessment in the first and two subsequent years. Longitudinal analyses were performed using multiple regression models. RESULTS More frequent neglect and psychological aggression during the first year of preschool were associated with a higher likelihood of a decreased BMI z score in subsequent years. Conversely, increased experience of physical maltreatment in the first year was associated with an increased likelihood of having overweight or obesity in the third year. CONCLUSIONS Results indicate that early maltreatment experience can impact physical growth. This highlights the importance of preventing abusive parenting and encouraging healthy habits in young children who have experienced maltreatment to decrease their future risk for weight problems.
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Affiliation(s)
- Rosa S Wong
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong SAR, China
| | - Keith T S Tung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Frederick K W Ho
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Nirmala Rao
- Faculty of Education, The University of Hong Kong, Hong Kong SAR, China
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
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Moon DJ, Nichols CB, Zhang Y, Cruce A, Haran H, Sgourakis A, Lee H, Johnson-Motoyama M. Engagement Measures in Maltreatment Prevention Studies: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1551-1567. [PMID: 37626470 DOI: 10.1177/15248380231188070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
Prevention services can promote public health by building protective factors and reducing maltreatment risk. Yet, engaging caregivers in prevention services presents a unique set of challenges. Measurement studies are important first steps to increase the knowledge of caregiver engagement in prevention services. The purpose of this scoping review was to investigate how family engagement has been measured and operationalized in the studies of maltreatment prevention/positive parenting programs. The review examined quantitative and mixed methods studies conducted in the U.S., which measured multiple dimensions of client engagement, including behavioral, attitudinal, and relational domains. A total of 88 studies selected from PubMed, CINAHL, ERIC, PsycINFO, Social Work Abstracts, Academic Search Premier, and Web of Science were included in this review. Results indicated that studies examine engagement constructs in all three domains of engagement with a primary focus on behavioral engagement. The attitudinal and relational engagement was mostly assessed through general satisfaction surveys, and a limited number of studies utilized validated measures to assess those constructs. While most studies reported acceptable internal reliabilities, only two studies reported other dimensions of psychometric qualities. Only one validated measure was found, which assessed client perceptions of provider cultural competence. More measurement studies are needed to further incorporate multiple dimensions of engagement into the studies of maltreatment prevention programs, which can inform the effort to develop tailored implementation strategies to fully engage various groups of parents in maltreatment prevention programs.
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González MR, Trujillo A. Examining the Moderating Role of Parental Stress in the Relationship between Parental Beliefs on Corporal Punishment and Its Utilization as a Behavior Correction Strategy among Colombian Parents. CHILDREN (BASEL, SWITZERLAND) 2024; 11:384. [PMID: 38671601 PMCID: PMC11049352 DOI: 10.3390/children11040384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/09/2024] [Accepted: 03/13/2024] [Indexed: 04/28/2024]
Abstract
Understanding beliefs about corporal punishment is crucial, as evidence suggests that positive beliefs in its effectiveness predict its use. High parental stress, especially in those valuing corporal punishment, increases the potential for child abuse. Factors such as having many children or low education and socioeconomic status contribute to parental tensions, leading to the use of corporal punishment for behavior correction. We posit that the accumulation of such variables results in heightened stress levels. Our focus aimed to determine the moderating role of stress levels among parental beliefs about corporal punishment and its reported use through quantitative research. In our study, 853 Colombian parents of low, middle, and high socioeconomic status, and from four different regions of Colombia, with children aged 0 to 17 participated. They provided information about their beliefs on corporal punishment, using the Beliefs and Punishment Scale. Correlations indicated that older parents with better socioeconomic status were less inclined to believe that strictness improves children. Regressions suggested that increased belief in corporal punishment modifying behavior, along with higher parental stress, increases corporal punishment use. Moderation models highlighted that when more stressors were present, corporal punishment was used due to stress rather than parental beliefs. Ultimately, stress emerged as a crucial factor influencing corporal punishment use among Colombian parents.
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Affiliation(s)
| | - Angela Trujillo
- Facuttad de Psicología y Ciencias del Comportamiento, Universidad de La Sabana, Chía 250005, Colombia;
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Kamran Z, Kazi A. Association Between Harsh Disciplinary Methods and Child Functioning in Children Aged 7-14 Years in Punjab, Pakistan. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241239449. [PMID: 38504471 DOI: 10.1177/08862605241239449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Despite having adverse physical and mental health outcomes, harsh disciplinary methods are commonly practiced all over the world. This study aims to measure the harsh disciplinary actions taken by parents and their association with child functioning in children, aged 7 to 14 years in Punjab, Pakistan. This study is based on secondary data obtained from the United Nations Children's Fund (UNICEF's) Multiple Indicator Cluster Survey, conducted in the Punjab province from 2017 to 2018. Parents/caregivers of 19,721 children were included in the analysis. Questionnaire-based interviews were conducted, and the data collection form included sociodemographic information, questions on different "Methods of Child Discipline" and the "Child functioning module." The data was analyzed using STATA 15.0. Multiple logistic regression analysis was conducted to calculate the adjusted odds ratio and 95% CI exploring the association between harsh disciplinary methods and child functioning. More than 50% of children were exposed to severe physical, psychological, and emotional disciplinary methods. Exposure to severe physical aggression was associated with increased difficulty in learning (2.60 [1.27, 5.31]), remembering (2.83 [1.47, 5.44]), controlling behavior (1.63 [1.21, 2.18]), anxiety (1.98 [1.25, 3.13]), depression (2.57 [1.57, 4.22]) and making friends (1.94 [1.01, 3.79]). Whereas moderate physical aggression and psychological aggression were associated with (1.48 [1.19, 1.84]) and 1.5 times (1.20, 1.84) increase in difficulty in controlling behavior, respectively. Nonviolent actions were associated with protective odds for self-care (0.33 [0.17, 0.65]), communication (0.51 [0.27, 0.96]), learning (0.56 [0.33, 0.95]), remembering (0.62 [0.39, 0.90]), concentration (0.50 [0.31, 0.80]), anxiety (0.60 [0.46, 0.79]) and depression (0.67 [0.49, 0.92]). Severe disciplinary methods are detrimental to the child's personal care, mental, social, emotional, and psychological well-being, whereas nonviolent actions are associated with positive child functioning. In a third-world country such as Pakistan, this topic is widely undiscovered and understudied, thus emphasizing the need for awareness and education of parents and healthcare providers.
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Affiliation(s)
- Zaibunnisa Kamran
- Medical College, Aga Khan University, Karachi, Pakistan
- Princess Nora Bent Abdullah Research Chair for Women Health, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ambreen Kazi
- Princess Nora Bent Abdullah Research Chair for Women Health, King Saud University Medical City, Riyadh, Saudi Arabia
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Chiang L, Miedema S, Saul J, Mercy J, Brooks A, Butchart A, Bachman G, Hegle J, Ligiero D, Logan J, Massetti G. Successful child sexual violence prevention efforts start with data: how the Violence Against Children and Youth Survey helped curb the tide of child sexual violence in 20 countries. BMJ Paediatr Open 2024; 8:e002497. [PMID: 38479727 PMCID: PMC10936510 DOI: 10.1136/bmjpo-2024-002497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Affiliation(s)
- Laura Chiang
- Division of Violence Prevention, CDC, Atlanta, Georgia, USA
| | | | - Janet Saul
- Bureau of Global Health Security and Diplomacy, US Department of State, Washington, District of Columbia, USA
| | - James Mercy
- Division of Violence Prevention, CDC, Atlanta, Georgia, USA
| | - Andrew Brooks
- UNICEF Eastern and Southern Africa Regional Office, Nairobi, Kenya
| | - Alexander Butchart
- Prevention of Violence Unit, World Health Organization, Geneva, Switzerland
| | | | - Jennifer Hegle
- Division of Global HIV and TB, CDC, Atlanta, Georgia, USA
| | | | - Joseph Logan
- Division of Global HIV and TB, CDC, Atlanta, Georgia, USA
| | - Greta Massetti
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia, USA
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Bloom M, McCoy C, Hendrix-Dicken AD, Elenwo C, Baxter MA, Coffey S, Hartwell M. Association and disparities of food insecurity and exposure to violence: analysis of the National Survey of Children's Health. J Osteopath Med 2024; 0:jom-2023-0263. [PMID: 38451468 DOI: 10.1515/jom-2023-0263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/01/2024] [Indexed: 03/08/2024]
Abstract
CONTEXT Lack of access to food is a significant concern for child well-being, and it creates many health disparities and adverse social outcomes. Food insecurity and its many associated risk factors increase parental stress, which are strongly correlated with an increased risk of child abuse and maltreatment. Research now identifies being witness to domestic abuse as a form of child maltreatment, and exposure to violence in the community has been shown to result in similar long-term impacts. OBJECTIVES Given the potential for lifelong adverse effects from experiencing adverse childhood events involving violence and food insecurity, our primary objective was to assess the relationship between the two and disparities among demographic factors. METHODS We conducted an observational study utilizing data from the National Survey of Children's Health (NSCH) 2016-2021. The NSCH is a United States nationally representative survey completed by primary caregivers of one child per home aged 0-17 years. We determined population estimates (n=216,799; n=83,424,126) and rates of children experiencing food insecurity and parent-reported exposure to violence. We then constructed logistic regression models to assess associations, through odds ratios (ORs), between food security and exposure to violence including demographic factors. RESULTS Among the sample, 5.42 % of children experienced low food security and 7.4 % were exposed to violence. The odds of exposure to violence are 5.19 times greater for children with low food security compared to food-secure children (95 % confidence interval [CI]: 4.48-6.02). Indigenous and Black children were 7.8 and 6.81 times more likely to experience or witness violence when food insecure compared to food secure White children, respectively (95 % CI: 3.18-19.13, 5.24-8.86 respectively). CONCLUSIONS Food insecurity was associated with increased odds of children experiencing and/or witnessing violence compared to those who were food secure. The interaction between exposure to violence and food insecurity also disproportionately impacts children with specific demographic factors, notably race/ethnicity including multiracial, Indigenous, and Black children. By developing and adapting strategies to improve food security, it is possible to indirectly reduce the rates of childhood exposure to violence and the long-term impacts that result.
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Affiliation(s)
- Molly Bloom
- 12373 Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research , Tahlequah, OK, USA
| | - Cassie McCoy
- 12373 Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research , Tahlequah, OK, USA
| | - Amy D Hendrix-Dicken
- Senior Staff Research Assistant, Department of Pediatrics, 161413 University of Oklahoma School of Community Medicine , Tulsa, OK, USA
| | - Covenant Elenwo
- 12373 Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research , Tahlequah, OK, USA
| | - Michael A Baxter
- Associate Professor of Pediatrics, Medical Director of Child Abuse Pediatrics Clinic, and Program Director of Child Abuse Pediatrics Fellowship, Department of Pediatrics, 161413 University of Oklahoma School of Community Medicine , Tulsa, OK, USA
| | - Sara Coffey
- Associate Clinical Professor and Interim Chair, Department of Psychiatry and Behavioral Sciences, 33264 Oklahoma State University Center for Health Sciences , Tulsa, OK, USA
| | - Micah Hartwell
- Clinical Assistant Professor, Department of Psychiatry and Behavioral Sciences, 33264 Oklahoma State University Center for Health Sciences , Tulsa, OK, USA
- Director of Office of Medical Student Research, 12373 Oklahoma State University College of Osteopathic Medicine at Cherokee Nation , Tahlequah, OK, USA
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Kurata S, Nishitani S, Kawata NYS, Yao A, Fujisawa TX, Okazawa H, Tomoda A. Diffusion tensor imaging of white-matter structural features of maltreating mothers and their associations with intergenerational chain of childhood abuse. Sci Rep 2024; 14:5671. [PMID: 38453944 PMCID: PMC10920819 DOI: 10.1038/s41598-024-53666-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/03/2024] [Indexed: 03/09/2024] Open
Abstract
Child abuse causes lifelong adverse outcomes for both physical and mental health, although many are resilient. Efforts to prevent this issue from the parental side require an understanding of the neurobiological basis that leads abusive parents to perpetrate abuse and the influence of the intergenerational chain of childhood abuse. Therefore, this study was conducted to compare the brain white-matter fiber structures between 11 maltreating mothers who had been recognized as having conducted child abuse prior to the intervention and 40 age-matched control mothers using tract-based spatial statistics. There was a significantly reduced axial diffusivity (AD) and a similar trend in fractional anisotropy (FA) in the right corticospinal tract in maltreating mothers compared to control mothers. Therefore, maltreating mothers may have excessive control over the forcefulness of voluntary movements. These features also decreased as the number of childhood abuse experiences increased, suggesting that an intergenerational chain of child abuse may also be involved. Other aspects observed were that the higher the current depressive symptoms, the lower the AD and FA values; however, they were not related to parental practice or empathy. These results corroborate the neurobiological features that perpetrate behaviors in abusive mothers.
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Affiliation(s)
- Sawa Kurata
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Kanazawa University, Kanazawa, Japan
- Hamamatsu University School of Medicine, Hamamatsu, Japan
- Chiba University, Chiba, Japan
- University of Fukui, Osaka, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Shota Nishitani
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan.
- Kanazawa University, Kanazawa, Japan.
- Hamamatsu University School of Medicine, Hamamatsu, Japan.
- Chiba University, Chiba, Japan.
- University of Fukui, Osaka, Japan.
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan.
| | - Natasha Y S Kawata
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Akiko Yao
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Takashi X Fujisawa
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Kanazawa University, Kanazawa, Japan
- Hamamatsu University School of Medicine, Hamamatsu, Japan
- Chiba University, Chiba, Japan
- University of Fukui, Osaka, Japan
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hidehiko Okazawa
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Akemi Tomoda
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan.
- Kanazawa University, Kanazawa, Japan.
- Hamamatsu University School of Medicine, Hamamatsu, Japan.
- Chiba University, Chiba, Japan.
- University of Fukui, Osaka, Japan.
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan.
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan.
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Abdelhamid S, Kraaijenvanger E, Fischer J, Steinisch M. Assessing adverse childhood experiences in young refugees: a systematic review of available questionnaires. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-023-02367-6. [PMID: 38451312 DOI: 10.1007/s00787-023-02367-6] [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: 04/12/2023] [Accepted: 12/21/2023] [Indexed: 03/08/2024]
Abstract
Today, various questionnaires are available to assess Adverse Childhood Experiences (ACEs) in children; however, it is uncertain if these questionnaires are comprehensive in addressing adversities of vulnerable subgroups, specifically refugee children. This review's objectives are to (1) identify current ACE questionnaires and determine if they are suitable in assessing refugee children's adversities, and (2) identify those previously used within a refugee population. A systematic literature search was conducted across five databases for articles published since 2010, including studies using an ACE-questionnaire that recognized multiple adversities in healthy children and were published in English. A total of 103 ACE questionnaires were identified in 506 studies. Only 14 of the 103 questionnaires addressed a refugee-specific adversity. Their ability to capture refugee children's experiences was limited: available questionnaires used a maximum of three items to assess refugee-specific adversities, covering only a fraction of forms of adversities relevant to refugee children. Psychometric characteristics were rarely reported. In addition, only two ACE questionnaires were used within a refugee population. With the tools currently available, it is not possible to comprehensively assess the exposure to and severity of the adversities faced by refugee children. The perpetuation of ongoing crises necessitates assessing refugee children's adversities to understand how their wellbeing is affected and to identify children at risk.
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Affiliation(s)
- Shaymaa Abdelhamid
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Heidelberg University, Alte Brauerei, Röngtenstraße 7, 68167, Mannheim, Germany.
| | - Eline Kraaijenvanger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Joachim Fischer
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Heidelberg University, Alte Brauerei, Röngtenstraße 7, 68167, Mannheim, Germany
| | - Maria Steinisch
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of Public Health, Social and Preventive Medicine, Heidelberg University, Alte Brauerei, Röngtenstraße 7, 68167, Mannheim, Germany
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Falb KL, Blackwell A, Hategekimana JDD, Sifat M, Roth D, O'Connor M. Co-Occurring Intimate Partner Violence and Child Abuse in Eastern Democratic Republic of Congo: The Influence of Early Life Experiences of Abuse. Violence Against Women 2024; 30:873-889. [PMID: 36579814 DOI: 10.1177/10778012221145302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Little is known about co-occurring intimate partner violence (IPV) against women and child abuse within families in humanitarian settings. Baseline data from 203 couples in eastern Democratic Republic of Congo were analyzed to assess associations between childhood experiences of abuse with present co-occurring violence. Over half of women (56.1%) and men (50.5%) reported co-occurring violence. Adjusted models demonstrate experiencing physical abuse as a child was associated with greatest odds of recent co-occurring violence while witnessing parental IPV had mixed influence. Programmatic approaches focused on reducing early childhood violence may be promising to prevent both IPV and child abuse.
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Mattelin E, Paidar K, Söderlind N, Fröberg F, Korhonen L. A systematic review of studies on resilience and risk and protective factors for health among refugee children in Nordic countries. Eur Child Adolesc Psychiatry 2024; 33:667-700. [PMID: 35445318 PMCID: PMC10894096 DOI: 10.1007/s00787-022-01975-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/09/2022] [Indexed: 11/03/2022]
Abstract
The Nordic welfare model is often used as an example for the promotion of health and wellbeing, even in vulnerable groups of children, such as refugees. Nonetheless, there are no published reviews on resilience and/or risk and protective factors for physical and mental health among refugee children living in Nordic countries. In this systematic review, we identified 5181 studies on the topic, screened titles, and abstracts, viewed 632, and finally included 26 studies. These studies described 18 samples with a total of 34,080 individuals ranging in ages 0-18 years. Overall, the studies were of good quality. Nearly all studies assessed adversity. Six studies reported physical health outcomes and all studies mental health outcomes, most often post-traumatic stress disorder and anxiety. None explicitly studied resilience. While we found that age and sex are the most frequently studied risk- and protective factors, findings are inconclusive, since the direction of the associations was different in the different studies. This systematic review indicates that there is still a need for well-designed and -powered studies using clear definitions of key study concepts to examine health outcomes and resilience among refugee children in Nordic countries.
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Affiliation(s)
- Erica Mattelin
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kristina Paidar
- Department of Child and Adolescent Psychiatry, Region Halland, Kungsbacka, Sweden
| | - Natalie Söderlind
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Frida Fröberg
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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Kim BN, Jo H, Kang S, Kim SY, Park HY, Park J, Kang HS. Development and Validation of the Mental Health Scale for Maltreated Children. Psychiatry Investig 2024; 21:242-254. [PMID: 38569582 PMCID: PMC10990630 DOI: 10.30773/pi.2023.0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/09/2023] [Accepted: 12/09/2023] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE This study aimed to develop and validate a comprehensive self-report questionnaire to assess emotional and behavioral problems and psychological trauma in maltreated children. METHODS The Mental Health Scale for Maltreated Children (MHS-MC) was constructed to encompass five major symptoms (depression, anxiety, inattention/hyperactivity/impulsivity, aggression/defiance, and psychological trauma) prevalent in maltreated children. Critical items and ego-resilience subscale were also devised to increase clinical utility. After informed consent, 205 children (maltreated children, n=157, 76.6%) were recruited nationwide, and they answered a package of self-report measures, including the MHS-MC. Reliability, construct validity, concurrent validity, and criterion-related validity were examined to explore the psychometric properties. RESULTS The reliability was good to excellent. Confirmatory factor analysis yielded a five-factorial solution for the symptom subscales supporting construct validity. In logistic regression, the total scores of the MHS-MC predicted membership in the maltreated group. Criterion-related validity was generally satisfactory in that all subscales of the MHS-MC showed significant correlations with relevant measures in the expected direction. CONCLUSION This is the first attempt to develop a comprehensive psychological scale based on nationwide data collected from maltreated Korean children. We hope that the continued standardization of this scale will contribute to evidence-based clinical and policy decisionmaking for maltreated children.
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Affiliation(s)
- Bin-Na Kim
- Department of Psychology, Gachon University, Seongnam, Republic of Korea
| | - Hyeseon Jo
- Child Protection Office, National Center for the Rights of the Child, Seoul, Republic of Korea
| | - Suhyeon Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Soo-Yeon Kim
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Ha-young Park
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Jungkyu Park
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
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Ligiero D, De Angulo B, Gatera G. Prevention, healing, and justice: a survivor-centred framework for ending violence against women and children. Lancet 2024; 403:595-597. [PMID: 38008106 DOI: 10.1016/s0140-6736(23)02518-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 11/28/2023]
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Mihret AM, Heinrichs N. Intergenerational effects of child maltreatment on adolescents' anxiety and depression in Ethiopia: the important mediating and moderating roles of current psychological distress. BMC Psychiatry 2024; 24:126. [PMID: 38360563 PMCID: PMC10870629 DOI: 10.1186/s12888-024-05586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Child abuse is widespread around the world, and one continent with particularly high rates is Africa. Research in high- and middle-income countries shows the cascading effect of parental history of child abuse and neglect on adolescents' maltreatment and, in turn, on mental health problems. This cascade has been reported in young children but has rarely been studied in parent-adolescent dyads or in low-income countries (LICs). The goal of this study was to test intergenerational associations of child abuse and neglect and to examine how these experiences are in turn associated with youth anxiety and depression in an LIC. METHODS A total of 231 adolescents (age: 13-21 years) and 185 of their parents (n = 90 fathers and n = 95 mothers) were recruited from secondary schools in Addis Abeba, Ethiopia. Using a cross-sectional design, participants completed a set of questionnaires assessing child maltreatment (in adolescence and own past history in parents), parental psychological distress, youth depression and anxiety, and sociodemographic factors. RESULTS The frequencies of child maltreatment exposure were 68% for adolescents and 65% for their parents (when they were a child). Fifty-one percent and 42% of adolescents had borderline to clinical levels of anxiety and depression symptoms, respectively. Adolescents of parents with a history of child abuse and neglect also reported higher exposure to maltreatment themselves (p < 0.001). Current paternal, but not maternal, psychological distress mediated this intergenerational association of maltreatment experiences (95% CI [1.164, 9.467]). We further found parents' psychological distress to be a significant moderator of the indirect pathways of the intergenerational effect of child maltreatment on adolescents' anxiety and depression (95% CI [- 0.770, - 0.012]). CONCLUSIONS We found child maltreatment to be intergenerationally associated, and this effect subsequently affected adolescents' anxiety and depression through different pathways supporting the cascading effects across generations. Intervention plans may be effective through an array of possible indirect pathways and encourage the implementation of multiple access points to facilitate change in the lives of affected youth in Africa.
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Affiliation(s)
- Amare Misganaw Mihret
- Clinical Psychology and Psychotherapy, Universität Bremen, Grazer Straße 6, 28359, Bremen, Germany.
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Bielefeld University Universität Bielefeld, Universität Straße 25, 33615, Bielefeld, Germany.
| | - Nina Heinrichs
- Clinical Psychology and Psychotherapy, Universität Bremen, Grazer Straße 6, 28359, Bremen, Germany
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Bielefeld University Universität Bielefeld, Universität Straße 25, 33615, Bielefeld, Germany
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Hammad MA, Al-Otaibi MN, Awed HS. Child maltreatment among deaf and hard-of-hearing adolescent students: associations with depression and anxiety. Front Psychol 2024; 15:1287741. [PMID: 38414873 PMCID: PMC10897975 DOI: 10.3389/fpsyg.2024.1287741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 01/30/2024] [Indexed: 02/29/2024] Open
Abstract
Objective Child abuse and neglect have several short- and long-term consequences for the victim. Though Deaf and Hard-of-Hearing children are at higher risk of being maltreated as compared to hearing children, little research in Saudi Arabia has focused on this population. To determine the prevalence of child maltreatment and to examine its association with depression and anxiety among a sample of Deaf and Hard-of-Hearing students in Saudi Arabia, recruited from secondary schools in southern Saudi Arabia. Methods The sample included 186 Deaf and Hard-of-Hearing students aged 14-17 years (M = 15.7 years; SD = 3.41 years). Data were collected using the Child Abuse Self-Report Scale, Center for Epidemiological Studies Depression Scale for Children, and Generalized Anxiety Disorder Questionnaire. Bivariate and Linear regression analyses were conducted using SPSS 20. Results About 47.3% of the students were exposed severe to very severe child maltreatment. The severity of maltreatment varied based on parents' educational and income level, number of children in the family, the Deaf and Hard-of-Hearing student's gender, and parents' hearing status. Linear regression analysis indicated that child maltreatment was a significant predictor of depression and anxiety in this sample. Conclusion Considering the socio-demographic factors influencing the prevalence of maltreatment in the present study, it seems important to work with parents of Deaf and Hard-of-Hearing children to improve their skills in rearing a child with special needs. Addressing the social stigma and social barriers experienced by DHH individuals through familial, institutional, and community interventions may be a first step toward long-term prevention of maltreatment among DHH children.
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Affiliation(s)
- Mohammad Ahmed Hammad
- Department of Special Education, College of Education, Najran University, Najran, Saudi Arabia
| | - Mansour Nayef Al-Otaibi
- Department of Education and Psychology, College of Education, Najran University, Najran, Saudi Arabia
| | - Huda Shaaban Awed
- Department of Special Education, College of Education, Najran University, Najran, Saudi Arabia
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