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Lines LE, Kakyo TA, McLaren H, Cooper M, Sivertsen N, Hutton A, Zannettino L, Starrs R, Hartz D, Brown S, Grant J. Interprofessional Education in Child Protection for Preservice Health and Allied Health Professionals: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:2657-2671. [PMID: 38281156 PMCID: PMC11370204 DOI: 10.1177/15248380231221279] [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: 01/30/2024]
Abstract
Health and allied health professionals are uniquely positioned to collaborate in prevention, early intervention and responses to child maltreatment. Effective collaboration requires comprehensive interprofessional education (IPE), and inadequate collaboration across sectors and professions continually contributes to poor outcomes for children. Little is known about what interprofessional preparation health and allied health professionals receive before initial qualification (preservice) that equips them for interprofessional collaboration and provision of culturally safe care in child protection. This scoping review aimed to identify what is known internationally about IPE in child protection for preservice health and allied health professionals. Thirteen manuscripts reporting 12 studies met the inclusion criteria and were included in the synthesis. Key characteristics of the educational interventions are presented, including target disciplines, core content and their learning objectives and activities. Findings demonstrated primarily low-quality methodologies and educational interventions that had not been replicated beyond their initial context. Many educational interventions did not provide comprehensive content covering the spectrum of prevention, early intervention and responses for all types of child maltreatment, and/or did not clearly indicate how IPE was achieved. Key challenges to delivering comprehensive interprofessional child protection include lack of institutional support and competing priorities across disciplines who must meet requirements of separate regulatory bodies. Consequently, there is a need for further development and robust evaluation of educational interventions to explore how interprofessional collaborative skills for child protection can be developed and delivered in preservice health and allied health professional education.
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Affiliation(s)
- Lauren Elizabeth Lines
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Tracy Alexis Kakyo
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Helen McLaren
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Megan Cooper
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Nina Sivertsen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Faculty of Health Sciences, Sámi Nursing, UiT Arctic University of Norway, Hammerfest, Norway
| | - Alison Hutton
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Lana Zannettino
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Rebecca Starrs
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Donna Hartz
- School of Nursing and Midwifery, Western Sydney University (Parramatta & South) and Western Sydney Local Health District, Penrith, NSW, Australia
- Molly Wardaguga Research Center, Charles Darwin University, Casuarina, NT, Australia
| | - Shannon Brown
- College and Research Services, Flinders University, Adelaide, SA, Australia
| | - Julian Grant
- Faculty of Science and Health, Charles Sturt University, Bathurst, NSW, Australia
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Kamke K, Kirkner A, Goodman KL. "Nothing Was Done": Experiences of continued sexual abuse after disclosing to a mandated reporter among youth in the United States. CHILD ABUSE & NEGLECT 2024; 155:106959. [PMID: 39094279 DOI: 10.1016/j.chiabu.2024.106959] [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: 12/22/2023] [Revised: 07/15/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Disclosing ongoing child sexual abuse (CSA) to a mandated reporter should facilitate youth safety. Unfortunately, youth may continue to experience abuse after disclosure, although little research has examined this phenomenon. OBJECTIVE We aimed to understand when and why the child protection process fails after youth disclose to a mandated reporter. PARTICIPANTS AND SETTING Hotline support specialists completed an online survey about 124 anonymous hotline chats with youth whose abuse continued after a prior disclosure to a mandated reporter. METHODS We thematically analyzed support specialists' open-ended descriptions of information disclosed by the victim in their chat. RESULTS In most cases (71 %), the abuse was seemingly not reported or not investigated. Mandated reporters' belief of the victim and minimization of abuse affected reporting decisions. Some mandated reporters tried to address the abuse directly with the perpetrators, endangering victims. Rarely, mandated reporters did not report to respect the victim's wishes. In 24 % of cases, the victim described an investigation that did not result in protection. Victims indicated that investigators "sided to the perpetrator" or said there was not enough evidence. Some victims recanted, often in fear. In 6 % of cases, formal actions were taken but did not provide long-term protection. Victims described temporary cessation of abuse that resumed because their guardian(s) allowed the perpetrator to access them. CONCLUSIONS Disclosing to a mandated reporter can engender traumatic experiences without resulting in long-term safety. Professionals need additional training to increase their knowledge of CSA and respond in ways that prioritize physical and emotional safety.
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Affiliation(s)
- Kristyn Kamke
- Rape, Abuse & Incest National Network (RAINN), 1220 L St NW Suite 500, Washington, DC 20005, United States of America.
| | - Anne Kirkner
- Rape, Abuse & Incest National Network (RAINN), 1220 L St NW Suite 500, Washington, DC 20005, United States of America
| | - Kimberly L Goodman
- Rape, Abuse & Incest National Network (RAINN), 1220 L St NW Suite 500, Washington, DC 20005, United States of America
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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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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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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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Midtsund AD, Henriksen L, Lukasse M, Valla L. Detecting and preventing child maltreatment in primary care and PHNs' role-a cross-sectional study. BMC PRIMARY CARE 2024; 25:218. [PMID: 38879472 PMCID: PMC11179210 DOI: 10.1186/s12875-024-02445-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/22/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important in preventing and detecting child maltreatment. In Norway, children undergo universal preventive health assessments and receive complimentary follow-up care from specialized public health nurses in child and family health clinics. These nurses conduct regular check-ups and home visits to monitor children for signs of maltreatment. OBJECTIVE The objective of this study is to describe how public health nurses at child and family health clinics follow the National Clinical Guidelines to prevent and detect child maltreatment, with a particular focus on clinical procedures and interdisciplinary collaboration. Furthermore, we aim to determine factors that are associated with identification of child maltreatment. DESIGN A cross-sectional online survey was conducted among public health nurses working in primary care between October 24th and December 31st, 2022. Public health nurses who worked with children aged 0-5 years and had consultations with families were eligible to participate, resulting in 554 responses. The study employed descriptive analysis, including frequency, percentage and mean, as well as a two-step logistic regression analysis. The study was approved by the relevant authority, and informed consent was obtained through questionnaire completion. RESULTS The public health nurses in this study displayed strong adherence to the guidelines and utilized various comprehensive assessment procedures to monitor child well-being, growth, and development. However, there was limited and infrequent collaboration with other professionals, such as child protection services, general practitioners, and hospitals. Most public health nurses reported occasional suspicion of child maltreatment, with age and years of experience in child and family clinics influencing these suspicions. Older public health nurses were more likely to suspect physical violence, while those with less than two years of experience reported less experience in suspecting maltreatment. Additional education increased the probability of suspecting sexual violence. CONCLUSIONS This study provides insights into the practices of public health nurses in Norway regarding the detection and prevention of child maltreatment in child and family clinics. While adherence to guidelines is strong, suspicion of maltreatment is relatively rare. Collaboration across agencies is crucial in addressing child maltreatment. Age and experience may influence the detection of maltreatment. Improved collaboration, targeted guidelines, and ongoing professional development are needed to enhance child protection.
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Affiliation(s)
- Astrid Durdei Midtsund
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
- Oslo Municipality, Grünerløkka Child and Family Health Clinic, Oslo, Norway.
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Division of General Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Department of Nursing and Social Sciences, Institute of Nursing and Health Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Lisbeth Valla
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
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Keller LA, Kayser K. The Impact of Training on Nurses' Attitudes Toward Reporting Child Sexual Abuse: a Pilot Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:373-381. [PMID: 38938958 PMCID: PMC11199467 DOI: 10.1007/s40653-023-00581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 06/29/2024]
Abstract
The purpose of this project is to assess, for practicing pediatric nurses in the U.S., what is the impact of the Stewards of Children Child Sexual Abuse (CSA) program on their attitudes about reporting suspected CSA. A sample size of 32 nurses completed an online 2-hour continuing education course by Stewards of Children, with a pre/post-test survey. A modified 14-item version of the Teachers Reporting Attitudes Scale for Child Sexual Abuse (TRAS-CSA) was used to measure the nurses' attitudes before and after educational training. The surveys were analyzed to assess changes in attitudes using two-tailed sign tests. Nurses' commitment to reporting CSA is high, even before training. Nurses' confidence in the system of reporting and in the response of authorities related to CSA increased after taking the Stewards of Children online course. While these results are limited in strength by low sample sizes and some null changes, they indicate that trainings like the Stewards of Children course can positively impact nurses' attitudes towards reporting CSA, particularly with regards to confidence in reporting, and therefore warrant further investigation into CSA training for nurses and its effects. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-023-00581-7.
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Affiliation(s)
- Lindsay A. Keller
- Department of Nursing, Otterbein University, Westerville, OH USA
- Tampa, FL USA
- Urgent Care, CityMD, New York, New York, United States
- Urgent Care, BayCare, Tampa, FL United States
| | - Kirk Kayser
- Department of Mathematics & Actuarial Science, Otterbein University, Westerville, OH USA
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Bahji A, Crockford D, Brasch J, Schutz C, Buckley L, Danilewitz M, Dubreucq S, Mak M, George TP. Training in Substance use Disorders, Part 1: Overview of Clinical Practice Recommendations. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:428-456. [PMID: 38613369 PMCID: PMC11107443 DOI: 10.1177/07067437241231128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Affiliation(s)
- Anees Bahji
- Clinical Assistant Professor, Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - David Crockford
- Clinical Professor, University of Calgary, Cumming School of Medicine, Department of Psychiatry, Calgary, AB, Canada; Hotchkiss Brain Institute & Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, AB, Canada
| | - Jennifer Brasch
- Associate Professor, Department of Psychiatry & Behavioural Neurosciences, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; Lead, Addiction Psychiatry, St. Joseph's Healthcare, Hamilton, ON, Canada; Past-President, Canadian Society of Addiction Medicine, Calgary, AB, Canada
| | - Christian Schutz
- Professor, Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; Research Lead Adult Mental Health and Substance Use, Provincial Health Service Authority, Vancouver, BC, Canada
| | - Leslie Buckley
- Associate Professor, Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Marlon Danilewitz
- Assistant Professor, Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Associate Medical Director, General Psychiatry, Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
| | - Simon Dubreucq
- Psychiatrist, Department of Addiction Medicine, CHUM, Montreal, QC, Canada; Assistant Professor, Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| | - Michael Mak
- Assistant Professor, Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Adjunct Assistant Professor, Department of Medicine, McMaster University, Hamilton, ON, Canada; Adjunct Research Professor, Department of Psychiatry, Western University, London, ON, Canada
| | - Tony P George
- Professor, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Radziszewski S, Parent S, St-Pierre E, Daignault IV, Hébert M, Baril K. A Rapid Review on Complaint Mechanisms for Interpersonal Violence: Integrating Research-Based Recommendations from Multiple Sectors to Inform Sport Settings. TRAUMA, VIOLENCE & ABUSE 2024:15248380241253822. [PMID: 38813811 DOI: 10.1177/15248380241253822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Past studies have highlighted the lack of independent formal complaint mechanisms as one of the most significant barriers to reporting interpersonal violence (IV) in sport. Some countries have since implemented complaint mechanisms specific to sport settings. Evaluations of similar mechanisms in other sectors could inform the development and implementation of complaint mechanisms for IV in sport. This rapid review included studies inside and outside the sport context to document the characteristics of complaint mechanisms of IV, barriers or limitations related to such mechanisms, and recommendations resulting from their evaluation. Following the Cochrane Rapid Reviews Interim Guidance, six databases were searched for peer-reviewed references in English or French, published between 2012 and 2022, and pertaining to the evaluation of formal reporting mechanisms of IV. The 35 references covered mechanisms mainly targeting IV in general (any type) or sexual violence specifically. Complaint mechanisms varied in scope and as a function of their setting, including work, university, military, and medical. We identified barriers and limitations concerning fear of consequences, lack of knowledge, lack of efficiency, lack of trust, and unsupportive culture. Finally, we documented 18 recommendations to improve complaint mechanisms of IV, spanning four categories: (a) organizational accountability, (b) awareness and accessibility, (c) adapted process, and (d) ongoing evaluation. This rapid review draws recommendations from various research disciplines and types of mechanisms to offer a comprehensive portrait of best practices. The findings show that numerous aspects of complaint mechanisms at multiple levels should be considered when developing and implementing complaint mechanisms of IV.
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Affiliation(s)
- Stephanie Radziszewski
- Research Chair in Security and Integrity in Sport, Université Laval, Québec, QC, Canada
- Université Laval, Québec, QC, Canada
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, QC, Canada
- Équipe Violence Sexuelle et Santé (ÉVISSA), Université du Québec à Montréal, Montréal, QC, Canada
| | - Sylvie Parent
- Research Chair in Security and Integrity in Sport, Université Laval, Québec, QC, Canada
- Université Laval, Québec, QC, Canada
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, QC, Canada
- Équipe Violence Sexuelle et Santé (ÉVISSA), Université du Québec à Montréal, Montréal, QC, Canada
- International Research Network on Violence and Integrity in Sport (IRNOVIS), Antwerp, Belgium
| | - Elisabeth St-Pierre
- Research Chair in Security and Integrity in Sport, Université Laval, Québec, QC, Canada
- Université Laval, Québec, QC, Canada
| | - Isabelle V Daignault
- Research Chair in Security and Integrity in Sport, Université Laval, Québec, QC, Canada
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, QC, Canada
- Équipe Violence Sexuelle et Santé (ÉVISSA), Université du Québec à Montréal, Montréal, QC, Canada
- International Research Network on Violence and Integrity in Sport (IRNOVIS), Antwerp, Belgium
- Université de Monréal, Montréal, QC, Canada
| | - Martine Hébert
- Research Chair in Security and Integrity in Sport, Université Laval, Québec, QC, Canada
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, QC, Canada
- Équipe Violence Sexuelle et Santé (ÉVISSA), Université du Québec à Montréal, Montréal, QC, Canada
- Université du Québec à Montréal, Montréal, QC, Canada
| | - Karine Baril
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, QC, Canada
- Équipe Violence Sexuelle et Santé (ÉVISSA), Université du Québec à Montréal, Montréal, QC, Canada
- Université du Québec en Outaouais, Gatineau, QC, Canada
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Sigad LI, Tener D, Lusky-Weisrose E, Shaibe J, Katz C. "Pay Attention! Pay Attention! Pay Attention!!!": The Pivotal Role of Educators and the Educational System as Experienced by Survivors of Child Sexual Abuse. Behav Sci (Basel) 2024; 14:419. [PMID: 38785910 PMCID: PMC11117898 DOI: 10.3390/bs14050419] [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: 02/13/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Educational institutions and educators are significant in children's lives, and they have a crucial role in implementing policies, practices, and sexual education to enhance children's safety. Such policies and practices should be based on the voices of CSA survivors. This study explored child sexual abuse (CSA) survivors' viewpoints on their past experiences with educators and the educational system. A qualitative thematic approach was used to analyze 61 written testimonies collected in 2020-2021 by the Israeli Independent Public Inquiry on CSA. Two interrelated themes arose: (1) CSA survivors' retrospective perspectives of educators and the educational system's responses to signs of their CSA, described as ranging from abusive to life-saving. Specifically, they shared three types of responses: (a) harmful and hurtful; (b) dismissive and ignoring; and (c) accepting and attending. (2) The second theme described the survivors' messages to educators to promote constructive change. The survivors conveyed expectations that educators should play a central role in CSA prevention, detection, and intervention and, specifically, the need for educators to receive professional training, provide beneficial sexual education, and identify and respond to CSA. The findings promoted moving beyond individual-level interventions to focus on improving educational institutional and organizational cultures related to CSA in both national and international contexts.
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Affiliation(s)
- Laura I. Sigad
- Department of Inclusive Education, Faculty of Graduate Studies, Oranim College of Education, Kiryat Tiv’on 3600600, Israel;
| | - Dafna Tener
- The Paul Baerwald School of Social Work and Social Welfare, Mount Scopus Campus, Hebrew University of Jerusalem, Jerusalem 9190500, Israel; (D.T.); (E.L.-W.)
| | - Efrat Lusky-Weisrose
- The Paul Baerwald School of Social Work and Social Welfare, Mount Scopus Campus, Hebrew University of Jerusalem, Jerusalem 9190500, Israel; (D.T.); (E.L.-W.)
| | - Jordan Shaibe
- Department of Inclusive Education, Faculty of Graduate Studies, Oranim College of Education, Kiryat Tiv’on 3600600, Israel;
| | - Carmit Katz
- Bob Shappell School of Social Work, Tel Aviv University, Tel Aviv 6997801, Israel;
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Sigad LI, Gosen NB, Golan L, Lusky-Weisrose E, Shaibe J, Tener D, Moshon-Cohen TE, Roe D. 'A kindergarten teacher must have 100 eyes and 100 ears!': Kindergarten teachers' experiences coping with child sexual abuse and problematic sexual behavior. CHILD ABUSE & NEGLECT 2024; 151:106713. [PMID: 38447239 DOI: 10.1016/j.chiabu.2024.106713] [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: 09/08/2023] [Revised: 01/24/2024] [Accepted: 02/18/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Child sexual abuse (CSA) and problematic sexual behavior (PSB) are worldwide phenomena that occur across all ages. Kindergarten teachers' proactive involvement can be crucial to the prevention, disclosure and intervention of CSA and PSB. However, research on their experiences of contending with CSA and PSB remains limited. OBJECTIVE This study examines kindergarten teachers' experiences in Israel with the CSA and PSB of their students. PARTICIPANTS AND SETTING Semi-structured interviews were conducted with 31 teachers: 11 secular Jewish, seven religious Jewish, nine Druze Arab, and four Muslim Arab. METHODS A qualitative analysis was conducted using the interview transcripts as data. RESULTS The analysis revealed three themes illustrating teachers' professional transformations regarding their knowledge of these phenomena: 1) initial shock, uncertainty and sense of responsibility when exposed to CSA and PSB due to missing knowledge, 2) implementation of prevention and intervention strategies regarding CSA and PSB, and 3) embracing a social role to disseminate CSA and PSB knowledge. The findings indicated that the majority of the teachers went from overwhelming shock and fear due to a lack of knowledge in coping with CSA and PSB to a sense of responsibility as a community leader. CONCLUSIONS The fragmentation of the Israeli education system isolates kindergartens, and the lack of training and education for the teachers left them alone when contending with the CSA and PSB of their students. Nevertheless, the participants exhibited remarkable agency and resourcefulness, gaining the necessary knowledge and acting as knowledge agents within their communities.
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Mathisen Haaland IE, Bondas TE. Public Health Nurses in an Internal Negotiation Process When There Is Concern About the Child's Care. Glob Qual Nurs Res 2024; 11:23333936241267003. [PMID: 39185747 PMCID: PMC11344900 DOI: 10.1177/23333936241267003] [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: 11/19/2023] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 08/27/2024] Open
Abstract
The aim of the study was to explore and describe how public health nurses at child health clinics experience and perceive the follow-up of children and families when there is concern about the child's care. The goal was to contribute to knowledge development to guide health-promoting nursing care for children and their families. Theoretical perspectives included health promotion, child-centered and family-centered care, in addition to nursing care. An exploratory qualitative design informed by a hermeneutic approach was used. Data were collected in 3 focus groups with 16 public health nurses and analyzed using latent content analysis. The findings detail public health nurses' internal negotiation processes in the follow-up of children and the family, and the ways these negotiation processes were influenced by various prerequisites, the approaches for follow-up, dilemmas that affected public health nurses' approaches, and prolonged dwellings on past responses to children and families of concern. The lack of routines and goals for follow-up, a dominant parental perspective, and ambiguity related to health promotion and disease prevention, all created challenges for the public health nurses. Based on these findings, a model of public health nurse's follow-up when there is concern about the child's care was developed for future research.
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Work EC, Muftu S, MacMillan KDL, Gray JR, Bell N, Terplan M, Jones HE, Reddy J, Wilens TE, Greenfield SF, Bernstein J, Schiff DM. Prescribed and Penalized: The Detrimental Impact of Mandated Reporting for Prenatal Utilization of Medication for Opioid Use Disorder. Matern Child Health J 2023; 27:104-112. [PMID: 37253899 PMCID: PMC10229393 DOI: 10.1007/s10995-023-03672-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Some states, including Massachusetts, require automatic filing of child abuse and neglect for substance-exposed newborns, including infants exposed in-utero to clinician-prescribed medications to treat opioid use disorder (MOUD). The aim of this article is to explore effects of these mandated reporting policies on pregnant and postpartum people receiving MOUD. METHODS We used modified grounded research theory, literature findings, and constant comparative methods to extract, analyze and contextualize perinatal experiences with child protection systems (CPS) and explore the impact of the Massachusetts mandated reporting policy on healthcare experiences and OUD treatment decisions. We drew from 26 semi-structured interviews originally conducted within a parent study of perinatal MOUD use in pregnancy and the postpartum period. RESULTS Three themes unique to CPS reporting policies and involvement emerged. First, mothers who received MOUD during pregnancy identified mandated reporting for prenatally prescribed medication utilization as unjust and stigmatizing. Second, the stress caused by an impending CPS filing at delivery and the realities of CPS surveillance and involvement after filing were both perceived as harmful to family health and wellbeing. Finally, pregnant and postpartum individuals with OUD felt pressure to make medical decisions in a complex environment in which medical recommendations and the requirements of CPS agencies often compete. CONCLUSIONS FOR PRACTICE Uncoupling of OUD treatment decisions in the perinatal period from mandated CPS reporting at time of delivery is essential. The primary focus for families affected by OUD must shift from surveillance and stigma to evidence-based treatment and access to supportive services and resources.
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Affiliation(s)
- Erin C Work
- Division of General Academic Pediatrics, MassGeneral for Children, 125 Nashua St Suite 860, Boston, MA, 02114, USA.
- Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Dr. S., Los Angeles, CA, 90095, USA.
- Department of Social Welfare, UCLA Luskin School of Public Affairs, 337 Charles E. Young Dr. E., Los Angeles, CA, 90095, USA.
| | - Serra Muftu
- Division of General Academic Pediatrics, MassGeneral for Children, 125 Nashua St Suite 860, Boston, MA, 02114, USA
| | - Kathryn Dee L MacMillan
- Division of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, 02114, USA
- Division of Pediatric Hospital Medicine, MassGeneral Hospital for Children, 55 Fruit St, Boston, MA, 02114, USA
| | - Jessica R Gray
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
- Division of Pediatrics, MassGeneral for Children, Boston, USA
| | - Nicole Bell
- Living in Freedom Together-LIFT Inc, Worcester, MA, USA
| | - Mishka Terplan
- Friends Research Institute, 1040 Park Ave, Suite 103, Baltimore, MD, 21202, USA
| | - Hendree E Jones
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina Chapel Hill, 410 North Greensboro St., Carrboro, NC, USA
| | - Julia Reddy
- Gillings School of Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Timothy E Wilens
- Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Shelly F Greenfield
- Division of Women's Mental Health and Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Judith Bernstein
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Davida M Schiff
- Division of General Academic Pediatrics, MassGeneral for Children, 125 Nashua St Suite 860, Boston, MA, 02114, USA
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Winquist A, Leiker CB, Landis T, Fraser J, Eddy LL, Burduli E. Development and psychometric evaluation of the reporting suspected child abuse and neglect (RSCAN) scale for United States registered nurses. J Pediatr Nurs 2023; 73:e319-e326. [PMID: 37863784 DOI: 10.1016/j.pedn.2023.09.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/22/2023]
Abstract
PURPOSE In the United States (US), nurses have a mandated duty to report child abuse and neglect (CAN). Despite comprising the highest proportion of the US healthcare workforce, limited research has explored the institutional barriers they face in reporting suspected CAN. Furthermore, there is no existing valid and reliable measure of reporting relevant to US. The purpose of this research is to develop and psychometrically evaluate a scale to measure nurse knowledge and self-efficacy as CAN mandated reporters. DESIGN AND METHODS The Reporting Suspected Child Abuse and Neglect (RSCAN) tool was developed from two existing international tools to examine institutional barriers and facilitators to US nurses' professional knowledge and reporting of CAN. A convenience sample of one hundred and sixty-six US nurses primarily from the Pacific Northwest responded to an online survey. An exploratory factor analysis (EFA) and Cronbach's α were used to examine validity and internal consistency, respectively, of an initial 16-item scale. RESULTS A two-factor model consisting of eight items indicated good model fit (CFI = 0.986, RMSEA = 0.049, and SRMR = 0.028) and was internally consistent (Cronbach's α = 0.822). CONCLUSION RSCAN is the first US instrument to reliably measure nurses' professional knowledge and self-efficacy of reporting suspected CAN. PRACTICE IMPLICATIONS Future research can build upon these findings to recognize and support nurses in their mandated role to report CAN.
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Affiliation(s)
- Anna Winquist
- University of Colorado Anschutz, College of Nursing, Aurora, CO 80045, USA.
| | - Celestina Barbosa Leiker
- Washington State University, College of Nursing, 412 E. Spokane Falls Blvd., Spokane, WA 99202-231, USA.
| | - Tullamora Landis
- Washington State University, College of Nursing, 412 E. Spokane Falls Blvd., Spokane, WA 99202-231, USA.
| | - Jennifer Fraser
- University of Sydney, Medicine and Health, Sydney, NSW 2006, Australia.
| | - Linda L Eddy
- Washington State University, College of Nursing, 14204 NE Salmon Creek Ave, Vancouver, WA 98686, USA.
| | - Ekaterina Burduli
- Washington State University, College of Nursing, 412 E. Spokane Falls Blvd., Spokane, WA 99202-231, USA.
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Hari S, Ruch DA, Bridge JA, Brink FW. The evaluation of emotional maltreatment's effect on family dynamics and suicidal behaviors. CHILD ABUSE & NEGLECT 2023; 144:106351. [PMID: 37515917 DOI: 10.1016/j.chiabu.2023.106351] [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: 09/01/2022] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Emotional maltreatment and poor family functioning are known risks for youth suicide, but few studies have examined these issues as prospective predictors of future attempts. OBJECTIVES Examine family functioning and suicide risk associated with emotional maltreatment in youth with a lifetime history of major depressive disorder (MDD) and the prospective association of emotional maltreatment and family functioning with future suicide attempts. PARTICIPANTS AND SETTING Participants included 321 youth aged 12-15 years (251 with emotional maltreatment; 70 with no emotional maltreatment) recruited from a metropolitan children's hospital from 2011 to 2018. Prospective analyses included 280 youths (221 with emotional maltreatment; 59 without emotional maltreatment). METHODS Semi-structured interviews and self-reports assessed family functioning and suicidal thoughts and behaviors in youth with and without emotional maltreatment at baseline, 6-month, 1-year, and 2-year follow-up. Multivariate analyses examined whether emotional maltreatment predicted future suicide attempts, beyond the effect of prior suicide attempts. RESULTS Emotionally maltreated youth reported significantly lower scores for family adaptability, cohesion, and family alliance, and higher rates of suicidal ideation and suicide attempts, compared to youth without emotional maltreatment. Youth experiencing multiple forms of abuse were significantly more likely to attempt suicide at future timepoints, however this association was attenuated after controlling for prior suicide attempts. CONCLUSION Youth who experienced emotional maltreatment had a significantly higher percentage of past suicidal thoughts and behaviors and significantly less favorable scores for family functioning associated with an increased suicide risk. Findings support family-focused suicide prevention strategies as a promising approach to reduce youth suicide.
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Affiliation(s)
- Shilpa Hari
- The Center for Family Safety and Healing at Nationwide Children's Hospital, 655 East Livingston Avenue, Columbus, OH 43205, USA.
| | - Donna A Ruch
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 444 Butterfly Gardens Drive, Columbus, OH 43215, USA.
| | - Jeffrey A Bridge
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 444 Butterfly Gardens Drive, Columbus, OH 43215, USA; The Ohio State University College of Medicine, 370 W 9(th) Ave, Columbus, OH 43210, USA.
| | - Farah W Brink
- The Center for Family Safety and Healing at Nationwide Children's Hospital, 655 East Livingston Avenue, Columbus, OH 43205, USA; The Ohio State University College of Medicine, 370 W 9(th) Ave, Columbus, OH 43210, USA.
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Joh-Carnella N, Livingston E, Kagan-Cassidy M, Vandermorris A, Smith JN, Lindberg DM, Fallon B. Understanding the roles of the healthcare and child welfare systems in promoting the safety and well-being of children. Front Psychiatry 2023; 14:1195440. [PMID: 37324821 PMCID: PMC10268001 DOI: 10.3389/fpsyt.2023.1195440] [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: 03/28/2023] [Accepted: 05/02/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction The accurate identification and appropriate investigation of child maltreatment is a key priority for promoting the optimal health and development of children. Healthcare providers are often well-positioned professionals to report suspected child abuse and neglect, and, therefore, interact regularly with child welfare workers. Little research has examined the relationship between these two groups of professionals. Methods We interviewed healthcare providers and child welfare workers in order to examine the referral and child welfare investigation processes to understand strengths and identify areas of improvement for future collaboration. Thirteen child welfare workers from child welfare agencies and eight healthcare providers from a pediatric tertiary care hospital in Ontario, Canada were interviewed to meet the study's objectives. Results Healthcare providers spoke about positive experiences making reports, factors impacting reporting decisions, areas for improvement (e.g., difficulties communicating, lack of collaboration, and disruption of therapeutic alliance), training, and professional roles. For interviews with child welfare workers, identified themes included healthcare professionals' perceived expertise and understanding the role of child welfare. Both groups brought up the need for increased collaboration as well as systemic barriers and legacies of harm. Discussion Our core finding was a reported lack of communication between the groups of professionals. Other identified barriers in collaboration included a lack of understanding of each other's roles, hesitation for healthcare providers making reports, as well as legacies of harm and systemic inequities in both institutions. Future research should build on this examination by including the voices of healthcare providers and child welfare workers to identify sustainable solutions for increased collaboration.
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Affiliation(s)
| | - Eliza Livingston
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Miya Kagan-Cassidy
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Ashley Vandermorris
- The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Jennifer N. Smith
- The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Daniel M. Lindberg
- Departments of Emergency Medicine and Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Milidou I, Merrild CH, Frost L, Charles AV, Kjeldsen HC, Søndergaard C. Suspicion of child maltreatment: Knowledge and experiences with mandatory reports to social services among general practitioners in Denmark in 2019-20. CHILD ABUSE & NEGLECT 2023; 139:106132. [PMID: 36924625 DOI: 10.1016/j.chiabu.2023.106132] [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] [Received: 10/10/2022] [Revised: 02/22/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Child maltreatment has many consequences through the lifespan. The general practitioners (GPs) are in longitudinal contact with the family and can play an important role in identifying children in danger and reporting to the social services. OBJECTIVE To explore how GPs manage suspicions of child maltreatment and to investigate potential demographic and geographic differences in reporting practices among Danish GPs. PARTICIPANTS AND SETTING All registered GPs in Denmark retrieved from Medcom, a state-financed non-profit organization. METHODS We mailed a questionnaire to all registered GPs with demographics, experiences, knowledge, and attitudes in the context of child maltreatment. RESULTS We received 1252 completed questionnaires (response rate: 38 %). Most of the participants had suspected child maltreatment during their professional life (90 %) and had made a mandatory report (85 %). More than half had received feedback after the report (56 %) and said that their report led to action (56 %). Most GPs reported feeling confident in dealing with child maltreatment (79 %) and being willing to get involved in case of suspicion (8.9 on a 0-10 scale). We observed no geographical differences in reporting neither across the Danish regions nor among rural and urban practices, but GPs working in single practices made fewer reports to the social services. CONCLUSIONS Participant GPs in this study are aware of their role in child protection, have experiences with mandatory reports, and are willing to get involved. Possible areas for attention include collaboration and support between different settings, especially between GP practice, hospitals, justice sector, and social services.
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Affiliation(s)
- Ioanna Milidou
- Department of Pediatrics and Adolescent Medicine, Gødstrup Hospital, Hospitalsparken 15, 7400 Herning, Denmark.
| | | | - Lise Frost
- Department of Forensic Medicine, Palle Juul-Jensens Blvd. 99, 8200 Aarhus, Aarhus University, Denmark
| | - Annie Vesterby Charles
- Department of Forensic Medicine, Palle Juul-Jensens Blvd. 99, 8200 Aarhus, Aarhus University, Denmark
| | | | - Charlotte Søndergaard
- Department of Pediatrics and Adolescent Medicine, Gødstrup Hospital, Hospitalsparken 15, 7400 Herning, Denmark
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Soneson E, Das S, Burn AM, van Melle M, Anderson JK, Fazel M, Fonagy P, Ford T, Gilbert R, Harron K, Howarth E, Humphrey A, Jones PB, Moore A. Leveraging Administrative Data to Better Understand and Address Child Maltreatment: A Scoping Review of Data Linkage Studies. CHILD MALTREATMENT 2023; 28:176-195. [PMID: 35240863 PMCID: PMC9806482 DOI: 10.1177/10775595221079308] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND This scoping review aimed to overview studies that used administrative data linkage in the context of child maltreatment to improve our understanding of the value that data linkage may confer for policy, practice, and research. METHODS We searched MEDLINE, Embase, PsycINFO, CINAHL, and ERIC electronic databases in June 2019 and May 2020 for studies that linked two or more datasets (at least one of which was administrative in nature) to study child maltreatment. We report findings with numerical and narrative summary. RESULTS We included 121 studies, mainly from the United States or Australia and published in the past decade. Data came primarily from social services and health sectors, and linkage processes and data quality were often not described in sufficient detail to align with current reporting guidelines. Most studies were descriptive in nature and research questions addressed fell under eight themes: descriptive epidemiology, risk factors, outcomes, intergenerational transmission, predictive modelling, intervention/service evaluation, multi-sector involvement, and methodological considerations/advancements. CONCLUSIONS Included studies demonstrated the wide variety of ways in which data linkage can contribute to the public health response to child maltreatment. However, how research using linked data can be translated into effective service development and monitoring, or targeting of interventions, is underexplored in terms of privacy protection, ethics and governance, data quality, and evidence of effectiveness.
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Affiliation(s)
- Emma Soneson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Shruti Das
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Anne-Marie Burn
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Marije van Melle
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Mina Fazel
- Department of Psychiatry, Warneford Hospital, University of Oxford, Headington, Oxford, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Ruth Gilbert
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Katie Harron
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Emma Howarth
- School of Psychology, University of East London, London, UK
| | - Ayla Humphrey
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Anna Moore
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Eaves T, Roney L, Neitlich J, Knapik K, Lapointe K. A-TEAM: An Interprofessional Approach to Mandated Reporting in the Hospital Setting. J Pediatr Health Care 2023; 37:e1-e5. [PMID: 36682970 DOI: 10.1016/j.pedhc.2022.12.008] [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: 10/06/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/21/2023]
Abstract
Reporting suspected child maltreatment in pediatric settings presents unique challenges. Variation in mandated reporter training may lead to discomfort and emotional dysregulation. Failure to collaborate inter-professionally potentially results in suboptimal care for vulnerable children and families. A-TEAM promotes awareness, transparency, empathy, a nonjudgmental strategy, and management by an interprofessional team when referring patients for child protective services evaluation. A faculty trained in pediatric trauma nursing led the development of A-TEAM. Integrating nursing and social work expertise protects the integrity of family-centered patient care. The A-TEAM approach may be a valuable contribution to the continuing education of pediatric health care professionals.
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Affiliation(s)
- Tanika Eaves
- Tanika Eaves, Assistant Professor of Social Work, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Linda Roney, Associate Professor of Nursing, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Joshua Neitlich, Director of Field Education, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Katherine Knapik, Labor and Delivery Nurse, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Kayla Lapointe, MSW Candidate, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT..
| | - Linda Roney
- Tanika Eaves, Assistant Professor of Social Work, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Linda Roney, Associate Professor of Nursing, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Joshua Neitlich, Director of Field Education, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Katherine Knapik, Labor and Delivery Nurse, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Kayla Lapointe, MSW Candidate, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT
| | - Joshua Neitlich
- Tanika Eaves, Assistant Professor of Social Work, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Linda Roney, Associate Professor of Nursing, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Joshua Neitlich, Director of Field Education, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Katherine Knapik, Labor and Delivery Nurse, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Kayla Lapointe, MSW Candidate, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT
| | - Katherine Knapik
- Tanika Eaves, Assistant Professor of Social Work, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Linda Roney, Associate Professor of Nursing, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Joshua Neitlich, Director of Field Education, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Katherine Knapik, Labor and Delivery Nurse, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Kayla Lapointe, MSW Candidate, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT
| | - Kayla Lapointe
- Tanika Eaves, Assistant Professor of Social Work, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Linda Roney, Associate Professor of Nursing, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Joshua Neitlich, Director of Field Education, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Katherine Knapik, Labor and Delivery Nurse, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT.; Kayla Lapointe, MSW Candidate, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT
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20
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Liu Y, Shepherd-Banigan M, Evans KE, Stilwell L, Terrell L, Hurst JH, Gifford EJ. Do children evaluated for maltreatment have higher subsequent emergency department and inpatient care utilization compared to a general pediatric sample? CHILD ABUSE & NEGLECT 2022; 134:105938. [PMID: 36330904 PMCID: PMC11025450 DOI: 10.1016/j.chiabu.2022.105938] [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: 06/10/2022] [Revised: 09/16/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Child maltreatment leads to substantial adverse health outcomes, but little is known about acute health care utilization patterns after children are evaluated for a concern of maltreatment at a child abuse and neglect medical evaluation clinic. OBJECTIVE To quantify the association of having a child maltreatment evaluation with subsequent acute health care utilization among children from birth to age three. PARTICIPANTS AND SETTING Children who received a maltreatment evaluation (N = 367) at a child abuse and neglect subspecialty clinic in an academic health system in the United States and the general pediatric population (N = 21,231). METHODS We conducted a retrospective cohort study that compared acute health care utilization over 18 months between the two samples using data from electronic health records. Outcomes were time to first emergency department (ED) visit or inpatient hospitalization, maltreatment-related ED use or inpatient hospitalization, and ED use or inpatient hospitalization for ambulatory care sensitive conditions (ACSCs). Multilevel survival analyses were performed. RESULTS Children who received a maltreatment evaluation had an increased hazard for a subsequent ED visit or inpatient hospitalization (hazard ratio [HR]: 1.3, 95 % confidence interval [CI]: 1.1, 1.5) and a maltreatment-related visit (HR: 4.4, 95 % CI: 2.3, 8.2) relative to the general pediatric population. A maltreatment evaluation was not associated with a higher hazard of health care use for ACSCs (HR: 1.0, 95 % CI: 0.7, 1.3). CONCLUSION This work can inform targeted anticipatory guidance to aid high-risk families in preventing future harm or minimizing complications from previous maltreatment.
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Affiliation(s)
- Yuerong Liu
- Center for Child and Family Policy, Duke University, Durham, NC, United States of America; Sanford School of Public Policy, Duke University, Durham, NC, United States of America.
| | - Megan Shepherd-Banigan
- Margolis Center for Health Policy, Duke University, Durham, NC, United States of America; Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America
| | - Kelly E Evans
- Center for Child and Family Policy, Duke University, Durham, NC, United States of America; Sanford School of Public Policy, Duke University, Durham, NC, United States of America
| | - Laura Stilwell
- Sanford School of Public Policy, Duke University, Durham, NC, United States of America; School of Medicine, Duke University, Durham, NC, United States of America
| | - Lindsay Terrell
- Department of Pediatrics, School of Medicine, Duke University, Durham, NC, United States of America; Department of Pediatrics, Duke Children's Primary Care, Duke University Medical Center, Durham, NC, United States of America
| | - Jillian H Hurst
- Department of Pediatrics, Division of Infectious Diseases, Duke University, Durham, NC, United States of America; Children's Health and Discovery Initiative, Duke University, Durham, NC, United States of America
| | - Elizabeth J Gifford
- Center for Child and Family Policy, Duke University, Durham, NC, United States of America; Sanford School of Public Policy, Duke University, Durham, NC, United States of America; Margolis Center for Health Policy, Duke University, Durham, NC, United States of America; Department of Pediatrics, School of Medicine, Duke University, Durham, NC, United States of America; Children's Health and Discovery Initiative, Duke University, Durham, NC, United States of America
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Kuruppu J, Humphreys C, McKibbin G, Hegarty K. Tensions in the therapeutic relationship: emotional labour in the response to child abuse and neglect in primary healthcare. BMC PRIMARY CARE 2022; 23:48. [PMID: 35300610 PMCID: PMC8932236 DOI: 10.1186/s12875-022-01661-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/07/2022] [Indexed: 11/15/2022]
Abstract
Background Child abuse and neglect (child abuse) is a prevalent public health issue linked to survivors experiencing a higher risk of health issues such as obesity, heart disease and major depression. Given the significant impact of child abuse on health, general practitioners (GPs) and primary care nurses (nurses) are well-placed to respond to child abuse. However, research shows that responding to child abuse is difficult for health practitioners, especially the act of reporting child abuse. The present study aimed to understand how GPs and nurses experience the response to child abuse in primary healthcare. Methods This study employed qualitative methods. Twenty-six in-depth individual and group interviews were conducted with 30 GPs and nurses. The interviews were audio recorded with consent, transcribed verbatim and thematically analysed. Results The participants were mostly metropolitan-based female GPs. Participants were sampled from two settings: private general practice and community health; and Doctors in Secondary Schools, a program that places GPs and nurses in high schools. Thematic analysis generated four themes: blowing trust out of the water; riding the reaction wave; opening a hornet’s nest; and battling emotions. Participants felt that, in considering child abuse, they were betraying the trust of the therapeutic relationship and thus, had to manage their patients’ reactions to preserve the therapeutic relationship. They used strategies that created shifts in perception in both themselves and their patients to help maintain the therapeutic relationship. Participants often felt that they had to compromise their professional code of ethics to fulfil their mandatory reporting obligations. Thus, they experienced internal emotional battles when responding which led to some experiencing burnout or vicarious trauma and others resilience. This complex interplay of relationship and emotional management was placed in the context of emotional labour theory. We contend that our participants undertook emotional labour across three levels: internal, organisational and systemic. Conclusions We conclude that the emotional labour exerted in the response to child abuse can be diminished by: developing strategies for therapeutic relationship management; undertaking an internal, organisational and systemic values assessment; and facilitating communication between health professionals and the child protection system.
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McTavish JR, Chandra PS, Stewart DE, Herrman H, MacMillan HL. Child Maltreatment and Intimate Partner Violence in Mental Health Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315672. [PMID: 36497747 PMCID: PMC9735990 DOI: 10.3390/ijerph192315672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 06/01/2023]
Abstract
Intimate partner violence (IPV) and child maltreatment (physical, emotional, sexual abuse, neglect, and children's exposure to IPV) are two of the most common types of family violence; they are associated with a broad range of health consequences. We summarize evidence addressing the need for safe and culturally-informed clinical responses to child maltreatment and IPV, focusing on mental health settings. This considers clinical features of child maltreatment and IPV; applications of rights-based and trauma- and violence-informed care; how to ask about potential experiences of violence; safe responses to disclosures; assessment and interventions that include referral networks and resources developed in partnership with multidisciplinary and community actors; and the need for policy and practice frameworks, appropriate training and continuing professional development provisions and resources for mental health providers. Principles for a common approach to recognizing and safely responding to child maltreatment and IPV are discussed, recognizing the needs in well-resourced and scarce resource settings, and for marginalized groups in any setting.
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Affiliation(s)
- Jill R. McTavish
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington St. North, Hamilton, ON L8L 8E7, Canada
| | - Prabha S. Chandra
- NIMHANS Hospital, Hosur Rd, near Bangalore Milk Dairy, Hombegowda Nagar, Bengaluru 560029, Karnataka, India
| | - Donna E. Stewart
- Centre for Mental Health, University Health Network, 200 Elizabeth St, 7EN229, Toronto, ON M5G 2C4, Canada
| | - Helen Herrman
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
- Orygen, Parkville, VIC 3052, Australia
| | - Harriet L. MacMillan
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington St. North, Hamilton, ON L8L 8E7, Canada
- Department of Pediatrics, McMaster University, Health Sciences Centre 3A, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
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Alfandari R, Enosh G, Nouman H, Dolev L, Dascal-Weichhendler H. Judgements of physicians, nurses, and social workers regarding suspected Child maltreatment in community health care services. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4782-e4792. [PMID: 35701894 DOI: 10.1111/hsc.13885] [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: 01/23/2022] [Revised: 05/11/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
This study investigated how physicians, nurses, and social workers in community health care services make judgements about possible child maltreatment in ambiguous situations. We examined the influences of social biases (i.e., perceptions linking ethnicity, gender, and family socioeconomic status to child maltreatment) and belonging to distinctive occupational groups (i.e., physicians, nurses, and social workers) on professionals' assessment of suspected child maltreatment, intention to consult with others, and reporting. We used an experimental survey design including vignettes presenting a child's history inspired by real-life clinical cases. Data were collected from 397 health care professionals-170 physicians, 179 nurses, and 48 social workers-employed at community health care clinics in northern Israel. Findings show that the child's gender and family socioeconomic status had significant effects on assessment of possible child maltreatment. Also, professionals' occupational group had significant effects on assessment of child maltreatment and intention to pursue consultation. Another key finding was the significant effects of judgements about child maltreatment assessment, consultation, and reporting on one another. The study reinforces efforts to improve health care professionals' management of suspected child maltreatment that include the development of clinical decision support systems that use routinely collected electronic medical record data.
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Affiliation(s)
- Ravit Alfandari
- Post-doctoral Researcher, School of Social Work, University of Haifa, Haifa, Israel
| | - Guy Enosh
- Professor of Social Work, School of Social Work, University of Haifa, Haifa, Israel
| | - Hani Nouman
- Lecturer, School of Social Work, University of Haifa, Haifa, Israel
| | | | - Hagit Dascal-Weichhendler
- Senior Clinical Lecturer (Educator), The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
- Department of Family Medicine, Clalit Health Services, Haifa, Israel
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Cooley DT, Jackson Y, Stoolmiller M. Discrepancies in youth self-report and case file report of maltreatment and association with internalizing and externalizing symptoms. CHILD ABUSE & NEGLECT 2022; 133:105845. [PMID: 35987048 DOI: 10.1016/j.chiabu.2022.105845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 07/11/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childhood maltreatment is a potential risk factor for the later development of psychopathology (Jaffee, 2017). However, there is no gold standard for identifying victims of child maltreatment, and when multiple informants - such as case files and youth self-report - are used, these sources often disagree (Cooley & Jackson, 2022). OBJECTIVE The current study aimed to explore discrepancies between youth self-report and case file report of maltreatment and examine how these discrepancies related to internalizing and externalizing symptoms. PARTICIPANTS/SETTING Participants were 470 youth living in foster care between the ages of 8 and 18 and their caregivers. METHODS Latent class analysis (LCA) was used to create novel groups based on informant discrepancies. RESULTS Agreement between informants was in the poor-to-fair agreement range for all types of maltreatment. Latent class analysis identified a 3-class solution with significant group differences on both externalizing (Χ2 (2, N = 470) = 6.16, p = 0.05) and internalizing symptoms (Χ2 (2, N = 470) = 6.10, p = 0.05). Specifically, those in the "self-report only" class had significantly higher symptoms than those in the "neither informant/case file only" class for both internalizing and externalizing behavior. CONCLUSIONS Case files and youth self-report of maltreatment are discrepant. Youth self-report of maltreatment history may be more closely linked to psychopathology than case file report of maltreatment. Researchers and practitioners should look to youth self-report rather than relying solely on case files when determining risk for psychopathology.
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Affiliation(s)
- Daryl T Cooley
- Department of Psychology, The Pennsylvania State University, 140 Moore Building, University Park, PA 16802, USA.
| | - Yo Jackson
- Department of Psychology, The Pennsylvania State University, 140 Moore Building, University Park, PA 16802, USA
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McTavish JR, McKee C, MacMillan HL. Foster children's perspectives on participation in child welfare processes: A meta-synthesis of qualitative studies. PLoS One 2022; 17:e0275784. [PMID: 36215294 PMCID: PMC9550086 DOI: 10.1371/journal.pone.0275784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
The objective of this meta-synthesis was to systematically synthesise qualitative research that explores foster children's perspectives on participation in child welfare processes. Searches were conducted in Medline (OVID), Embase, PsycINFO, and Social Science Citation Index. Children in non-kinship foster care in any setting (high-income, middle-income, low-income countries) who self-reported their experiences of care (removal from home, foster family processes, placement breakdown) were eligible for inclusion. Selected studies took place in 11 high-income countries. A total of 8436 citations were identified and 25 articles were included in this meta-synthesis. Studies summarized the views of 376 children. Children had been in foster care between two weeks and 17 years. Findings synthesize 'facets' of children's participation (e.g., being asked vs making decisions), as well as children's perceived barriers and facilitators to participation. A main priority for children was the quality of their relationships, especially in terms of values (e.g., fairness, honesty, inclusivity). No one way of participating in child welfare processes is better than another, as some children more clearly expressed a desire for passive listening roles and others indicated a desire for active roles in decision-making. However, meaningful adults in foster children's lives have a responsibility to act in a way that strengthens the emphasis on children's needs and voices.
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Affiliation(s)
- Jill R. McTavish
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,* E-mail:
| | - Christine McKee
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Harriet L. MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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Witte S, López López M, Baldwin H, Biehal N, Kindler H. Child maltreatment investigations: Comparing children, families, and reasons for referral in three European countries. CHILD ABUSE & NEGLECT 2022; 132:105805. [PMID: 35964367 DOI: 10.1016/j.chiabu.2022.105805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/15/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Almost all countries have developed measures to ensure that children do not suffer from violence in their families. However, the legal framework, definitions of maltreatment, and institutional structures differ. Whereas in other areas of social policy comparative research is very common, child protection research falls behind. RESEARCH QUESTIONS The article examines the differences between cases referred to local child and youth welfare authorities due to concerns about abuse or neglect in Germany, England and the Netherlands, comparing the characteristics of the child, the family, the person reporting the suspected maltreatment, and the type of maltreatment. METHOD 1207 case files on children investigated due to suspected child maltreatment from the Netherlands, England, and Germany were analyzed using a standardized coding scheme. RESULTS The family backgrounds of the children reported differed substantially, with more lone parents in England and more children living in two households in the Netherlands. The persons and institutions reporting their concerns to the local child and youth welfare authorities also differed, with more reports from children and family members in Germany and more from health services in England. In England, physical abuse, sexual abuse, and sexual exploitation were more frequently the reason for referral than in the Netherlands and Germany. DISCUSSION Differences between countries can partially be explained based on differences in policies and relations of other systems to the child protection system.
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Affiliation(s)
| | | | - Helen Baldwin
- Department of Social Policy and Social Work, University of York, England, United Kingdom
| | - Nina Biehal
- Department of Social Policy and Social Work, University of York, England, United Kingdom
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Kimber M, Vanstone M, Dimitropoulos G, Collin-Vézina D, Stewart D. Researching the Impact of Service provider Education (RISE) Project - a multiphase mixed methods protocol to evaluate implementation acceptability and feasibility. Pilot Feasibility Stud 2022; 8:135. [PMID: 35780156 PMCID: PMC9250197 DOI: 10.1186/s40814-022-01096-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health and social service providers receive limited education on recognizing and responding to family violence. With adequate education, providers could be prepared to identify individuals subjected to family violence and help reduce the risk of associated impairment. Informed by the Active Implementation Frameworks, our research will determine the scope of strategies needed for the uptake and sustainability of educational interventions focused on family violence for providers. It will also determine the acceptability, feasibility, and proof-of-concept for a new educational intervention, called VEGA (Violence, Evidence, Guidance, Action), for developing and improving primary care provider knowledge and skills in family violence. METHODS This paper details the protocol for the Researching the Impact of Service provider Education (RISE) Project. The RISE Project follows a sequential multiphase mixed method research design; qualitative and quantitative data are being collected and integrated over three conceptually and methodologically linked research phases. Activities primarily occur in Ontario, Alberta, and Quebec. Phase 1 uses a sequential exploratory mixed method research design to characterize the scope and salience of learning and implementation needs and preferences for family violence education. Phase 2 will use an embedded mixed method research design to determine whether VEGA technology supports providers to achieve their family violence learning goals with effectiveness, efficiency, and satisfaction. Phase 3 will use a concurrent mixed method research design to determine acceptability, feasibility, and proof-of-concept for evaluating whether VEGA improves primary care providers' knowledge and skills in family violence. This final phase will provide information on implementation strategies for family violence education in the "real world." It will also generate data on provider recruitment, retention, and data completeness, as well as exploratory estimates of the effect for provider outcome measures proposed for a randomized controlled trial. DISCUSSION The RISE Project comprehensively integrates an implementation approach to improve family violence education for the health and social service professions. It will provide important information about factors that could influence the uptake and effectiveness of a health profession's educational intervention into the real world, as well as provide foundational evidence concerning the tenability of using a randomized controlled trial to evaluate the impact of VEGA in primary care settings.
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Affiliation(s)
- Melissa Kimber
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neuroscience, McMaster University, BAHT 132, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada. .,Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St West, Hamilton, ON, Canada.
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, 1280 Main St West, Hamilton, ON, Canada
| | - Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, MacKimmie Tower 413, 2500 University Dr NW, Calgary, AB, Canada
| | - Delphine Collin-Vézina
- School of Social Work, McGill University, 3506 Rue University #300, Montréal, QC, Canada.,Department of Pediatrics, McGill University, 1001 Decarie Blvd, Montréal, QC, Canada
| | - Donna Stewart
- Centre for Mental Health, University of Toronto and University Health Network, EN-7-229, 200 Elizabeth Street, Toronto, ON, Canada
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Pilla NI, Nasreddine A, Christie KJ, Hennrikus WL. Rate of orthopedic resident and medical student recognition of nonaccidental trauma: a pilot study. J Pediatr Orthop B 2022; 31:407-413. [PMID: 34985011 DOI: 10.1097/bpb.0000000000000948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to evaluate the efficacy and accuracy of mandated reporters to identify child abuse in children presenting with fractures. An Institutional Review Board approved survey-based study between January 2017 and December 2017 was conducted at a tertiary care academic medical center. 10 cases were combined to create one survey. Each case had information on presentation history, radiographic data, and social history. This study assesses the ability of 13 orthopedic residents and 11 medical students to diagnose child abuse. Participants had the option to explain their reasoning for a given case. To evaluate decision-making reasoning, we split responses into three cohorts, encompassing objective evidence, subjective evidence, or social evidence. Twenty-four participants completed the survey; 203 out of 240 (85%) included the rationale for the diagnosis of child abuse. The observed diagnostic odds ratio was 0.83 for medical students, 0.93 for junior residents, and 0.96 for senior residents. There was no statistically significant difference in diagnosing child abuse between a participant's level of experience, age, or whether participants had their own children. Participants who used more than one source of evidence were significantly more likely to make the correct diagnosis (P = 0.013). Participant decisions were no more accurate than a coin toss. The use of several data sources led to increased diagnostic accuracy. There is low accuracy in correctly diagnosing child abuse in our cohort of mandated reporters. Participants who highlighted using several sources of evidence were more likely to diagnose child abuse accurately.
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Affiliation(s)
- Nicholas I Pilla
- Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
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Making Sense of Mandatory Reporting: A Qualitative Study of Reporting Practices from the Perspectives of Schools and Child Welfare Services in Sweden. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11070273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Schools play an important role in ensuring the well-being of children, although the process of mandatory reporting of concern for children is not widely understood. This qualitative focus group study investigated the process from the perspectives of school and child welfare service professionals. Using theories of human service organizations and professional discretion, we analyzed viewpoints on an individual duty being handled by an organization. We investigated the expectations that a report be simultaneously simple and value-free, while providing depth and clear examples of concerns. Finally, we investigated the views of the supportive and protective functions supposedly underlying the duty to report. The results indicated problems associated with a collective reporting process. Ambiguity in how information in a report is communicated may also contribute to a more problematic reporting process from schools and then in interpretations and the follow up reports made by social workers.
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Piersiak HA, Levi BH, Humphreys KL. Statutory Threshold Wording is Associated with Child Maltreatment Reporting. CHILD MALTREATMENT 2022:10775595221092961. [PMID: 35587785 DOI: 10.1177/10775595221092961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The purpose of this study was to determine whether statutory wording of child maltreatment mandated reporting legislation was associated with reporting patterns and substantiation of abuse across U.S. states and territories. Annual state averages for total referrals, referrals screened-out, referrals screened-in, referrals substantiated, and child population (all children in the U.S.; annual average = 74,457,928) were obtained from the 2010-2017 Child Maltreatment Reports. Odds ratios were calculated for: (1) two major statutory language frameworks (suspicion versus belief), (2) seven sub-categories (e.g., suspect, reasonably believe, etc.), and (3) universal mandated reporting (yes versus no). Use of suspicion (versus belief) was associated with higher rates of referrals made (OR = 1.13) and screened-in (OR = 1.13), but lower substantiation rates (OR = .92). States using universal mandated reporting (versus those who did not) had slightly lower rates of referrals (OR = .99), but higher rates of referrals screened-in (OR = 1.16) and substantiated (OR = 1.06). Differences in statutory wording are associated with variability in reports, suggesting the possibility that statutory wording is one factor involved with these differences. However, future research is needed to explore alternative contributing factors and/or explanations.
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Affiliation(s)
- Hannah A Piersiak
- Department of Psychology and Human Development, 5718Vanderbilt University, Nashville, TN, USA
| | - Benjamin H Levi
- Departments of Humanities and Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, 5718Vanderbilt University, Nashville, TN, USA
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Laupacis M, Acai A, MacMillan HL, Vanstone M, Stewart D, Dimitropoulos G, Kimber M. A Qualitative Description of Resident Physicians' Understanding of Child Maltreatment: Impacts, Recognition, and Response. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3319. [PMID: 35329006 PMCID: PMC8949331 DOI: 10.3390/ijerph19063319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/22/2022]
Abstract
Child maltreatment (CM) is a public health problem with devastating effects on individuals, families, and communities. Resident physicians have varied formal education in CM, and report feeling inadequately trained in identifying and responding to CM. The purpose of this study is to explore residents' understanding of the impacts of CM, and their perceptions of their role in recognizing and responding to CM to better understand their educational needs. This study analyzed qualitative data obtained from a larger project on family violence education. Twenty-nine resident physicians enrolled in pediatric, family medicine, emergency medicine, obstetrics and gynecology, and psychiatry training programs in Alberta, Ontario, and Québec participated in semi-structured interviews to elicit their ideas, experiences, and educational needs relating to CM. Conventional (inductive) content analysis guided the development of codes and categories. Residents had thorough knowledge about the impacts of CM and their duty to recognize CM, but there was less consistency in how residents understood their role in responding to CM. Residents identified the need for more education about recognizing and responding to CM, and the need for educational content to be responsive to training, patient and family factors, and systemic issues. Despite knowledge about the impacts of CM and laws pertaining to mandated reporting, residents reported challenges with responding to concerns of CM. Findings of this study emphasize the need for better training in response to CM. Future educational interventions should consider a multidisciplinary, experiential approach.
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Affiliation(s)
- Megan Laupacis
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada; (M.L.); (H.L.M.)
- McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
| | - Anita Acai
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada;
| | - Harriet L. MacMillan
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada; (M.L.); (H.L.M.)
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada;
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, ON L8S 4K1, Canada;
| | - Donna Stewart
- Centre for Mental Health, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada;
| | - Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Melissa Kimber
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada;
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
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Stoklosa H, Alhajji L, Finch L, Williams S, Prakash J, Sfakianaki AK, Duthely LM, Potter JE. "Because the resources aren't there, then we fail. We fail as a society": A Qualitative Analysis of Human Trafficking Provider Perceptions of Child Welfare Involvement among Trafficked Mothers. Matern Child Health J 2022; 26:623-631. [PMID: 35015174 DOI: 10.1007/s10995-021-03342-w] [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] [Accepted: 11/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is understood about child welfare involvement (CWI) in cases where the birth mother has experienced human trafficking. OBJECTIVES The aim of this study was to explore provider perceptions of the impact of CWI for the trafficked mother. METHODS Participants were selected among providers caring for trafficked birth mothers. Semi-structured interviews were conducted with providers and qualitative content analysis was conducted. RESULTS Interviewees reported reasons for CWI, positive and negative impacts of CWI and provided recommendations for systems improvement. CONCLUSION FOR PRACTICE Recommendations from this exploratory study include mechanisms to support trafficked mothers, train hospital social workers, and systems change. During the prenatal period, strategies to support the trafficked mother may include addressing gaps in social determinants of health, ensuring appropriate medical and mental health care, early screening and referral to substance use treatment services, enhancing community support, and working to develop safety plans for survivors and their families. Enhanced engagement of social workers and all providers to improve understanding of the unique complexity of trafficked mothers is needed. Education should include an understanding that judgement of a caretaker's ability to parent should be current and holistic and not reflexive based on history in the electronic medical record. An exploration of the child welfare system itself should also be undertaken to identify and modify discriminatory laws and policies. Finally, efforts to address social determinants of health in the community and enhance the trauma-informed nature of child welfare referrals could improve the lives of trafficked mothers.
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Affiliation(s)
- Hanni Stoklosa
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
- HEAL Trafficking, Los Angeles, USA.
| | - Lujain Alhajji
- Department of Psychiatry & Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA
| | - Lindsey Finch
- Jackson Health System, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA
| | - Sacha Williams
- Johns Hopkins All Children's Hospital, St. Petersburg, USA
| | | | - Anna K Sfakianaki
- Section of Maternal-Fetal Medicine, Gynecology and Reproductive Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA
| | - Lunthita M Duthely
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA
| | - JoNell E Potter
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA
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Will DD, Whiting TL. Animal protection reporting requirements of Canadian veterinarians: Example case. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2022; 63:301-306. [PMID: 35237019 PMCID: PMC8842380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Dennis D Will
- 223 Thain Way, Saskatoon, Saskatchewan S7K 6T4 (Will); 191 Lawndale Avenue, Winnipeg, Manitoba R2H 1T4 (Whiting)
| | - Terry L Whiting
- 223 Thain Way, Saskatoon, Saskatchewan S7K 6T4 (Will); 191 Lawndale Avenue, Winnipeg, Manitoba R2H 1T4 (Whiting)
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Mandatory Reporting “will Paralyze People” or “Without it, People Would not Report”: Understanding Perspectives from Within the Child Protection System. CHILD & YOUTH CARE FORUM 2022. [DOI: 10.1007/s10566-022-09676-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dimitropoulos G, Lindenbach D, Devoe DJ, Gunn E, Cullen O, Bhattarai A, Kuntz J, Binford W, Patten SB, Arnold PD. Experiences of Canadian mental health providers in identifying and responding to online and in-person sexual abuse and exploitation of their child and adolescent clients. CHILD ABUSE & NEGLECT 2022; 124:105448. [PMID: 34952461 DOI: 10.1016/j.chiabu.2021.105448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Sex offenders often use the internet to communicate with children to facilitate in-person sexual abuse or to create and distribute sexual images of children. Mental healthcare providers are a major source of referrals to child welfare authorities and are well-positioned to identify sexual exploitation. OBJECTIVE This study investigated the perceived ability of mental healthcare workers to recognize and respond to concerns about online and in-person sexual exploitation of their pediatric clients. PARTICIPANTS AND SETTING The authors administered a cross-sectional survey to 209 mental healthcare providers within the public health system of Alberta, Canada. METHODS The survey contained four sections related to sexual exploitation: two of which can take place online or in-person (grooming and sexual abuse) and two of which require the internet or a digital device (luring and sexual image distribution). Each section asked whether the mental healthcare provider had experience working with clients affected by these concerns, what barriers they encounter, how confident they are in their abilities and whether they have formal training in a topic. RESULTS The vast majority of participants (83%) worked with a client impacted by grooming, luring, sexual abuse or sexual image distribution in the last year. Participants reported more training, more confidence and fewer barriers when identifying and responding to sexual abuse as compared to grooming, luring or sexual image distribution. CONCLUSIONS There is a need to improve mental health providers understanding of how technology is being utilized to exploit children, so that they can respond effectively to protect their clients.
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Affiliation(s)
- Gina Dimitropoulos
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Faculty of Social Work, University of Calgary, MLT 301, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada.
| | - David Lindenbach
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - Daniel J Devoe
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D11, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - Emily Gunn
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Faculty of Social Work, University of Calgary, MLT 301, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
| | - Olivia Cullen
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Faculty of Social Work, University of Calgary, MLT 301, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
| | - Asmita Bhattarai
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D11, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - Jennifer Kuntz
- Alberta Health Services, Child and Adolescent Addiction Mental Health & Psychiatry Program, Calgary Zone, 10301 Southport Rd SW, Calgary, AB T2W 1S7, Canada
| | - Warren Binford
- School of Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Mail Stop B065, Aurora, CO 80045, United States
| | - Scott B Patten
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D11, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - Paul D Arnold
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
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Fallon B, Filippelli J, Joh-Carnella N, Collin-Vézina D, Lefebvre R, Moody B, Trocmé N, Quinn A. An Examination of Past Trends in School Reports to Child Welfare: Considerations for Reported Child Maltreatment. CHILD MALTREATMENT 2022; 27:25-32. [PMID: 33291968 DOI: 10.1177/1077559520979588] [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: 06/12/2023]
Abstract
This study examines whether increased interaction and observation of young children by school professionals leads to an increase in school-based reports to child welfare authorities and in the identification of child maltreatment victims. Comparing provincial-level data collected before and after full-day kindergarten implementation in Ontario, a doubling in rates of school-referred investigations involving 4- and 5-year-old children was found. There was no significant difference in the rates of maltreatment substantiation, service referrals made or transfers to ongoing services, but the rate of child functioning concerns noted in these investigations tripled. The findings suggest there are differences in how the school and child welfare systems define and respond to suspected child maltreatment. Implications for practice, policy and research are explored.
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Affiliation(s)
- Barbara Fallon
- Factor-Inwentash Faculty of Social Work, 7938University of Toronto, Ontario, Canada
| | - Joanne Filippelli
- Factor-Inwentash Faculty of Social Work, 7938University of Toronto, Ontario, Canada
| | | | | | - Rachael Lefebvre
- Factor-Inwentash Faculty of Social Work, 7938University of Toronto, Ontario, Canada
| | - Brenda Moody
- Peel Children's Aid Society, Mississauga, Ontario, Canada
| | - Nico Trocmé
- School of Social Work, 5620McGill University, Montreal, Quebec, Canada
| | - Ashley Quinn
- Factor-Inwentash Faculty of Social Work, 7938University of Toronto, Ontario, Canada
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Marcellus L, Tonmyr L, Jack SM, Gonzalez A, Sheenan D, Varcoe C, Kurtz Landy C, Campbell K, Catherine N, MacMillan H, Waddell C. Public health nurses' perceptions of their interactions with child protection services when supporting socioeconomically disadvantaged young mothers in British Columbia, Canada. CHILD ABUSE & NEGLECT 2022; 124:105426. [PMID: 34995927 DOI: 10.1016/j.chiabu.2021.105426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/10/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Children of girls and young women experiencing socioeconomic disadvantage are at risk of maltreatment and associated health and developmental problems. Nurse-Family Partnership (NFP) is an early intervention program designed to improve child and maternal health outcomes. The effectiveness of NFP is being evaluated in British Columbia (BC) through a randomized controlled trial, augmented by a process evaluation to identify influences on how NFP was implemented. OBJECTIVE To describe how public health nurses providing NFP perceived their interactions with child protection professionals. PARTICIPANTS AND SETTING Forty-seven public health nurses across BC. METHODS The principles of interpretive description informed the qualitative component of the process evaluation. Data from interviews and focus groups were analyzed using the framework analysis approach. A thematic framework was generated through processes of coding, charting and mapping, with a focus on organizational and systems influences. RESULTS Nurses' practice in supporting families often involved engagement with child protection services. Four themes about the nature of this work were identified: 1) developing a deeper understanding of the disciplinary perspectives of child protection, 2) striving for strengthened collaboration, 3) navigating change and uncertainty, and 4) responding to family and community complexity. CONCLUSIONS Participants valued the contribution of child protection professionals and expressed willingness to collaborate to support families. However, collaboration was constrained by multiple structural barriers. Collaborative models offer possibilities for integrated practice, although can be difficult to implement within current health and child protection systems and child protection regulatory contexts.
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Affiliation(s)
- Lenora Marcellus
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada.
| | - Lil Tonmyr
- Public Health Agency of Canada, Family Violence Surveillance, 785 Carling, AL 6807B, Ottawa, ON K1A 0K9, Canada.
| | - Susan M Jack
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada.
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada.
| | - Debbie Sheenan
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, 515 West Hastings Street, Vancouver, BC V6B 5K3, Canada
| | - Colleen Varcoe
- School of Nursing, T201-2211 Wesbrook Mall, University of British Columbia, Vancouver, BC V6T 2B5, Canada.
| | | | - Karen Campbell
- School of Nursing, Western University, London, ON N6A 3K7, Canada.
| | - Nicole Catherine
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, 515 West Hastings Street, Vancouver, BC V6B 5K3, Canada.
| | - Harriet MacMillan
- Offord Centre for Child Studies, McMaster Innovation Park, Suite 201A, McMaster University, 1280 Main St. West, Hamilton, ON L8S 4K1, Canada.
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, 515 West Hastings Street, Vancouver, BC V6B 5K3, Canada.
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Zafar N, Naeem M, Zehra A. Professional team response to violence against children: From experts to teamwork. CHILD ABUSE & NEGLECT 2021; 119:104777. [PMID: 33139069 DOI: 10.1016/j.chiabu.2020.104777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Prevention and management of violence against children requires a multidisciplinary approach. Countries and regions tackle this problem according to their understanding and capacity, and therefore these teams work differently in different countries and regions. OBJECTIVES Current study is a bird's eye view looking at the response to violence against children through exploring multidisciplinary approaches and challenges in child protection in high, upper-middle, and lower-middle-income countries. PARTICIPANTS Participants for this study were selected through purposive sampling from eleven countries, one key informant from each country (N = 11). METHODS Current study is qualitative in nature and phenomenological design was used. Key informants were approached through email, and semi-structured online interviews were conducted. Thematic analysis was used to analyze the data and several themes emerged. RESULTS Capacity building systems are established in upper-middle and high-income countries, whereas lower-income countries are struggling with these systems, the Philippines having a better structured system. The process of child protection services is mostly similar except the availability of multidisciplinary teams, which lacks in lower-middle and even in upper-middle-income countries. These teams function relatively well in high-income countries although the lead role in these teams differs from country to country. There are many challenges in managing these teams in low-middle income countries. Child protection systems are also reasonably well established in upper and upper-middle-income countries whereas gaps are visible between policies and implementation in lower-middle-income countries. CONCLUSION It is the responsibility of each country to protect children as per their commitment to SDGs. Although the functioning of multidisciplinary teams seems better in high and upper-middle countries, the low-middle income countries are trying to combat violence against children according to their priorities, some are doing better than others.
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Affiliation(s)
- Naeem Zafar
- Protection and Help of Children Against Abuse and Neglect (PAHCHAAN), Pakistan; Child Rights Department, The University of Lahore, Pakistan.
| | - Mehek Naeem
- Protection and Help of Children Against Abuse and Neglect (PAHCHAAN), Pakistan; Child Rights Department, The University of Lahore, Pakistan.
| | - Andleeb Zehra
- Child Rights Department, The University of Lahore, Pakistan.
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Enosh G, Alfandari R, Nouman H, Dolev L, Dascal-Weichhendler H. Assessing, Consulting, Reporting Heuristics in Professional Decision-Making Regarding Suspected Child Maltreatment in Community Healthcare Services. CHILD MALTREATMENT 2021; 26:291-301. [PMID: 32633613 DOI: 10.1177/1077559520937351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study investigated child protection decision-making practices of healthcare-professionals in community-health-services. We examined the effect of heuristics in professional judgments regarding suspected maltreatment, as affected by the child's ethnicity, gender, and family socioeconomic-status, as well as the healthcare-worker's workload-stress, and personal and professional background. Furthermore, we examined how these variables influence judgments regarding suspected maltreatment and intentions to consult and report child-maltreatment. We used an experimental survey design including vignettes manipulating the child's characteristics. Data was collected from 412 professionals employed at various community-health-service-clinics of the largest health-management organization in northern Israel. Findings show that all subjective factors have a significant effect on suspected child-maltreatment assessment, which appears as a significant predictor of later decisions regarding consultation and reporting. This study lends support to prior research indicating that healthcare-professionals' decisions may incorporate biases, and suggests how the effects of these biases' are mediated through a sequence of decisions. Recommendations focus on providing regular consultation opportunities for practitioners.
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Affiliation(s)
- Guy Enosh
- School of Social Work, 26748University of Haifa, Israel
| | | | - Hani Nouman
- School of Social Work, 26748University of Haifa, Israel
| | - Lilach Dolev
- 36631Clalit Health Services, Haifa and West Galilee District, Israel
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Bolton A, Gandevia S, Newell BR. Appropriate responses to potential child abuse: The importance of information quality. CHILD ABUSE & NEGLECT 2021; 117:105062. [PMID: 33839498 DOI: 10.1016/j.chiabu.2021.105062] [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: 10/13/2020] [Revised: 02/16/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND When people suspect a child or young person is experiencing, or at risk of, abuse or neglect, they have to decide how to respond. However, the under and over reporting of child welfare issues indicate that people may struggle to identify an appropriate response. OBJECTIVE To develop scenarios (for future training and research purposes) that closely resemble the child welfare situations health/allied health practitioners encounter, and for which there is a reasonable level of child protection professional consensus as to what the appropriate response for each situation should be. PARTICIPANTS, SETTING, AND METHODS We developed 285 scenarios from 190 child protection reports made by health/allied health practitioners to two Australian government child welfare agencies, that covered a range of appropriate response pathways and abuse types. An appropriate response pathway for each scenario was identified by having 34 child protection professionals provide their opinion and rationales. RESULTS Child protection professionals displayed moderate (e.g., krippendorf's alpha = 0.58, 95 % CI: 0.52 to 0.62) interrater agreement as to the appropriate response pathway for the scenarios. For 127 of the 285 scenarios (44.56 %), there was strong consensus (K = 0.73, 95 % CI: 0.66 to 0.78). CONCLUSION Professional consensus was higher than anticipated from previous research, although still low compared to generally acceptable levels of consensus. Our results suggest several promising avenues to increase professional consensus, such as improving the quality of information that people typically report to child welfare agencies.
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Affiliation(s)
- Annalese Bolton
- UNSW Forensic Psychology Clinic, UNSW, Sydney, Australia; Matilda Centre, The University of Sydney, Sydney, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia.
| | - Simon Gandevia
- Neuroscience Research Australia (NeuRA), Sydney, Australia; School of Medicine, UNSW, Sydney, Australia
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Stewart B, Gyedu A, Otupiri E, Nakua E, Boakye G, Mehta K, Donkor P, Mock C. Comparison of childhood household injuries and risk factors between urban and rural communities in Ghana: A cluster-randomized, population-based, survey to inform injury prevention research and programming. Injury 2021; 52:1757-1765. [PMID: 33906741 DOI: 10.1016/j.injury.2021.04.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/11/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Childhood household injuries incur a major proportion of the global disease burden, particularly in low- and middle-income countries (LMICs). However, household injury hazards are differentially distributed across developed environments. Therefore, we aimed to compare incidence of childhood household injuries and prevalence of risk factors between communities in urban and rural Ghana to inform prevention initiatives. METHODS Data from urban and a rural cluster-randomized, population-based surveys of caregivers of children <5 years in Ghana were combined. In both studies, caregivers were interviewed about childhood injuries that occurred within the past 6 months and 200 meters of the home that resulted in missed school/work, hospitalization, and/or death. Sampling weights were applied, injuries and incidence rate ratios (IRRs) were described, and multi-level regression was used to identify and compare risk factors. RESULTS We sampled 200 urban and 357 rural households that represented 20,575 children in Asawase and 14,032 children in Amakom, Ghana, respectively. There were 143 and 351 injuries in our urban and rural samples, which equated to 594 and 542 injuries per 1,000 child-years, respectively (IRR 1.09, 95%CI 1.05-1.14). Toddler-aged children had the highest odds of injury both urban and rural communities (OR 3.77 vs 3.17, 95%CI 1.34-10.55 vs 1.86-5.42 compared to infants, respectively). Urban children were more commonly injured by falling (IRR 1.50, 95%CI 1.41-1.60), but less commonly injured by flame/hot substances (IRR 0.51, 95%CI 0.44-0.59), violence (IRR 0.41, 95%CI 0.36-0.48), or motor vehicle (IRR 0.50, 95%CI 0.39-0.63). Rural households that cooked outside of the home (OR 0.36, 95%CI 0.22-0.60) and that also supervised older children (OR 0.33, 95%CI 0.17-0.62) had lower odds of childhood injuries than those that did not. CONCLUSIONS Childhood injuries were similarly common in both urban and rural Ghana, but with different patterns of mechanisms and risk factors that must be taken into account when planning prevention strategies. However, the data suggest that several interventions could be effective, including: community-based, multi-strategy initiatives (e.g., home hazard reduction, provision of safety equipment, establishing community creches); traffic calming interventions in rural community clusters; and passive injury surveillance systems that collect data to inform violence and broader prevention strategies.
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Affiliation(s)
- Barclay Stewart
- Harborview Injury Prevention & Research Center, Seattle, WA, USA; Department of Surgery, University of Washington, Seattle, WA, USA.
| | - Adam Gyedu
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Easmon Otupiri
- Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Nakua
- Department of Epidemiology and Biotatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Kajal Mehta
- Department of Surgery, University of Washington, Seattle, WA, USA.
| | - Peter Donkor
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Mock
- Harborview Injury Prevention & Research Center, Seattle, WA, USA; Department of Surgery, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA.
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Kimber M, McTavish JR, Vanstone M, Stewart DE, MacMillan HL. Child maltreatment online education for healthcare and social service providers: Implications for the COVID-19 context and beyond. CHILD ABUSE & NEGLECT 2021; 116:104743. [PMID: 32980151 PMCID: PMC7513691 DOI: 10.1016/j.chiabu.2020.104743] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 05/12/2023]
Abstract
Evidence indicates that healthcare and social service providers (HSSPs) receive inadequate education related to recognizing and responding to child maltreatment. This is despite the fact HSSPs are identified as an important factor in the primary, secondary, and tertiary prevention of this childhood exposure. The need for online education for HSSPs' is highlighted during the COVID-19 pandemic restrictions and will continue to be relevant afterward. The objective of this commentary is to provide an overview of: (a) educational interventions for HSSPs' related to recognizing and responding to child maltreatment; (b) the development of VEGA (Violence, Evidence, Guidance, Action), which is an online platform of educational resources to support HSSPs to recognize and respond to child maltreatment; and (c) the RISE (Researching the Impact of Service provider Education) project, which is an ongoing multi-province evaluation of VEGA in Canada. It is important to consider ongoing ways that HSSPs can receive education related to recognizing and responding to child maltreatment. The virtual implementation of VEGA and the RISE Project provide a necessary opportunity to continue to increase the capacity of Canada's HSSPs to adequately and safely recognize and respond to child maltreatment, while simultaneously advancing education scholarship for the field of child maltreatment and which will have relevance for the COVID-19 context and beyond.
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Affiliation(s)
- Melissa Kimber
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada.
| | - Jill R McTavish
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | - Meredith Vanstone
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, 1280 Main Street West, DBHSC 5003E, Hamilton, ON, L8S 4K1, Canada
| | - Donna E Stewart
- Centre for Mental Health, University of Toronto and University Health Network, 200 Elizabeth Street, EN-7-229, Toronto, ON, M5G 2C4, Canada
| | - Harriet L MacMillan
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, and Department of Pediatrics, McMaster University, 1280 Main Street West, MIP 201A, Hamilton, ON, L8S 4K1, Canada
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Can We Ask Everyone? Addressing Sexual Abuse in Primary Care. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Dixon S, Duddy C, Harrison G, Papoutsi C, Ziebland S, Griffiths F. Conversations about FGM in primary care: a realist review on how, why and under what circumstances FGM is discussed in general practice consultations. BMJ Open 2021; 11:e039809. [PMID: 33753429 PMCID: PMC7986780 DOI: 10.1136/bmjopen-2020-039809] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/11/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Little is known about the management of female genital mutilation (FGM) in primary care. There have been significant recent statutory changes relevant to general practitioners (GPs) in England, including a mandatory reporting duty. We undertook a realist synthesis to explore what influences how and when GPs discuss FGM with their patients. SETTING Primary care in England. DATA SOURCES Realist literature synthesis searching 10 databases with terms: GPs, primary care, obstetrics, gynaecology, midwifery and FGM (UK and worldwide). Citation chasing was used, and relevant grey literature was included, including searching FGM advocacy organisation websites for relevant data. Other potentially relevant literature fields were searched for evidence to inform programme theory development. We included all study designs and papers that presented evidence about factors potentially relevant to considering how, why and in what circumstances GPs feel able to discuss FGM with their patients. PRIMARY OUTCOME MEASURE This realist review developed programme theory, tested against existing evidence, on what influences GPs actions and reactions to FGM in primary care consultations and where, when and why these influences are activated. RESULTS 124 documents were included in the synthesis. Our analysis found that GPs need knowledge and training to help them support their patients with FGM, including who may be affected, what needs they may have and how to talk sensitively about FGM. Access to specialist services and guidance may help them with this role. Reporting requirements may complicate these conversations. CONCLUSIONS There is a pressing need to develop (and evaluate) training to help GPs meet FGM-affected communities' health needs and to promote the accessibility of primary care. Education and resources should be developed in partnership with community members. The impact of the mandatory reporting requirement and the Enhanced Dataset on healthcare interactions in primary care warrants evaluation. PROSPERO REGISTRATION NUMBER CRD42018091996.
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Affiliation(s)
- Sharon Dixon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Claire Duddy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Chrysanthi Papoutsi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sue Ziebland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Frances Griffiths
- Centre for Health Policy, University of the Witwatersrand, Johannesburg, South Africa
- Warwick Medical School, University of Warwick, Coventry, UK
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Holland ML, Hutchens BF, Sadler LS. Encountering Child Abuse and Neglect in Home Visiting: a Qualitative Study of Visitor and Supervisor Experiences. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:1108-1119. [PMID: 33730259 DOI: 10.1007/s11121-021-01223-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
Prevention of child maltreatment is a goal of home visiting (HV) for new mothers. How home visitors and their clinical supervisors manage concerns about child maltreatment may impact both the families' and the home visitors' engagement with the program. We sought to understand how HV personnel encounter and respond to concerns of child maltreatment and how these concerns are related to their work with families. We conducted an interpretive descriptive qualitative study of home visitors and supervisors in a statewide HV program, using the Parents as Teachers curriculum, to describe the experience of HV personnel. Two researchers conducted semi-structured interviews March 2016 to October 2017. Interviews were concurrently transcribed, coded, and analyzed, using thematic analysis. After 13 interviews with home visitors and 13 interviews with supervisors, codes and themes were saturated. We identified three themes: Decision to Call Child Protective Services (CPS), Relationships, and Collaborating with CPS. The decision to call CPS was described as difficult, and there was substantial variation in the details of this decision. The relationship between home visitor and family was consistently the most important. Variations were seen in how home visitors and supervisors collaborated with CPS, ranging from strong connections through liaisons to frustrations due to poor communication and perceived variation in how cases were handled. The decision to report a family to CPS is a challenging clinical issue; additional training and connections with CPS may improve consistency across sites for home visitors.
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Affiliation(s)
- Margaret L Holland
- Yale Child Study Center, 230 South Frontage Rd, New Haven, CT, 06520, USA.
| | - Bridget Frese Hutchens
- Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA.,Dr. Hutchen's Present Address, University of San Diego, Hahn School of Nursing, 5998 Alcala Park, San Diego, CA, 92110, USA
| | - Lois S Sadler
- Yale Child Study Center, 230 South Frontage Rd, New Haven, CT, 06520, USA.,Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
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Maintaining the Therapeutic Alliance When Reporting Child Maltreatment: Recommendations for Mental Health Clinicians. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2021. [DOI: 10.1007/s10879-020-09476-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jack SM, Gonzalez A, Marcellus L, Tonmyr L, Varcoe C, Van Borek N, Sheehan D, MacKinnon K, Campbell K, Catherine N, Kurtz Landy C, MacMillan HL, Waddell C. Public Health Nurses' Professional Practices to Prevent, Recognize, and Respond to Suspected Child Maltreatment in Home Visiting: An Interpretive Descriptive Study. Glob Qual Nurs Res 2021; 8:2333393621993450. [PMID: 33628866 PMCID: PMC7882742 DOI: 10.1177/2333393621993450] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/31/2022] Open
Abstract
The purpose of this analysis was to understand public health nurses’ experiences in preventing and addressing suspected child maltreatment within the context of home visiting. The principles of interpretive description guided study decisions and data were generated from interviews with 47 public health nurses. Data were analyzed using reflexive thematic analysis. The findings highlighted that public health nurses have an important role in the primary prevention of child maltreatment. These nurses described a six-step process for managing their duty to report suspected child maltreatment within the context of nurse-client relationships. When indicators of suspected child maltreatment were present, examination of experiential practice revealed that nurses developed reporting processes that maximized child safety, highlighted maternal strengths, and created opportunities to maintain the nurse-client relationship. Even with child protection involvement, public health nurses have a central role in continuing to work with families to develop safe and competent parenting skills.
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Affiliation(s)
| | | | | | - Lil Tonmyr
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | | | - Debbie Sheehan
- Simon Fraser University, Vancouver, British Columbia, Canada
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Lindenbach D, Cullen O, Bhattarai A, Perry R, Diaz RL, Patten SB, Dimitropoulos G. Capacity, confidence and training of Canadian educators and school staff to recognize and respond to sexual abuse and internet exploitation of their students. CHILD ABUSE & NEGLECT 2021; 112:104898. [PMID: 33385927 DOI: 10.1016/j.chiabu.2020.104898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/19/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Sexual exploitation of children online is an issue of growing public concern. This form of exploitation typically involves adults using the internet to communicate with children for sexual purposes or to distribute sexually explicit material involving children. To date, there is no research on the knowledge and skills of educators to recognize online sexual exploitation. This research is urgently needed since educators are well-positioned to detect, identify and report sexual exploitation of their students. OBJECTIVE The study was conducted to understand the confidence and capacity of grade school educators to recognize and respond to online child sexual exploitation. PARTICIPANTS AND SETTING This cross-sectional study surveyed 450 educators in Alberta, Canada between April and December 2018. METHODS Vignettes were used to obtain experiences and attitudes surrounding four categories of exploitation or abuse: grooming, luring, sexual abuse, and sexual abuse imagery (also known as child pornography). RESULTS Among school district staff, 28 % reported working with a student affected by sexual abuse in the last year, as compared to 25 % for grooming, 17 % for luring and 14 % for sexual abuse imagery. A minority of respondents expressed confidence in their ability to recognize if the internet was being employed for grooming (35 % of staff), luring (46 %) or sexual abuse (45 %) of their students. CONCLUSIONS Educators encounter issues of online sexual exploitation of their students almost as often as contact sexual abuse. Child protection efforts in schools should be modernized to incorporate training in online safety of children and adolescents.
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Affiliation(s)
- David Lindenbach
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th Floor, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Olivia Cullen
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th Floor, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada; Faculty of Social Work, University of Calgary, MLT 301, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Asmita Bhattarai
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th Floor, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D11, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Rosemary Perry
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th Floor, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Ruth L Diaz
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th Floor, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Scott B Patten
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th Floor, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D11, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Gina Dimitropoulos
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th Floor, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada; Faculty of Social Work, University of Calgary, MLT 301, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.
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Livingston E, Joh-Carnella N, Lindberg DM, Vandermorris A, Smith J, Kagan-Cassidy M, Giokas D, Fallon B. Characteristics of child welfare investigations reported by healthcare professionals in Ontario: secondary analysis of a regional database. BMJ Paediatr Open 2021; 5:e001167. [PMID: 34471704 PMCID: PMC8370554 DOI: 10.1136/bmjpo-2021-001167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/29/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This study examines the characteristics and outcomes of child welfare investigations reported by hospital-based and community-based healthcare professionals. METHODS A sample of 7590 child maltreatment-related investigations from the Ontario Incidence Study of Reported Child Abuse and Neglect-2018, a cross-sectional study, was analysed. Bivariate analyses compared characteristics of hospital and community healthcare-reported investigations. Chi-square automatic interaction detector analyses were used to predict the most influential factors in the decision to provide a family with services following a child welfare investigation from each referral source. RESULTS Community healthcare-reported investigations were more likely to have a primary concern of physical abuse while hospital-reported investigations were more likely to be focused on assessing risk of future maltreatment. Hospital-reported investigations were more likely to involve noted primary caregiver (eg, mental health issues, alcohol/drug abuse, victim of intimate partner violence (IPV)) and household risk factors. The most significant predictor of service provision following an investigation was having a caregiver who was identified as a victim of IPV in hospital-reported investigations (χ2=30.237, df=1, adj. p<0.001) and having a caregiver for whom few social supports was noted in community healthcare-reported investigations (χ2=18.892, df=1, adj. p<0.001). CONCLUSION Healthcare professionals likely interact with children who are at high risk for maltreatment. This study's findings highlight the important role that healthcare professionals play in child maltreatment identification, which may differ across hospital-based and community-based settings and has implications for future collaborations between the healthcare and child welfare systems.
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Affiliation(s)
- Eliza Livingston
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Nicolette Joh-Carnella
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Daniel M Lindberg
- Departments of Emergency Medicine & Pediatrics, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ashley Vandermorris
- Division of Adolescent Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer Smith
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Miya Kagan-Cassidy
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Danielle Giokas
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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Identification of Abusive Head Trauma in High-Risk Infants: A Cost-Effectiveness Analysis. J Pediatr 2020; 227:176-183.e3. [PMID: 32531314 PMCID: PMC10372721 DOI: 10.1016/j.jpeds.2020.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/08/2020] [Accepted: 06/03/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To evaluate the cost-effectiveness of abusive head trauma detection strategies in emergency department settings with and without rapid magnetic resonance imaging (rMRI) availability. STUDY DESIGN A Markov decision model estimated outcomes in well-appearing infants with high-risk chief complaints. In an emergency department without rMRI, we considered 3 strategies: clinical judgment, universal head computed tomography (CT) scan, or the Pittsburgh Infant Brain Injury Score (PIBIS) with a CT scan. In an emergency department with rMRI for brain availability, we considered additional strategies: universal rMRI, universal rMRI with a CT scan, PIBIS with rMRI, and PIBIS with rMRI followed by a CT scan. Correct diagnosis eliminated future risk; missed abusive head trauma led to reinjury risk with associated poor outcomes. Cohorts were followed for 1 year from a healthcare perspective. One-way and probabilistic sensitivity analyses were performed. The main outcomes evaluated in this study were abusive head trauma correctly identified and incremental cost per quality-adjusted life-year. RESULTS Without rMRI availability, PIBIS followed by a CT scan was the most cost-effective strategy. Results were sensitive to variation of CT scan-induced cancer parameters and abusive head trauma prevalence. When rMRI was available, universal rMRI followed by a confirmatory CT scan cost $25 791 to gain 1 additional quality-adjusted life-year compared with PIBIS followed by rMRI with a confirmatory CT scan. In both models, clinical judgement was less effective than alternative strategies. CONCLUSIONS By applying CT scans to a more targeted population, PIBIS decreases radiation exposure and is more effective for the identification of abusive head trauma compared with clinical judgment. When rMRI is available, universal rMRI with a CT scan is more effective than PIBIS and is economically favorable.
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