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Waltzman D, Sarmiento K, Daugherty J, Lumba-Brown A, Klevens J, Miller GF. Firearm-Related Traumatic Brain Injury Homicides in the United States, 2000-2019. Neurosurgery 2023; 93:43-49. [PMID: 36727717 PMCID: PMC10391713 DOI: 10.1227/neu.0000000000002367] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/15/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a leading cause of homicide-related death in the United States. Penetrating TBI associated with firearms is a unique injury with an exceptionally high mortality rate that requires specialized neurocritical trauma care. OBJECTIVE To report incidence patterns of firearm-related and nonfirearm-related TBI homicides in the United States between 2000 and 2019 by demographic characteristics to provide foundational data for prevention and treatment strategies. METHODS Data were obtained from multiple cause of death records from the National Vital Statistics System using Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database for the years 2000 to 2019. Number, age-adjusted rates, and percent of firearm and nonfirearm-related TBI homicides by demographic characteristics were calculated. Temporal trends were also evaluated. RESULTS During the study period, there were 77 602 firearm-related TBI homicides. Firearms were involved in the majority (68%) of all TBI homicides. Overall, men, people living in metro areas, and non-Hispanic Black persons had higher rates of firearm-related TBI homicides. The rate of nonfirearm-related TBI homicides declined by 40%, whereas the rate of firearm-related TBI homicides only declined by 3% during the study period. There was a notable increase in the rate of firearm-related TBI homicides from 2012/2013 through 2019 for women (20%) and nonmetro residents (39%). CONCLUSION Firearm-related violence is an important public health problem and is associated with the majority of TBI homicide deaths in the United States. The findings from this study may be used to inform prevention and guide further research to improve treatment strategies directed at reducing TBI homicides involving firearms.
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Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
| | - Jill Daugherty
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
| | | | - Joanne Klevens
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
| | - Gabrielle F. Miller
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
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Duong HT, Monahan JL, Mercer Kollar LM, Klevens J. Examining Sources of Social Norms Supporting Child Corporal Punishment Among Low-Income Black, Latino, and White Parents. Health Commun 2022; 37:1413-1422. [PMID: 33685307 PMCID: PMC8608415 DOI: 10.1080/10410236.2021.1895418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Child corporal punishment is a prevalent public health problem in the US. Although corporal punishment is sustained through parents' perceptions of social norms supporting this discipline behavior, little research has investigated where these normative perceptions come from. To fill this gap, we conducted 13 focus groups including 75 low-income Black, Latino, and White parents across five states in the US. Results revealed that one influential source of Black and White parents' perceived norms was their positive framing of corporal punishment experiences during childhood. Furthermore, Black parents formed normative perceptions based on identification with parents in their racial/ethnic group, while White parents did so with parents sharing the same generation. Results are interpreted in light of the false consensus effect and self-categorization theory. In contrast, Latino parents viewed their childhood experience of corporal punishment as negative and distanced their parenting practices from those practiced in their countries of origin, suggesting an influence of acculturation. Their perceived norms were likely transmitted through interpersonal communication within their social networks. These findings shed light on how social norms are formed and in turn guide parents' use of corporal punishment as a tool to discipline children.
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Affiliation(s)
| | | | - Laura M. Mercer Kollar
- Division of Violence Prevention, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control
| | - Joanne Klevens
- Division of Violence Prevention, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control
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3
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Abstract
Evolutionary psychologists claim that stepparents perpetrate substantially more child physical abuse than genetic parents, and that they do so because they are less invested in genetically unrelated children. The objective of this study was to examine these claims by investigating whether, and why, fathers in a Colombian sample physically abused their stepchildren more than their genetic children. Fathers (N = 86) and their partners living in Bogotá were interviewed by Klevens et al. Half of the fathers had been reported to authorities for child physical abuse, the other half were matched controls. Secondary analysis was conducted of Klevens et al.'s data. Hypotheses from the evolutionary and ecological accounts of child maltreatment were tested using logistic and ordinal regression. Both the prevalence and the frequency of physical abuse by stepfathers were considerably greater than those of genetic fathers. Several indicators of adversity-including parental youth and experience of abuse, fathers' chronic stress, and mothers' poor communication with the child-were associated with both abuse and stepparenthood. Models including these variables indicated that they accounted for much of the stepfathers' higher rates of abuse. Consistent with the ecological account, much of the stepfathers' greater prevalence and frequency of abuse in this sample is likely to have resulted from confounding variables, rather than from the step relationship per se.
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Affiliation(s)
| | | | - Catia Malvaso
- The University of Adelaide, South Australia, Australia
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4
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F. Wilson R, Klevens J, Fortson B, Williams D, Xu L, Yuan K. Neonaticides in the United States-2008-2017. Acad Forensic Pathol 2022; 12:3-14. [PMID: 35694006 PMCID: PMC9179000 DOI: 10.1177/19253621221077870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 01/16/2022] [Indexed: 11/16/2022]
Abstract
Objective This study examines factors associated with homicide in the first 24 hours of life (i.e., neonaticide) in the United States. Methods National Vital Statistics System (NVSS) linked birth-infant death data, for 50 states and the District of Columbia, from 2008 through 2017, were used to examine characteristics associated with neonaticide. National Violent Death Reporting System (NVDRS) data were used to examine circumstances of neonaticides that occurred in 14 states. Circumstances of neonaticides are described, and rates for maternal and infant characteristics are presented as rates per 100,000 person-years. Results Among neonaticide victims in NVSS (N = 81), those of mothers who are young, unmarried, non-Hispanic, Black, and have lower education levels, are at an increased risk of neonaticide. Further, among mothers in NVDRS who committed neonaticide (N = 42), 66.7% were known to have given birth at a residence, without medical assistance. Approximately three-fourths (73.8%; n = 31) concealed their pregnancy, with 35.7% (n = 15) disposing of their infants in a trash receptacle after giving birth. Additionally, more than half of neonaticide victims were tested for alcohol, opioids, amphetamines, and cocaine, but a relatively small number tested positive for these substances. Conclusions Results highlight the importance of identifying factors that elevate risk to neonates so these deaths can be prevented. As such, many mothers who commit neonaticide are young, unmarried, and conceal their pregnancy; thus, programs that prevent teen pregnancy, decrease shame and stigma associated with birth to young mothers, and provide support and resources to pregnant women, may help prevent neonaticide.
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Affiliation(s)
- Rebecca F. Wilson
- Rebecca F. Wilson PhD, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341;
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5
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Klevens J, Treves-Kagan S, Metzler M, Merrick M, Reidy MC, Herbst JH, Ports K. Association of public explanations of why children struggle and support for policy solutions using a national sample. Anal Soc Issues Public Policy 2021; 22:268-285. [PMID: 37180092 PMCID: PMC10174280 DOI: 10.1111/asap.12285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Purpose Despite evidence showing the importance of structural determinants for child well-being and the existence of policies that can promote child well-being, many communities are not adopting these policies. Limited awareness of structural determinants may explain this gap. This study establishes the public's recognition of structural determinants and their associations with support for policies that promote child well-being. Methods Secondary analyses of survey data collected in 2019 from a random sample of 2496 adults in the United States. This survey asked why some children "struggle" (e.g., do poorly in school, use drugs, or get involved in crime). Respondents could select individual (e.g., lack of effort) and structural (e.g., low wages) explanations. Respondents were also asked about their support for policies that are supportive of children and families. Results Stronger beliefs of structural explanations were associated with greater support for policies that strengthen family economics, family-friendly work, and afford access to high-quality early childcare and education. Beliefs in individual explanations were inversely associated with support for these policies. Conclusions These findings suggest increasing recognition of the structural determinants that hinder child development may help increase support for policies that are effective in improving children's outcomes.
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Affiliation(s)
- Joanne Klevens
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Treves-Kagan
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marilyn Metzler
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
- TJFACT, Atlanta, Georgia
| | - Melissa Merrick
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary Clare Reidy
- Training & Organizational Development Department, Health Federation of Philadelphia, Philadelphia, Pennsylvania
| | - Jeffrey H. Herbst
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katie Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Duong HT, Monahan JL, Mercer Kollar LM, Klevens J. Identifying knowledge, self-efficacy and response efficacy of alternative discipline strategies among low-income Black, Latino and White parents. Health Educ Res 2021; 36:192-205. [PMID: 33447855 PMCID: PMC8043958 DOI: 10.1093/her/cyaa053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
Corporal punishment (CP) leads to detrimental mental and physical consequences for a child. One way to prevent CP is to encourage parents to apply alternative discipline strategies that do not involve violence. Based on the knowledge-behavior gap framework in public health education, this study analyzed the focus group data of 75 low-income Black, Latino and White parents to uncover commonalties and differences in their knowledge, self-efficacy and response efficacy of alternative discipline strategies. Findings revealed that parents knew several alternative discipline strategies and had confidence in their ability to conduct these strategies. However, parents reported that some strategies were hard to implement because they lacked the relevant resources. Moreover, parents did not perceive that alternative discipline strategies were effective without using some forms of CP. Knowledge, self-efficacy and response efficacy of alternative discipline strategies are risk factors for child physical abuse and addressing them will help prevent injury and health impacts on children, while providing safe, stable, nurturing relationships and environments for child development.
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Affiliation(s)
- Hue Trong Duong
- Department of Communication, Georgia State University, Atlanta, GA, USA
| | - Jennifer L. Monahan
- Department of Communication Studies, Franklin College of the Arts and Sciences, University of Georgia, Athens, GA, USA
| | - Laura M. Mercer Kollar
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joanne Klevens
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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7
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Abstract
Foster care caseloads, an indicator of child maltreatment, are increasing. Children living in poverty are significantly more likely to be reported to the child welfare system and are overrepresented in foster care. Thus, it is critical to identify prevention strategies that can stem the flow of foster care entries, particularly among populations at higher risk. We used variations in the adoption and refund status of state-level Earned Income Tax Credit (EITC), a socioeconomic policy intended to reduce poverty, to examine their effect on foster care entry rates. Fixed-effects models, accounting for year- and state-fixed effects, demonstrated that a refundable EITC was associated with an 11% decrease in foster care entries compared to states without a state-level EITC after controlling for child poverty rate, racial/ethnic composition, education, and unemployment. Policies that strengthen economic supports for families may prevent child maltreatment and reduce foster care entries and associated costs.
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Affiliation(s)
- Whitney L. Rostad
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Casey Family Programs, Seattle, WA, USA
| | - Katie A. Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shichao Tang
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joanne Klevens
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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8
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Wilson RF, Klevens J, Williams D, Xu L. Infant Homicides Within the Context of Safe Haven Laws - United States, 2008-2017. MMWR Morb Mortal Wkly Rep 2020; 69:1385-1390. [PMID: 33001877 PMCID: PMC7537560 DOI: 10.15585/mmwr.mm6939a1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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McKool M, Freire K, Basile KC, Jones KM, Klevens J, DeGue S, Smith SG. A Process for Identifying Indicators With Public Data: An Example From Sexual Violence Prevention. Am J Eval 2020; 41:10.1177/1098214019891239. [PMID: 34733100 PMCID: PMC8563011 DOI: 10.1177/1098214019891239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Despite advances in the sexual violence (SV) prevention field, practitioners still face challenges with identifying indicators to measure the impact of their prevention strategies. Public data, such as existing administrative and surveillance system data, may be a good option for organizations to examine trends in indicators for the purpose of program evaluation. In this article, we describe a framework and a process for identifying indicators with public data. Specifically, we present the SV Indicator Framework and a five-step indicator review process, which we used to identify indicators for a national SV prevention program. We present the findings of the indicator review and explain how the process could be used by evaluators and program planners within other developing topic areas. Tracking indicators with public data, in conjunction with other evaluation methods, may be a viable option for state-level program evaluations. We discuss limitations and implications for practice and research.
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Affiliation(s)
- Marissa McKool
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
- University of California, Berkeley, CA, USA
| | - Kimberley Freire
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathleen C. Basile
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathryn M. Jones
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joanne Klevens
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah DeGue
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sharon G. Smith
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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10
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Merrick MT, Ford DC, Ports KA, Guinn AS, Chen J, Klevens J, Metzler M, Jones CM, Simon TR, Daniel VM, Ottley P, Mercy JA. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention - 25 States, 2015-2017. MMWR Morb Mortal Wkly Rep 2019; 68:999-1005. [PMID: 31697656 PMCID: PMC6837472 DOI: 10.15585/mmwr.mm6844e1] [Citation(s) in RCA: 300] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Adverse childhood experiences, such as violence victimization, substance misuse in the household, or witnessing intimate partner violence, have been linked to leading causes of adult morbidity and mortality. Therefore, reducing adverse childhood experiences is critical to avoiding multiple negative health and socioeconomic outcomes in adulthood. Methods Behavioral Risk Factor Surveillance System data were collected from 25 states that included state-added adverse childhood experience items during 2015–2017. Outcomes were self-reported status for coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, cancer (excluding skin cancer), kidney disease, diabetes, depression, overweight or obesity, current smoking, heavy drinking, less than high school completion, unemployment, and lack of health insurance. Logistic regression modeling adjusting for age group, race/ethnicity, and sex was used to calculate population attributable fractions representing the potential reduction in outcomes associated with preventing adverse childhood experiences. Results Nearly one in six adults in the study population (15.6%) reported four or more types of adverse childhood experiences. Adverse childhood experiences were significantly associated with poorer health outcomes, health risk behaviors, and socioeconomic challenges. Potential percentage reductions in the number of observed cases as indicated by population attributable fractions ranged from 1.7% for overweight or obesity to 23.9% for heavy drinking, 27.0% for chronic obstructive pulmonary disease, and 44.1% for depression. Conclusions and implications for public health practice Efforts that prevent adverse childhood experiences could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes. States can use comprehensive public health approaches derived from the best available evidence to prevent childhood adversity before it begins. By creating the conditions for healthy communities and focusing on primary prevention, it is possible to reduce risk for adverse childhood experiences while also mitigating consequences for those already affected by these experiences.
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Klevens J, Alexander S. Essentials for Childhood: Planting the Seeds for a Public Health Approach to Preventing Child Maltreatment. Int J Child Maltreat 2019; 1:10.1007/s42448-018-0009-8. [PMID: 32328563 PMCID: PMC7177181 DOI: 10.1007/s42448-018-0009-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/20/2018] [Indexed: 11/26/2022]
Abstract
Public health addresses child maltreatment and other adverse childhood experiences by focusing primarily on preventing them from happening in the first place; understanding and addressing their individual, relational, community, and societal causes using the best available scientific evidence; and engaging in large-scale, multi-sector partnerships. Such large scale efforts require bringing together a compelling narrative, relationships, and strategy. This article describes how the Centers for Disease Control and Prevention used a public health approach to develop a narrative, relationships, and strategy to prevent child maltreatment.
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Affiliation(s)
- Joanne Klevens
- Division of Violence Prevention, National Center for Injury
Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy,
Mailstop F-63, Atlanta, GA 30341, USA
| | - Sandra Alexander
- SciMetrika, Expert Consultant for the Division of Violence
Prevention, Atlanta, GA, USA
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12
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Klevens J, Kollar LM, Rizzo G, O’Shea G, Nguyen J, Roby S. Commonalities and Differences in Social Norms Related to Corporal Punishment Among Black, Latino and White Parents. Child Adolesc Social Work J 2019; 36:19-28. [PMID: 32327878 PMCID: PMC7177180 DOI: 10.1007/s10560-018-0591-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To establish commonalities and differences in social norms related to corporal punishment among Black, Latino, and White parents, we first examine survey data from a random sample of a nationally representative opt-in internet panel (n = 2500) to establish the frequency of corporal punishment among parents of children under five (n = 540) and their perceptions of the frequency of use of corporal punishment in their community and whether they ought to use corporal punishment. We disaggregate by race/ethnicity and education to identify higher risk groups. To better understand the beliefs underlying these perceptions among the higher risk group (i.e., less educated), we used a grounded theory approach to analyze data from 13 focus groups (n = 75) segmented by race/ethnicity (i.e., Black, Latino, or White), gender (i.e., mothers or fathers), and population density (i.e., rural or urban). Survey findings revealed that 63% of parents spanked, albeit the majority seldom or sometimes. Spanking was most frequent among Latinos (73%) and lowest among White parents (59%). While all participants across racial/ethnic groups believed the majority of parents spanked, even more than the proportion that actually do, about half believed they ought to spank. Perceptions of the frequency and acceptability of corporal punishment were associated with use of corporal punishment. The qualitative findings highlight more similarities than differences across Black, Latino, and White communities. The findings suggest social norms change efforts might focus on parents with less education and influencing perceptions around whether they ought to spank.
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Affiliation(s)
- Joanne Klevens
- Division of Violence Prevention, Centers for Disease
Control and Prevention, 4770 Buford Highway, NE, Mailstop F63, Atlanta, GA 30341,
USA
| | - Laura Mercer Kollar
- Division of Violence Prevention, Centers for Disease
Control and Prevention, 4770 Buford Highway, NE, Mailstop F63, Atlanta, GA 30341,
USA
| | - Genevieve Rizzo
- Rollins School of Public Health, Emory University, Atlanta,
GA, USA
| | - Gerad O’Shea
- Applied Curiosity Research, Long Island City, NY, USA
| | | | - Sarah Roby
- Division of Violence Prevention, Centers for Disease
Control and Prevention, 4770 Buford Highway, NE, Mailstop F63, Atlanta, GA 30341,
USA
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Rostad WL, Klevens J, Ports KA, Ford DC. Impact of the United States federal child tax credit on childhood injuries and behavior problems. Child Youth Serv Rev 2019; 107:10.1016/j.childyouth.2019.104718. [PMID: 32322131 PMCID: PMC7176404 DOI: 10.1016/j.childyouth.2019.104718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Children who grow up in poverty are at risk for various poor outcomes. Socioeconomic policies can shape the conditions in which families are raising children and may be effective at reducing financial strain and helping families obtain economic sufficiency, thereby reducing risk for poor health outcomes. This study used data from two surveys conducted in the US, the National Longitudinal Survey of Youth 1979 (NLSY79) and the NLSY79 Young Adult survey to determine whether the U.S. Federal Child Tax Credit (CTC), a socioeconomic policy that provides tax relief to low- and middle-income families to offset the costs of raising children, is associated with child well-being, as indicated by whether the child had injuries requiring medical attention and behavioral problems. Fixed-effects models, accounting for year and state of residence, detected a lower likelihood of injuries requiring medical attention (OR = 0.58, 95% CI [0.40, 0.86]) and significantly fewer behavior problems (b = -2.07, 95% CI [-4.06, -0.08]) among children with mothers eligible to receive a CTC, but only when it was partially refundable (i.e., mothers could receive a tax refund for a portion of the CTC that exceeds their tax liability) for families making as little as $3000 a year. Tax credits like the CTC have the potential to alleviate financial strain among families, and consequently, may have impacts on injury and behavior problems.
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Affiliation(s)
- Whitney L. Rostad
- Corresponding author at: 3030 14 Ave W, Seattle, WA, United States. (W.L. Rostad)
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14
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Latzman NE, Lokey C, Lesesne CA, Klevens J, Cheung K, Condron S, Garraza LG. An evaluation of welfare and child welfare system integration on rates of child maltreatment in Colorado. Child Youth Serv Rev 2019; 96:10.1016/j.childyouth.2018.12.009. [PMID: 32327868 PMCID: PMC7177175 DOI: 10.1016/j.childyouth.2018.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Policies that improve the socioeconomic conditions of families have been identified as one of the most promising strategies to prevent child maltreatment, particularly neglect. In this study, we examined the impact of integrated Temporary Assistance for Needy Families (TANF) and child welfare (CW) systems on child maltreatment-related hospitalizations and Child Protective Services investigations and substantiations in nine counties in Colorado from 1996 to 2014. Regression analyses showed TANF-CW integration was associated with subsequent year, but not second-year, increases rates of substantiated child maltreatment overall and neglect specifically (that is, there was no longer a difference in the rate two years after the change in integration). Neither unemployment nor the one- or two-year lagged effect of integration were significant for investigations or child maltreatment-related hospitalizations. Increased opportunities to interact with a family in crisis using an integrated case management model may help explain these findings. Implications for future research are discussed.
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Affiliation(s)
- Natasha E. Latzman
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-63, Atlanta, GA 30341, United States
- RTI International, 3040 Cornwallis Road, Research Triangle Park, NC, 27709, United States
- Corresponding author at: RTI International, 3040 Cornwallis Road, Research Triangle Park, NC, 27709, United States. (N.E. Latzman)
| | - Colby Lokey
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-63, Atlanta, GA 30341, United States
| | - Catherine A. Lesesne
- ICF International, 3 Corporate Square, Suite 370, Atlanta, GA 30329, United States
| | - Joanne Klevens
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-63, Atlanta, GA 30341, United States
| | - Karen Cheung
- ICF International, 3 Corporate Square, Suite 370, Atlanta, GA 30329, United States
| | - Susanne Condron
- ICF International, 3 Corporate Square, Suite 370, Atlanta, GA 30329, United States
| | - Lucas Godoy Garraza
- ICF International, 3 Corporate Square, Suite 370, Atlanta, GA 30329, United States
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Peterson C, Florence C, Klevens J. The economic burden of child maltreatment in the United States, 2015. Child Abuse Negl 2018; 86:178-183. [PMID: 30308348 PMCID: PMC6289633 DOI: 10.1016/j.chiabu.2018.09.018] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/20/2018] [Accepted: 09/24/2018] [Indexed: 05/22/2023]
Abstract
Child maltreatment incurs a high lifetime cost per victim and creates a substantial US population economic burden. This study aimed to use the most recent data and recommended methods to update previous (2008) estimates of 1) the per-victim lifetime cost, and 2) the annual US population economic burden of child maltreatment. Three ways to update the previous estimates were identified: 1) apply value per statistical life methodology to value child maltreatment mortality, 2) apply monetized quality-adjusted life years methodology to value child maltreatment morbidity, and 3) apply updated estimates of the exposed population. As with the previous estimates, the updated estimates used the societal cost perspective and lifetime horizon, but also accounted for victim and community intangible costs. Updated methods increased the estimated nonfatal child maltreatment per-victim lifetime cost from $210,012 (2010 USD) to $830,928 (2015 USD) and increased the fatal per-victim cost from $1.3 to $16.6 million. The estimated US population economic burden of child maltreatment based on 2015 substantiated incident cases (482,000 nonfatal and 1670 fatal victims) was $428 billion, representing lifetime costs incurred annually. Using estimated incidence of investigated annual incident cases (2,368,000 nonfatal and 1670 fatal victims), the estimated economic burden was $2 trillion. Accounting for victim and community intangible costs increased the estimated cost of child maltreatment considerably compared to previous estimates. The economic burden of child maltreatment is substantial and might off-set the cost of evidence-based interventions that reduce child maltreatment incidence.
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Affiliation(s)
- Cora Peterson
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
| | - Curtis Florence
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Joanne Klevens
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Klevens J, Ports KA, Austin C, Ludlow IJ, Hurd J. A cross-national exploration of societal-level factors associated with child physical abuse and neglect. Glob Public Health 2018; 13:1495-1506. [PMID: 29182043 PMCID: PMC5972049 DOI: 10.1080/17441692.2017.1404622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Children around the world experience violence at the hands of their caregivers at alarming rates. A recent review estimates that a minimum of 50% of children in Asia, Africa, and North America experienced severe physical violence by caregivers in the past year, with large variations between countries. Identifying modifiable country-level factors driving these geographic variations has great potential for achieving population-level reductions in rates of child maltreatment. This study builds on previous research by focusing on caregiver-reported physical abuse and neglect victimisation, examining 22 societal factors representing 11 different constructs among 42 countries from 5 continents at different stages of development. Our findings suggest that gender inequity may be important for both child physical abuse and neglect. Indicators of literacy and development may also be important for child neglect. Given the limitations of the correlational findings and measurement issues, it is critical to continue to investigate societal-level factors of child maltreatment so that interventions and prevention efforts can incorporate strategies that have the greatest potential for population-level impact.
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Affiliation(s)
- Joanne Klevens
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Katie A. Ports
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Chelsea Austin
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ivan J. Ludlow
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jacqueline Hurd
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
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17
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Schofield TJ, Donnellan MB, Merrick MT, Ports KA, Klevens J, Leeb R. Intergenerational Continuity in Adverse Childhood Experiences and Rural Community Environments. Am J Public Health 2018; 108:1148-1152. [PMID: 30089003 PMCID: PMC6085037 DOI: 10.2105/ajph.2018.304598] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To understand the role of the community environment on intergenerational continuity in adverse childhood experiences (ACEs) among a rural White sample. METHODS Parents in 12 counties in rural Iowa reported retrospectively on their own ACEs in 1989. We measured their child's ACEs retrospectively and prospectively across adolescence (n = 451 families). We measured structural and social process-related measures of community environment (i.e., community socioeconomic status, parents' perception of community services, perceived community social cohesion, and neighborhood alcohol vendor density) on multiple occasions during the child's adolescence. RESULTS The 4 measures of community environment were all correlated with the child's ACEs, but only alcohol vendor density predicted ACEs after inclusion of covariates. Intergenerational continuity in ACEs was moderated by both social cohesion (b = -0.11; SE = 0.04) and alcohol vendor density (b = -0.11; SE = 0.05). CONCLUSIONS Efforts to increase community social cohesion and manage alcohol vendor density may assist families in breaking the cycle of maltreatment across generations.
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Affiliation(s)
- Thomas J Schofield
- Thomas J. Schofield is with the Department of Human Development and Family Studies, Iowa State University, Ames. M. Brent Donnellan is with the Department of Psychology, Texas A&M University, College Station. Melissa T. Merrick, Katie A. Ports, Joanne Klevens, and Rebecca Leeb are with the Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - M Brent Donnellan
- Thomas J. Schofield is with the Department of Human Development and Family Studies, Iowa State University, Ames. M. Brent Donnellan is with the Department of Psychology, Texas A&M University, College Station. Melissa T. Merrick, Katie A. Ports, Joanne Klevens, and Rebecca Leeb are with the Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Melissa T Merrick
- Thomas J. Schofield is with the Department of Human Development and Family Studies, Iowa State University, Ames. M. Brent Donnellan is with the Department of Psychology, Texas A&M University, College Station. Melissa T. Merrick, Katie A. Ports, Joanne Klevens, and Rebecca Leeb are with the Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Katie A Ports
- Thomas J. Schofield is with the Department of Human Development and Family Studies, Iowa State University, Ames. M. Brent Donnellan is with the Department of Psychology, Texas A&M University, College Station. Melissa T. Merrick, Katie A. Ports, Joanne Klevens, and Rebecca Leeb are with the Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Joanne Klevens
- Thomas J. Schofield is with the Department of Human Development and Family Studies, Iowa State University, Ames. M. Brent Donnellan is with the Department of Psychology, Texas A&M University, College Station. Melissa T. Merrick, Katie A. Ports, Joanne Klevens, and Rebecca Leeb are with the Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rebecca Leeb
- Thomas J. Schofield is with the Department of Human Development and Family Studies, Iowa State University, Ames. M. Brent Donnellan is with the Department of Psychology, Texas A&M University, College Station. Melissa T. Merrick, Katie A. Ports, Joanne Klevens, and Rebecca Leeb are with the Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Stevens AL, Herrenkohl TI, Mason WA, Smith GL, Klevens J, Merrick MT. Developmental effects of childhood household adversity, transitions, and relationship quality on adult outcomes of socioeconomic status: Effects of substantiated child maltreatment. Child Abuse Negl 2018; 79:42-50. [PMID: 29407855 PMCID: PMC6134210 DOI: 10.1016/j.chiabu.2018.01.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 01/06/2018] [Accepted: 01/31/2018] [Indexed: 05/30/2023]
Abstract
The degree to which child maltreatment interacts with other household adversities to exacerbate risk for poor adult socioeconomic outcomes is uncertain. Moreover, the effects of residential, school, and caregiver transitions during childhood on adult outcomes are not well understood. This study examined the relation between household adversity and transitions in childhood with adult income problems, education, and unemployment in individuals with or without a childhood maltreatment history. The potential protective role of positive relationship quality in buffering these risk relationships was also tested. Data were from the Lehigh Longitudinal Study (n = 457), where subjects were assessed at preschool, elementary, adolescent, and adult ages. Multiple group path analysis tested the relationships between childhood household adversity; residential, school, and caregiver transitions; and adult socioeconomic outcomes for each group. Caregiver relationship quality was included as a moderator, and gender as a covariate. Household adversity was negatively associated with education level and positively associated with income problems for non-maltreated children only. For both groups, residential transitions was negatively associated with education level and caregiver transitions was positively associated with unemployment problems. Relationship quality was positively associated with education level only for non-maltreated children. For children who did not experience maltreatment, reducing exposure to household adversity is an important goal for prevention. Reducing exposure to child maltreatment for all children remains an important public health priority. Results underscore the need for programs and policies that promote stable relationships and environments.
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Affiliation(s)
- Amy L Stevens
- Boys Town National Research Institute, 14100 Crawford Street, Boys Town, NE, 68010, USA.
| | - Todd I Herrenkohl
- University of Washington School of Social Work, Box 354900, Seattle, WA, 98195-4900, USA.
| | - W Alex Mason
- Boys Town National Research Institute, 14100 Crawford Street, Boys Town, NE, 68010, USA.
| | - Gail L Smith
- Boys Town National Research Institute, 14100 Crawford Street, Boys Town, NE, 68010, USA.
| | - Joanne Klevens
- Centers for Disease Control and Prevention, 1600 Clifton Road Atlanta, GA, 30329-4027, USA.
| | - Melissa T Merrick
- Centers for Disease Control and Prevention, 1600 Clifton Road Atlanta, GA, 30329-4027, USA.
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Klevens J, Ports KA. Gender Inequity Associated with Increased Child Physical Abuse and Neglect: a Cross-Country Analysis of Population-Based Surveys and Country-Level Statistics. J Fam Violence 2017; 32:799-806. [PMID: 29599571 PMCID: PMC5868418 DOI: 10.1007/s10896-017-9925-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Gender inequity is proposed as a societal-level risk factor for child maltreatment. However, most cross-national research examining this association is limited to developing countries and has used limited measures of gender inequity and child homicides as a proxy for child maltreatment. To examine the relationship between gender inequity and child maltreatment, we used caregivers' reported use of severe physical punishment (proxy for physical abuse) and children under 5 left alone or under the care of another child younger than 10 years of age (supervisory neglect) and three indices of gender inequity (the Social and Institutional Gender Index, the Gender Inequality Index, and the Gender Gap Index) from 57 countries, over half of which were developing countries. We found all three gender inequity indices to be significantly associated with physical abuse and two of the three to be significantly associated with neglect, after controlling for country-level development. Based on these findings, efforts to prevent child abuse and neglect might benefit from reducing gender inequity.
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Affiliation(s)
- Joanne Klevens
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), 4770 Buford Hwy, Mailstop F-63, Atlanta, GA 30341, USA
| | - Katie A Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), 4770 Buford Hwy, Mailstop F-63, Atlanta, GA 30341, USA
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20
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Breiding MJ, Basile KC, Klevens J, Smith SG. Economic Insecurity and Intimate Partner and Sexual Violence Victimization. Am J Prev Med 2017; 53:457-464. [PMID: 28501239 PMCID: PMC6426442 DOI: 10.1016/j.amepre.2017.03.021] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 03/10/2017] [Accepted: 03/29/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Previous research has consistently found that low SES is associated with higher levels of both intimate partner violence (IPV) and sexual violence (SV) victimization. Though associated with poverty, two indicators of economic insecurity, food and housing insecurity, have been identified as conceptually distinct social determinants of health. This study examined the relationship between food and housing insecurity experienced in the preceding 12 months and IPV and SV victimization experienced in the preceding 12 months, after controlling for SES and other demographic variables. METHODS Data were from the 2010 National Intimate Partner and Sexual Violence Survey, a nationally representative telephone survey of U.S. adults. In 2016, multivariate logistic regression modeling was used to examine the association between food and housing insecurity and multiple forms of IPV and SV victimization. RESULTS Robust associations were found between food and housing insecurity experienced in the preceding 12 months and IPV and SV experienced in the preceding 12 months, for women and men, even after controlling for age, family income, race/ethnicity, education, and marital status. CONCLUSIONS Food and housing insecurity may be important considerations for the prevention of SV and IPV or the reductions of their consequences, although future research is needed to disentangle the direction of the association. Strategies aimed at buffering economic insecurity may reduce vulnerability to IPV and SV victimization.
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Affiliation(s)
- Matthew J Breiding
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Kathleen C Basile
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joanne Klevens
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sharon G Smith
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Klevens J, Schmidt B, Luo F, Xu L, Ports KA, Lee RD. Effect of the Earned Income Tax Credit on Hospital Admissions for Pediatric Abusive Head Trauma, 1995-2013. Public Health Rep 2017; 132:505-511. [PMID: 28609181 DOI: 10.1177/0033354917710905] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Policies that increase household income, such as the earned income tax credit (EITC), have shown reductions on risk factors for child maltreatment (ie, poverty, maternal stress, depression), but evidence is lacking on whether the EITC actually reduces child maltreatment. We examined whether states' EITCs are associated with state rates of hospital admissions for abusive head trauma among children aged <2 years. METHODS We conducted difference-in-difference analyses (ie, pre- and postdifferences in intervention vs control groups) of annual rates of states' hospital admissions attributed to abusive head trauma among children aged <2 years (ie, using aggregate data). We conducted analyses in 14 states with, and 13 states without, an EITC from 1995 to 2013, differentiating refundable EITCs (ie, tax filer gets money even if taxes are not owed) from nonrefundable EITCs (ie, tax filer gets credit only for any tax owed), controlling for state rates of child poverty, unemployment, high school graduation, and percentage of non-Latino white people. RESULTS A refundable EITC was associated with a decrease of 3.1 abusive head trauma admissions per 100 000 population in children aged <2 years after controlling for confounders ( P = .08), but a nonrefundable EITC was not associated with a decrease ( P = .49). Tax refunds ranged from $108 to $1014 and $165 to $1648 for a single parent working full-time at minimum wage with 1 child or 2 children, respectively. CONCLUSIONS Our findings with others suggest that policies such as the EITC that increase household income may prevent serious abusive head trauma.
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Affiliation(s)
- Joanne Klevens
- 1 National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brian Schmidt
- 2 Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Feijun Luo
- 1 National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Likang Xu
- 1 National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katie A Ports
- 1 National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rosalyn D Lee
- 1 National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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22
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Dias MS, Rottmund CM, Cappos KM, Reed ME, Wang M, Stetter C, Shaffer ML, Hollenbeak CS, Paul IM, Christian CW, Berger RP, Klevens J. Association of a Postnatal Parent Education Program for Abusive Head Trauma With Subsequent Pediatric Abusive Head Trauma Hospitalization Rates. JAMA Pediatr 2017; 171:223-229. [PMID: 28135348 PMCID: PMC5863059 DOI: 10.1001/jamapediatrics.2016.4218] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Studies suggest that a postnatal parental intervention may reduce the incidence of abusive head trauma (AHT) of infants and young children. OBJECTIVE To assess the effect of statewide universal AHT education for parents on AHT hospitalization rates in Pennsylvania and on parents' self-reported knowledge gains and parenting behaviors. DESIGN, SETTING, AND PARTICIPANTS Changes in AHT hospitalization rates in Pennsylvania before and during the intervention were compared with those in 5 other states lacking universal parental AHT education during the same period. Data were collected from maternity units and birthing centers throughout Pennsylvania from the parents of 1 593 834 infants born on these units from January 1, 2003, to December 31, 2013. Parental behavior and knowledge were assessed through immediate (n = 16 111) and 7-month postintervention (n = 146) parent surveys in a per protocol analysis of evaluable parents. INTERVENTIONS Parents read a brochure, viewed an 8-minute video about infant crying and AHT, asked questions of the nurse, and signed a commitment statement affirming their participation. Educational posters were displayed on each unit. MAIN OUTCOMES AND MEASURES Changes in AHT hospitalization rates before and during the intervention in Pennsylvania and 5 other states. Secondary outcomes included self-reported knowledge gains and changes in parenting practices. RESULTS A total of 1 180 291 parents (74.1%) of children ranging in age from 0 to 23 months signed a commitment statement. Incidence rate ratios for hospitalization for AHT increased in Pennsylvania from 24.1 (95% CI, 22.1-26.3) to 26.6 (95% CI, 24.9-28.4) per 100 000 children aged 0 to 23 months during the intervention period; changes in Pennsylvania were not significantly different from aggregate changes in the 5 other states, from 22.4 (95% CI, 21.2-23.6) to 22.0 (95% CI, 21.2-22.8) per 100 000 children aged 0 to 23 months. A total of 16 111 parents (21.5% men, 78.5% women) completed the postnatal survey. Despite an overall 74.1% adherence with the intervention, only 20.6% of parents saw the brochure and video and only 5.7% were exposed to the entire intervention. Among the respondents answering individual questions on the postnatal surveys, 10 958 mothers (91.0%) and 2950 fathers (88.6%) reported learning a lot about understanding infant crying as normal; 11 023 mothers (92.2%) and 2923 fathers (88.9%), calming their infant, 11 396 mothers (94.6%) and 3035 fathers (91.9%), calming themselves; 10 060 mothers (85.1%) and 2688 fathers (83.4%), selecting other infant caregivers; and 11 435 mothers (94.8%) and 3201 fathers (95.8%), that the information would decrease the likelihood of shaking an infant. Among the 143 respondents completing the 7-month survey, 109 (76.2%) reported remembering the information while their child was crying. CONCLUSIONS AND RELEVANCE This intervention was not associated with a reduction in pediatric AHT hospitalization rates but was associated with self-reported gains in parental knowledge that were retained for 7 months.
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Affiliation(s)
- Mark S. Dias
- Department of Neurosurgery, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania,Department of Pediatrics, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania
| | - Carroll M. Rottmund
- Department of Neurosurgery, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania
| | - Kelly M. Cappos
- Department of Neurosurgery, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania
| | - Marie E. Reed
- Department of Neurosurgery, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania
| | - Ming Wang
- Department of Public Health Sciences, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania
| | - Christina Stetter
- Department of Public Health Sciences, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania
| | - Michele L. Shaffer
- Department of Public Health Sciences, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania,Department of Pediatrics, University of Washington, Seattle,Children’s Core for Biomedical Statistics, Seattle Children’s Research Institute, Seattle, Washington
| | - Christopher S. Hollenbeak
- Department of Pediatrics, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania,Department of Public Health Sciences, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania
| | - Ian M. Paul
- Department of Pediatrics, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania,Department of Public Health Sciences, Penn State University College of Medicine, Penn State Children’s Hospital, Hershey, Pennsylvania
| | - Cindy W. Christian
- Department of Pediatrics, University of Pennsylvania School of Medicine, Children’s Hospital of Philadelphia, Philadelphia
| | - Rachel P. Berger
- Department of Pediatrics, University of Pittsburgh School of Medicine, Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Joanne Klevens
- Division of Violence Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Abstract
Substantial research shows that early adversity, including child abuse and neglect, is associated with diminished health across the life course and across generations. Less well understood is the relationship between early adversity and adult socioeconomic status, including education, employment, and income. Collectively, these outcomes provide an indication of overall life opportunity. We analyzed data from 10 states and the District of Columbia that used the adverse childhood experiences (ACE) module in the 2010 Behavioral Risk Factor Surveillance System to examine the association between ACEs and adult education, employment, and income. Compared to participants with no ACEs, those with higher ACE scores were more likely to report high school non-completion, unemployment, and living in a household below the federal poverty level. This evidence suggests that preventing early adversity may impact health and life opportunities that reverberate across generations. Current efforts to prevent early adversity might be more successful if they broaden public and professional understanding (i.e., the narrative) of the links between early adversity and poverty. We discuss our findings within the context of structural policies and processes that may further contribute to the intergenerational continuity of child abuse and neglect and poverty.
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Affiliation(s)
- Marilyn Metzler
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
- Karna, LLC, Atlanta, GA
| | - Melissa T. Merrick
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Joanne Klevens
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Katie A. Ports
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Derek C. Ford
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Reyes HLM, Foshee VA, Klevens J, Tharp AT, Chapman MV, Chen MS, Ennett ST. Familial Influences on Dating Violence Victimization Among Latino Youth. J Aggress Maltreat Trauma 2016; 25:773-792. [PMID: 29503523 PMCID: PMC5831146 DOI: 10.1080/10926771.2016.1210270] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Despite theoretical and empirical evidence suggesting that the family environment plays a central role in Latino youth development, relatively little is known about how family processes influence dating violence victimization among Latino adolescents. To address this gap in the literature, we used data from 210 Latino parents and their 13- to 15-year-old adolescents to examine associations between several different family processes, including both parenting practices (parent monitoring, parent-adolescent communication) and aspects of the family relational climate (family cohesion, family conflict, acculturation conflict) and psychological, physical, and sexual dating violence victimization. Consistent with expectations, lower levels of family cohesion and higher levels of family and acculturation conflict were associated with risk for dating violence victimization, although associations varied depending on victimization type. In contrast, neither parental monitoring nor parent-adolescent communication was significantly associated with any type of dating violence victimization. In addition, we found that parent, but not teen, Anglo-American acculturation was associated with higher dating violence victimization risk. Findings suggest that family-based dating abuse prevention programs for Latino youth should seek to increase family cohesion and decrease family conflict, including acculturation-based conflict.
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Affiliation(s)
- H. Luz McNaughton Reyes
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Vangie A. Foshee
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joanne Klevens
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Andra Teten Tharp
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mimi V. Chapman
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - May S. Chen
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Susan T. Ennett
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Klevens J, Shelley G, Clavel-Arcas C, Barney DD, Tobar C, Duran ES, Barajas-Mazaheri R, Esparza J. Latinos’ Perspectives and Experiences With Intimate Partner Violence. Violence Against Women 2016; 13:141-58. [PMID: 17251502 DOI: 10.1177/1077801206296980] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This qualitative study, utilizing focus group interviews with community members and in-depth interviews with victims and perpetrators, explored Latinos’ beliefs and perceptions of IPV in Oklahoma City, Oklahoma, as a basis for developing culturally appropriate intimate partner violence (IPV) services for this population. The findings from these interviews suggest that this community recognizes IPV as a problem and is aware of the multiple dimensions, potential causes, and negative consequences of IPV. In general, participants perceived family and neighbors as preferring to not get involved in situations of IPV. However, family was also expected to, and often did, provide tangible support to victims. Directions for developing prevention programs for this population and future research are suggested.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Spies EL, Klevens J. Fatal Abusive Head Trauma Among Children Aged <5 Years — United States, 1999–2014. MMWR Morb Mortal Wkly Rep 2016; 65:505-9. [DOI: 10.15585/mmwr.mm6520a1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Klevens J, Luo F, Xu L, Peterson C, Latzman NE. Paid family leave's effect on hospital admissions for pediatric abusive head trauma. Inj Prev 2016; 22:442-445. [PMID: 26869666 DOI: 10.1136/injuryprev-2015-041702] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/17/2015] [Accepted: 11/28/2015] [Indexed: 11/03/2022]
Abstract
Paediatric abusive head trauma (AHT) is a leading cause of fatal child maltreatment among young children. Current prevention efforts have not been consistently effective. Policies such as paid parental leave could potentially prevent AHT, given its impacts on risk factors for child maltreatment. To explore associations between California's 2004 paid family leave (PFL) policy and hospital admissions for AHT, we used difference-in-difference analyses of 1995-2011 US state-level data before and after the policy in California and seven comparison states. Compared with seven states with no PFL policies, California's 2004 PFL showed a significant decrease in AHT admissions in both <1 and <2-year-olds. Analyses using additional data years and comparators could yield different results.
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Affiliation(s)
- Joanne Klevens
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Feijun Luo
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Likang Xu
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Cora Peterson
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Natasha E Latzman
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
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Zolotor AJ, Runyan DK, Shanahan M, Durrance CP, Nocera M, Sullivan K, Klevens J, Murphy R, Barr M, Barr RG. Effectiveness of a Statewide Abusive Head Trauma Prevention Program in North Carolina. JAMA Pediatr 2015; 169:1126-31. [PMID: 26501945 PMCID: PMC4687484 DOI: 10.1001/jamapediatrics.2015.2690] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Abusive head trauma (AHT) is a serious condition, with an incidence of approximately 30 cases per 100,000 person-years in the first year of life. OBJECTIVE To assess the effectiveness of a statewide universal AHT prevention program. DESIGN, SETTING, AND PARTICIPANTS In total, 88.29% of parents of newborns (n = 405 060) in North Carolina received the intervention (June 1, 2009, to September 30, 2012). A comparison of preintervention and postintervention was performed using nurse advice line telephone calls regarding infant crying (January 1, 2005, to December 31, 2010). A difference-in-difference analysis compared AHT rates in the prevention program state with those of other states before and after the implementation of the program (January 1, 2000, to December 31, 2011). INTERVENTION The Period of PURPLE Crying intervention, developed by the National Center on Shaken Baby Syndrome, was delivered by nurse-provided education, a DVD, and a booklet, with reinforcement by primary care practices and a media campaign. MAIN OUTCOMES AND MEASURES Changes in proportions of telephone calls for crying concerns to a nurse advice line and in AHT rates per 100,000 infants after the intervention (June 1, 2009, to September 30, 2011) in the first year of life using hospital discharge data for January 1, 2000, to December 31, 2011. RESULTS In the 2 years after implementation of the intervention, parental telephone calls to the nurse advice line for crying declined by 20% for children younger than 3 months (rate ratio, 0.80; 95% CI, 0.73-0.87; P < .001) and by 12% for children 3 to 12 months old (rate ratio, 0.88; 95% CI, 0.78-0.99; P = .03). No reduction in state-level AHT rates was observed, with mean rates of 34.01 person-years before the intervention and 36.04 person-years after the intervention. A difference-in-difference analysis from January 1, 2000, to December 31, 2011, controlling for economic indicators, indicated that the intervention did not have a statistically significant effect on AHT rates (β coefficient, -1.42; 95% CI, -13.31 to 10.45). CONCLUSIONS AND RELEVANCE The Period of PURPLE Crying intervention was associated with a reduction in telephone calls to a nurse advice line. The study found no reduction in AHT rates over time in North Carolina relative to other states. Consequently, while this observational study was feasible and supported the program effectiveness in part, further programmatic efforts and evaluation are needed to demonstrate an effect on AHT rates.
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Affiliation(s)
- Adam J. Zolotor
- Department of Family Medicine, University of North Carolina at Chapel Hill2Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - Desmond K. Runyan
- Department of Pediatrics, Kempe Center, University of Colorado, Aurora
| | - Meghan Shanahan
- Injury Prevention Research Center, University of North Carolina at Chapel Hill4Department of Maternal and Child Health, University of North Carolina at Chapel Hill
| | | | - Maryalice Nocera
- Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - Kelly Sullivan
- Center for Child and Family Health, Durham, North Carolina
| | - Joanne Klevens
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert Murphy
- Center for Child and Family Health, Durham, North Carolina8Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Marilyn Barr
- National Center on Shaken Baby Syndrome, Farmington, Utah
| | - Ronald G. Barr
- Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada11Canadian Institute for Advanced Research, Toronto, Ontario, Canada
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Green BL, Ayoub C, Dym Bartlett J, Furrer C, Von Ende A, Chazan-Cohen R, Klevens J, Nygren P. It's not as simple as it sounds: Problems and solutions in accessing and using administrative child welfare data for evaluating the impact of early childhood interventions. Child Youth Serv Rev 2015; 57:40-49. [PMID: 26744551 PMCID: PMC4699440 DOI: 10.1016/j.childyouth.2015.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In recent years, there has been increasing interest in using administrative data collected by state child welfare agencies as a source of information for research and evaluation. The challenges of obtaining access to and using these data, however, have not been well documented. This study describes the processes used to access child welfare records in six different states and the approach to combining and using the information gathered to evaluate the impact of the Early Head Start program on children's involvement with the child welfare system from birth through age eleven. We provide "lessons learned" for researchers who are attempting to use this information, including being prepared for long delays in access to information, the need for deep understanding of how child welfare agencies record and code information, and for considerable data management work for translating agency records into analysis-ready datasets. While accessing and using this information is not easy, and the data have a number of limitations, we suggest that the benefits can outweigh the challenges and that these records can be a useful source of information for policy-relevant child welfare research.
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Affiliation(s)
- Beth L Green
- Center for the Improvement of Child and Family Studies, Portland State University, P.O. Box 751, Portland, OR 97207-07541, United States
| | - Catherine Ayoub
- Brazelton Touchpoints Center - BCH3111, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 1295 Boylston, Suite 320, Boston, MA 02215, United States
| | - Jessica Dym Bartlett
- Brazelton Touchpoints Center - BCH3111, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 1295 Boylston, Suite 320, Boston, MA 02215, United States
| | - Carrie Furrer
- Center for the Improvement of Child and Family Studies, Portland State University, P.O. Box 751, Portland, OR 97207-07541, United States
| | - Adam Von Ende
- Brazelton Touchpoints Center - BCH3111, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 1295 Boylston, Suite 320, Boston, MA 02215, United States
| | - Rachel Chazan-Cohen
- College of Education and Human Development, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125, United States
| | - Joanne Klevens
- Division of Violence Prevention, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F-63, Atlanta, GA 30341, United States
| | - Peggy Nygren
- Center for the Improvement of Child and Family Studies, Portland State University, P.O. Box 751, Portland, OR 97207-07541, United States
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Affiliation(s)
- Joanne Klevens
- Division of Violence Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura S Sadowski
- Collaborative Research Unit, John H. Stroger, Jr Hospital of Cook County, Chicago, Illinois
| | - Romina Kee
- Collaborative Research Unit, John H. Stroger, Jr Hospital of Cook County, Chicago, Illinois
| | - Diana Garcia
- Collaborative Research Unit, John H. Stroger, Jr Hospital of Cook County, Chicago, Illinois
| | - Colby Lokey
- Division of Violence Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
IMPORTANCE Interpersonal violence, which includes child abuse and neglect, youth violence, intimate partner violence, sexual violence, and elder abuse, affects millions of US residents each year. However, surveillance systems, programs, and policies to address violence often lack broad, cross-sector collaboration, and there is limited awareness of effective strategies to prevent violence. OBJECTIVES To describe the burden of interpersonal violence in the United States, explore challenges to violence prevention efforts and to identify prevention opportunities. DATA SOURCES We reviewed data from health and law enforcement surveillance systems including the National Vital Statistics System, the Federal Bureau of Investigation's Uniform Crime Reports, the US Justice Department's National Crime Victimization Survey, the National Survey of Children's Exposure to Violence, the National Child Abuse and Neglect Data System, the National Intimate Partner and Sexual Violence Survey, the Youth Risk Behavior Surveillance System, and the National Electronic Injury Surveillance System-All Injury Program. RESULTS Homicide rates have decreased from a peak of 10.7 per 100,000 persons in 1980 to 5.1 per 100,000 in 2013. Aggravated assault rates have decreased from a peak of 442 per 100,000 in 1992 to 242 per 100,000 in 2012. Nevertheless, annually, there are more than 16,000 homicides and 1.6 million nonfatal assault injuries requiring treatment in emergency departments. More than 12 million adults experience intimate partner violence annually and more than 10 million children younger than 18 years experience some form of maltreatment from a caregiver, ranging from neglect to sexual abuse, but only a small percentage of these violent incidents are reported to law enforcement, health care clinicians, or child protective agencies. Moreover, exposure to violence increases vulnerability to a broad range of mental and physical health problems over the life course; for example, meta-analyses indicate that exposure to physical abuse in childhood is associated with a 54% increased odds of depressive disorder, a 78% increased odds of sexually transmitted illness or risky sexual behavior, and a 32% increased odds of obesity. Rates of violence vary by age, geographic location, sex, and race/ethnicity, and significant disparities exist. Homicide is the leading cause of death for non-Hispanic blacks from age 1 through 44 years, whereas it is the fifth most common cause of death among non-Hispanic whites in this age range. Additionally, efforts to understand, prevent, and respond to interpersonal violence have often neglected the degree to which many forms of violence are interconnected at the individual level, across relationships and communities, and even intergenerationally. The most effective violence prevention strategies include parent and family-focused programs, early childhood education, school-based programs, therapeutic or counseling interventions, and public policy. For example, a systematic review of early childhood home visitation programs found a 38.9% reduction in episodes of child maltreatment in intervention participants compared with control participants. CONCLUSIONS AND RELEVANCE Progress has been made in reducing US rates of interpersonal violence even though a significant burden remains. Multiple strategies exist to improve violence prevention efforts, and health care providers are an important part of this solution.
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Affiliation(s)
- Steven A Sumner
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia2Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James A Mercy
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Linda L Dahlberg
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan D Hillis
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joanne Klevens
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Debra Houry
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Klevens J, Sadowski LS, Kee R, Garcia D. Does Screening or Providing Information on Resources for Intimate Partner Violence Increase Women's Knowledge? Findings from a Randomized Controlled Trial. J Womens Health Issues Care 2015; 4:181. [PMID: 26740959 PMCID: PMC4699553 DOI: 10.4172/2325-9795.1000181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Screening for IPV in health care settings might increase women's knowledge or awareness around its frequency and its impact on health. When IPV is disclosed, assuring women it is not their fault should improve their knowledge that IPV is the perpetrator's responsibility. Providing information about IPV resources may also increase women's knowledge about the availability of solutions. METHODS Women (n=2708) were randomly assigned to one of three groups: (1) partner violence screen plus video referral and list of local partner violence resources if screening was positive (n=909); (2) partner violence resource list only without screen (n=893); and (3) a no-screen, no-partner violence resource list control group (n=898). One year later, 2364 women (87%) were re-contacted and asked questions assessing their knowledge of the frequency of partner violence, its impact on physical and mental health, the availability of resources to help women experiencing partner violence, and that it is the perpetrator's fault. RESULTS There were no differences between women screened and provided with a partner violence resource list compared to a control group as to women's knowledge of the frequency of IPV, its impact on physical or mental health, or the availability of IPV services in their community. However, among women who experienced IPV in the year before or year after enrolling in the trial, those who were provided a list of IPV resources without screening were significantly less likely to know that IPV is not the victim's fault than those in the control or list plus screening conditions. CONCLUSIONS The results of this study suggest that providing information on partner violence resources, with or without asking questions about partner violence, did not result in improved knowledge.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Laura S Sadowski
- Department of Medicine, Stroger Hospital of Cook County, Chicago, USA
| | - Romina Kee
- Department of Medicine, Stroger Hospital of Cook County, Chicago, USA
| | - Diana Garcia
- Hektoen Medical Research Institute, Chicago, IL, USA
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Klevens J, Barnett SBL, Florence C, Moore D. Exploring policies for the reduction of child physical abuse and neglect. Child Abuse Negl 2015; 40:1-11. [PMID: 25124051 PMCID: PMC4689429 DOI: 10.1016/j.chiabu.2014.07.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 07/16/2014] [Accepted: 07/23/2014] [Indexed: 05/15/2023]
Abstract
Policies can be powerful tools for prevention given their potential to affect conditions that can improve population-level health. Given the dearth of empirical research on policies' impacts on child maltreatment, this article (a) identifies 37 state policies that might have impacts on the social determinants of child maltreatment; (b) identifies available data sources documenting the implementation of 31 policies; and (c) utilizes the available data to explore effects of 11 policies (selected because they had little missing data) on child maltreatment rates. These include two policies aimed at reducing poverty, two temporary assistance to needy families policies, two policies aimed at increasing access to child care, three policies aimed at increasing access to high quality pre-K, and three policies aimed at increasing access to health care. Multi-level regression analyses between within-state trends of child maltreatment investigation rates and these 11 policies, controlling for states' childhood poverty, adults without a high school diploma, unemployment, child burden, and race/ethnicity, identified two that were significantly associated with decreased child maltreatment rates: lack of waitlists to access subsidized child care and policies that facilitate continuity of child health care. These findings are correlational and are limited by the quality and availability of the data. Future research might focus on a reduced number of states that have good quality administrative data or population-based survey data on child maltreatment or reasonable proxies for child maltreatment and where data on the actual implementation of specific policies of interest can be documented.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, GA, USA
| | - Sarah Beth L Barnett
- Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, GA, USA
| | - Curtis Florence
- Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, GA, USA
| | - DeWayne Moore
- Clemson College of Business and Behavioral Science, School of Psychology, Clemson, SC, USA
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Haegerich TM, Sugerman DE, Annest JL, Klevens J, Baldwin GT. Improving injury prevention through health information technology. Am J Prev Med 2015; 48:219-228. [PMID: 25441230 PMCID: PMC4700542 DOI: 10.1016/j.amepre.2014.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 07/29/2014] [Accepted: 08/14/2014] [Indexed: 10/24/2022]
Abstract
Health information technology is an emerging area of focus in clinical medicine with the potential to improve injury and violence prevention practice. With injuries being the leading cause of death for Americans aged 1-44 years, greater implementation of evidence-based preventive services, referral to community resources, and real-time surveillance of emerging threats is needed. Through a review of the literature and capturing of current practice in the field, this paper showcases how health information technology applied to injury and violence prevention can lead to strengthened clinical preventive services, more rigorous measurement of clinical outcomes, and improved injury surveillance, potentially resulting in health improvement.
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Affiliation(s)
- Tamara M Haegerich
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia.
| | - David E Sugerman
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Joseph L Annest
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Joanne Klevens
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Grant T Baldwin
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
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Green BL, Ayoub C, Bartlett JD, Von Ende A, Furrer C, Chazan-Cohen R, Vallotton C, Klevens J. The effect of Early Head Start on child welfare system involvement: A first look at longitudinal child maltreatment outcomes. Child Youth Serv Rev 2014; 42:127-135. [PMID: 26744550 PMCID: PMC4700883 DOI: 10.1016/j.childyouth.2014.03.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The high societal and personal costs of child maltreatment make identification of effective early prevention programs a high research priority. Early Head Start (EHS), a dual generational program serving low-income families with children prenatally through age three years, is one of the largest federally funded programs for infants and toddlers in the United States. A national randomized trial found EHS to be effective in improving parent and child outcomes, but its effectiveness in reducing child maltreatment was not assessed. The current study used administrative data from state child welfare agencies to examine the impact of EHS on documented abuse and neglect among children from seven of the original seventeen programs in the national EHS randomized controlled trial. Results indicated that children in EHS had significantly fewer child welfare encounters between the ages of five and nine years than did children in the control group, and that EHS slowed the rate of subsequent encounters. Additionally, compared to children in the control group, children in EHS were less likely to have a substantiated report of physical or sexual abuse, but more likely to have a substantiated report of neglect. These findings suggest that EHS may be effective in reducing child maltreatment among low-income children, in particular, physical and sexual abuse.
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Affiliation(s)
- Beth L. Green
- Center for the Improvement of Child and Family Studies, Portland State University, P.O. Box 751, Portland, OR 97207-07541, United States
| | - Catherine Ayoub
- Harvard Medical School and Brazelton Touchpoints Center, Touchpoints Center, Division of Developmental Medicine, Boston Children's Hospital, 1295 Boylston Street, Suite 320, Boston, MA 02215, United States
| | - Jessica Dym Bartlett
- Brazelton Touchpoints Center, Division of Developmental Medicine, Boston Children's Hospital, 1295 Boylston Street, Suite 320, Boston, MA 02215, United States
| | - Adam Von Ende
- Brazelton Touchpoints Center, Division of Developmental Medicine, Boston Children's Hospital, 1295 Boylston Street, Suite 320, Boston, MA 02215, United States
| | - Carrie Furrer
- Center for the Improvement of Child and Family Studies, Portland State University, P.O. Box 751, Portland, OR 97207-07541, United States
| | - Rachel Chazan-Cohen
- George Mason University, Department of Psychology, MSN 3F5, 4400 University Drive, Fairfax, VA 22030, United States
| | - Claire Vallotton
- Human Development & Family Studies, Michigan State University, 552 W. Circle Drive, 2G Human Ecology, East Lansing, MI 48824, United States
| | - Joanne Klevens
- Division of Violence Prevention, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F-64, Atlanta, GA 30341, United States
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Ishida K, Klevens J, Rivera-García B, Mirabal B. Child maltreatment in Puerto Rico: findings from the 2010 National Child Abuse and Neglect Data System. P R Health Sci J 2013; 32:124-131. [PMID: 24133893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Child maltreatment can have long-term adverse effects. Quantifying the scope and characteristics of child maltreatment is necessary for effective prevention in Puerto Rico. METHODS The National Child Abuse and Neglect Data System Child File contains all the reports of child maltreatment from the United States (US) and Puerto Rico. A child maltreatment victim is defined as a child whose maltreatment was substantiated or indicated by the local child protective agency. We compared reporting and victimization rates and reporting sources in Puerto Rico, with those in the US and examined characteristics of child maltreatment in Puerto Rico. RESULTS During 2006-2010, a total of 31,849-40,712 cases of child maltreatment were reported annually in Puerto Rico. Victimization rates are consistently higher in Puerto Rico than in the US (10.7/1,000-14.8/1,000 in Puerto Rico vs. 10.1/1,000-12.1/1,000 in the US), despite consistently lower reporting rates. In 2010, victimization rates were highest among children aged 1-6 years. In Puerto Rico, neglect is the most common form of maltreatment, followed by emotional abuse; however, the majority of victims suffered multiple types of abuse. Reporting was more commonly anonymous in Puerto Rico (29.8%) than in the US (9.4%) and less commonly provided by professionals in Puerto Rico (37.2%) than in the US (58.7%). CONCLUSION We identified a high prevalence of child maltreatment in Puerto Rico. A lower reporting rate, higher victimization rate, and substantial percentage of anonymous reporting indicate potential underreporting of child maltreatment in Puerto Rico. Increasing the awareness and training professionals for improved child maltreatment identification could help alleviate the problem of underreporting.
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Affiliation(s)
- Kanako Ishida
- Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, 1600 Clifton Road, E-92, Atlanta, GA 30333, USA.
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Klevens J, Kee R, Trick W, Garcia D, Angulo FR, Jones R, Sadowski LS. Partner Violence Screening and Women’s Quality of Life—Reply. JAMA 2012. [PMID: 22893165 DOI: 10.1001/jama.2012.14876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, Georgia, USA.
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Abstract
CONTEXT Although partner violence screening has been endorsed by many health organizations, there is insufficient evidence that it has beneficial health outcomes. OBJECTIVE To determine the effect of computerized screening for partner violence plus provision of a partner violence resource list vs provision of a partner violence list only on women's health in primary care settings, compared with a control group. DESIGN, SETTING, AND PARTICIPANTS A 3-group blinded randomized controlled trial at 10 primary health care centers in Cook County, Illinois. Participants were enrolled from May 2009-April 2010 and reinterviewed 1 year (range, 48-56 weeks) later. Participants were English- or Spanish-speaking women meeting specific inclusion criteria and seeking clinical services at study sites. Of 3537 women approached, 2727 were eligible, 2708 were randomized (99%), and 2364 (87%) were recontacted 1 year later. Mean age of participants was 39 years. Participants were predominantly non-Latina African American (55%) or Latina (37%), had a high school education or less (57%), and were uninsured (57%). INTERVENTION Randomization into 3 intervention groups: (1) partner violence screen (using the Partner Violence Screen instrument) plus a list of local partner violence resources if screening was positive (n = 909); (2) partner violence resource list only without screen (n = 893); and (3) no-screen, no-partner violence list control group (n=898). MAIN OUTCOME MEASURES Quality of life (QOL, physical and mental health components) was the primary outcome, measured on the 12-item Short Form (scale range 0-100, mean of 50 for US population). RESULTS At 1-year follow-up, there were no significant differences in the QOL physical health component between the screen plus partner violence resource list group (n = 801; mean score, 46.8; 95% CI, 46.1-47.4), the partner violence resource list only group (n = 772; mean score, 46.4; 95% CI, 45.8-47.1), and the control group (n = 791; mean score, 47.2; 95% CI, 46.5-47.8), or in the mental health component (screen plus partner violence resource list group [mean score, 48.3; 95% CI, 47.5-49.1], the partner violence resource list only group [mean score, 48.0; 95% CI, 47.2-48.9], and the control group [mean score, 47.8; 95% CI, 47.0-48.6]). There were also no differences between groups in days unable to work or complete housework; number of hospitalizations, emergency department, or ambulatory care visits; proportion who contacted a partner violence agency; or recurrence of partner violence. CONCLUSIONS Among women receiving care in primary care clinics, providing a partner violence resource list with or without screening did not result in improved health. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00526994.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, Georgia, USA.
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Klevens J, Simon TR, Chen J. Are the perpetrators of violence one and the same? Exploring the co-occurrence of perpetration of physical aggression in the United States. J Interpers Violence 2012; 27:1987-2002. [PMID: 22328658 DOI: 10.1177/0886260511431441] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Important gaps exist in our understanding of aggressive behavior and the extent to which aggression involves one or more types of victims. This information is critical for determining the utility of integrated approaches for violence prevention versus continuation of independent efforts for reducing community violence, partner violence, and child maltreatment. To better understand the overlap in aggressive behaviors within the general population, the authors examine the co-occurrence of self-reports of physically striking strangers, acquaintances, intimate partners, and children among a nationally representative sample of 3,024 U.S. adults. The findings from this cross-sectional random digit dial telephone survey show that more than a third of the population reports engaging in at least one form of aggression and that, of these, a third had perpetrated violence against more than one type of victim. The percent of respondents who reported perpetrating violence against more than one type of victim range from 13% (percent of those striking a friend or acquaintance who also struck a child) to 34% (percent of those striking a friend or acquaintance who also struck a stranger). Furthermore, engaging in one type of aggression substantially increases the odds of engaging in another from 1.5 to 4 times. The findings suggest potential value in pursuing both integrated and independent approaches in research and prevention.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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Klevens J, Sadowski L, Kee R, Trick W, Garcia D. Comparison of screening and referral strategies for exposure to partner violence. Womens Health Issues 2011; 22:e45-52. [PMID: 21798763 DOI: 10.1016/j.whi.2011.06.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 02/15/2011] [Accepted: 06/21/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although under debate, routine screening for intimate partner violence (IPV) is recommended in health care settings. This study explored the utility of different screening and referral strategies for women exposed to IPV in primary health care. METHODS Using a randomized controlled trial design we compared two screening strategies (health care providers [HCP] versus audio computer-assisted self-interviews [A-CASI]) and three referral strategies (HCP alone, A-CASI referral with HCP endorsement, and A-CASI alone). English-speaking women who were 18 years and older and were attending women's health clinics at a public hospital were eligible to participate. Participants were randomly assigned to one of three study groups (HCP screen and referral, A-CASI screen and referral with HCP referral endorsement, and A-CASI screen and referral). Women were reinterviewed by telephone 1 week later. The primary outcome was rate of IPV disclosure; secondary outcomes were screening mode preference, reactions to IPV screening, and use of referral resources. RESULTS Of the 129 eligible women, 126 women were enrolled (98%); 102 women (81% of those enrolled) completed the follow-up telephone interview. Disclosure rates were higher for women screened with A-CASI compared with HCP-screened women (21% vs. 9%; p = .07). Screening mode preference, impact of screening (positive and negative reactions), and rates of use of referral resources were similar between study groups. CONCLUSION A-CASI tended to yield higher rates of IPV disclosure and similar rates of use of referral resources. A-CASI technology may be a practical way to screen for IPV.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, GA 30341, USA.
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Edberg M, Cleary SD, Collins E, Klevens J, Leiva R, Bazurto M, Rivera I, del Cid AT, Montero L, Calderon M. The SAFER Latinos project: Addressing a community ecology underlying Latino youth violence. J Prim Prev 2011; 31:247-57. [PMID: 20607409 DOI: 10.1007/s10935-010-0219-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This paper describes the intervention model, early implementation experience, and challenges for the Seguridad, Apoyo, Familia, Educacion, y Recursos (SAFER) Latinos project. The SAFER Latinos project is an attempt to build the evidence for a multilevel participatory youth violence prevention model tailored to the specific circumstances of Central American immigrants. Specific circumstances targeted in this intervention are decreased family cohesion as a result of sequential immigration (i.e., parents arriving first and bringing their children years later or youth arriving without parents); multiple school barriers; community disorganization and low community efficacy; limited access to services; and a social context (including gang presence) that is linked to youth norms supporting violence. In its implementation, the initial intervention model was adapted to address barriers and challenges. These are described, along with lessons learned and the ongoing evaluation.
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Affiliation(s)
- Mark Edberg
- Department of Prevention and Community Health, School of Public Health and Health Services, George Washington University, 2175 K Street NW, Suite 700, Washington, DC 20037, USA.
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Abstract
Injuries are among the leading causes of death and disability worldwide. The burden caused by injuries is even greater among the poorer nations and is projected to increase. Very often the lack of technical and financial resources, as well as the urgency of the problem, preclude applying sophisticated surveillance and research methods for generating relevant information to develop effective interventions. In these settings, it is necessary to consider more rapid and less costly methods in applying the public health approach to the problem of injury prevention and control. Rapid Assessment Procedures (RAP), developed within the fields of epidemiology, anthropology and health administration, can provide valid information in a manner that is quicker, simpler, and less costly than standard data collection methods. RAP have been applied widely and successfully to infectious and chronic disease issues, but have not been used extensively, if at all, as tools in injury control. This paper describes Rapid Assessment Procedures that (1) are useful for understanding the scope of the problem and for identifying potential risk factors, (2) can assist practitioners in determining intervention priorities, (3) can provide in-depth knowledge about a specific injury-related problem, and (4) can be used in surveillance systems to monitor outcomes. Finally, the paper describes some of the caveats in using RAP.
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Affiliation(s)
- Joanne Klevens
- Division of Violence Prevention, National Center for Injury Control and Prevention, Centers for Disease Control, Atlanta, GA 30341, USA.
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Klevens J, Leeb RT. Child maltreatment fatalities in children under 5: Findings from the National Violence Death Reporting System. Child Abuse Negl 2010; 34:262-6. [PMID: 20304491 DOI: 10.1016/j.chiabu.2009.07.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Revised: 06/30/2009] [Accepted: 07/02/2009] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To describe the distribution of child maltreatment fatalities of children under 5 by age, sex, race/ethnicity, type of maltreatment, and relationship to alleged perpetrator using data from the National Violent Death Reporting System (NVDRS). STUDY DESIGN Two independent coders reviewed information from death certificates, medical examiner and police reports corresponding to all deaths in children less than 5 years of age reported to NVDRS in 16 states. RESULTS Of the 1,374 deaths for children under 5 reported to NVDRS, 600 were considered attributable to child maltreatment. Over a half of the 600 victims of child maltreatment in this age group were under 1 year old, 59% were male, 42% non-Hispanic Whites, and 38% were non-Hispanic Blacks. Two thirds of child maltreatment fatalities in children under 5 were classified as being due to abusive head trauma (AHT), 27.5% as other types of physical abuse, and 10% as neglect. Based on these data, fathers or their substitutes were significantly more likely than mothers to be identified as alleged perpetrators for AHT and other types of physical abuse, while mothers were more likely to be assigned responsibility for neglect. CONCLUSIONS Among children under 5 years, children under 1 are the main age group contributing to child maltreatment fatalities in the NVDRS. AHT is the main cause of death in these data. These findings are limited by underascertainment of cases and fair inter-rater reliability of coding. PRACTICE IMPLICATIONS The findings suggest the need to develop and evaluate interventions targeting AHT to reduce the overall number of child maltreatment deaths in young children. These interventions should make special efforts to include fathers and their substitutes.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-64, Atlanta, GA 30341, USA
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Abstract
This article reviews the existing literature on intimate partner violence (IPV) among Latinos to put the findings of this special issue into context. This review of the literature suggests that IPV occurs as frequently among Latinos as among non-Latinos when confounders are controlled for. There is also some preliminary evidence that Latinas experience similar forms of IPV and suffer similar consequences. Many of the risk factors associated with its occurrence are the same as those observed among non-Latinos, except that beliefs approving IPV and alcohol-drinking patterns may not have much explanatory value for the occurrence of IPV among Latinos. Role strain, especially as a result of immigration and acculturation, might be unique to Latinos, and its importance, and the importance of male dominance among Latinas experiencing IPV, deserve more research.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Post LA, Klevens J, Maxwell CD, Shelley GA, Ingram E. An examination of whether coordinated community responses affect intimate partner violence. J Interpers Violence 2010; 25:75-93. [PMID: 19196879 DOI: 10.1177/0886260508329125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study tests the impact of coordinated community response (CCR) on reducing intimate partner violence (IPV) and on modifying knowledge and attitudes. The authors conduct hierarchical linear modeling of data from a stratified random-digit dial telephone survey (n = 12,039) in 10 test and 10 control sites, which include 23 counties from different regions in the United States, to establish the impact of a CCR on community members' attitudes toward IPV, knowledge and use of available IPV services, and prevalence of IPV. Findings indicate that CCRs do not affect knowledge, beliefs, or attitudes of IPV, knowledge and use of available IPV services, nor risk of exposure to IPV after controlling for age, gender, ethnicity, income, and education. Women in communities with 6-year CCRs (as opposed to 3-year CCRs) are less likely to report any aggression against them in the past year. These results are discussed within the context of evaluation challenges of CCRs (e.g., IPV activities in comparison communities, variability across interventions, time lag for expected impact, and appropriateness of outcome indicators) and in light of the evidence of the impact of other community-based collaborations.
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Abstract
In this paper, we review the basis of the U.S. Preventive Services Task Force's recommendations related to routine screening for intimate partner violence (IPV), focus on two of the arguments of those who have rejected these recommendations, and based on these, suggest that this controversy has occurred, in part, as a result of different interpretations of the meaning of "screening." We differentiate screening from situations in which asking about IPV is essential for differential diagnosis, that is, exploring exposure to IPV when there are signs and symptoms that might result from this exposure. Finally, we describe the randomized, controlled trial CDC is conducting to contribute to the evidence the U.S. Preventive Services Task Force requries to make its recommendations.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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Klevens J, Baker CK, Shelley GA, Ingram EM. Exploring the links between components of coordinated community responses and their impact on contact with intimate partner violence services. Violence Against Women 2008; 14:346-58. [PMID: 18292374 DOI: 10.1177/1077801207313968] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the 1990s, concerns with response fragmentation for intimate partner violence (IPV) led to the promotion of coordinated community responses (CCRs) to prevent and control IPV. Evaluation of CCRs has been limited. A previous evaluation of 10 CCRs funded by the Centers for Disease Control and Prevention showed no overall impact on rates of IPV when compared to matched communities. However, there was great variability in the quality and quantity of CCR efforts between sites and thus potentially different levels of impact. This article establishes the impact of each of the 10 CCRs on women's past-year exposure to IPV and contact with IPV services and explores the associations between specific CCR components and contact with IPV services.
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Affiliation(s)
- Joanne Klevens
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
Reviews on primary prevention have identified effective strategies to prevent child maltreatment but have ignored potentially promising interventions that have not yet been evaluated as well as gaps in the development of programs. The goal of this review was to identify these gaps and recommend future directions for developing interventions from a public health perspective. To this end, a systematic review of the literature for 1980-2004 utilizing existing databases and found 188 primary prevention interventions that addressed a broad range of risk factors was conducted. However, few had been rigorously evaluated, and only a handful demonstrated impact on child maltreatment or its risk factors. From a public health perspective, interventions that target prevalent and neglected risk factors such as poverty, partner violence, teenage pregnancy, and social norms tolerating violence toward children need to be developed and evaluated. In addition, more attention should be given to low cost interventions delivered to the public, by society, or that require minimal effort from recipients.
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Affiliation(s)
- Joanne Klevens
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
OBJECTIVE To describe the components and development of the Early Prevention of Violence Program in the city of Medellín, Colombia, and to evaluate the results of its first phase, three years after implementation. METHODS A before (2001) and after (2004) study of four variables--direct aggression, indirect aggression, prosocial behavior, and scholastic achievement--was conducted among a convenience sample of 339 program participants and their families. RESULTS Several program benefits were noted. Decreases in both direct and indirect aggression were observed, though the latter was reduced only in girls and in those over 12 years old. Prosocial behavior increased among children of all ages and both genders, including those who exhibited low levels of prosocial behavior in 2001. In addition, improved school performance was seen in the group as a whole. Results may have been affected by some changes to the prevention program's implementation and by the dangerous nature of the neighborhood, which limited the home visits. CONCLUSIONS The program seems to be an effective intervention for highly aggressive children, among whom a decline in direct aggression was observed. It also offers preventive benefits, as evidenced by the rise of prosocial behaviors in less aggressive children.
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Affiliation(s)
- Luis Fernando Duque
- Universidad de Antioquia, Facultad Nacional de Salud Pública, Calle 62 #52-59, Medellín, Colombia.
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