Preventing child maltreatment: Examination of an established statewide home-visiting program.
Preventing child maltreatment: Examination of an established statewide home-visiting program.
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DOI：
10.1016/j.chiabu.2018.02.019
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发表时间：
2018-05
影响因子：
4.8
通讯作者：
Leventhal JM
中科院分区：
文献类型：
--
作者：
Chaiyachati BH;Gaither JR;Hughes M;Foley-Schain K;Leventhal JM
虽然家访已被用于许多人口的预防工作，扩大家访方案对虐待和忽视的影响仍然不清楚。本研究的目的是评估自愿参与既定的全州家访计划的社会高风险家庭对儿童虐待的影响，确定由儿童保护服务（CPS）。倾向评分匹配被用来比较社会高风险家庭与2008年1月1日至2011年12月31日之间出生的孩子谁参加了康涅狄格州的家访计划为第一次母亲和家庭的比较队列谁有资格进行家访计划，但没有参加。主要成果是儿童虐待调查，证实，并由CPS在2008年1月1日至2013年12月31日之间的家庭安置。在非匹配样本中，参加家访的家庭有显着较高的中位数风险评分（P < 0.001）。根据测量的混杂因素对家族进行匹配后，两组进行CPS检查的家族百分比（21.1% vs. 20.9%，P = 0.86）相似。然而，对于接受家访的家庭，CPS证实的可能性降低了22%（风险比[HR] 0.78，95%置信区间[CI] 0.64-0.95）。第一次证实也发生在儿童的生活后期，在家访家庭中。有减少家庭外安置的趋势（HR 0.73，95% CI 0.53-1.02，P = 0.06）。这些来自全州范围内扩大的项目的结果突出了家访作为预防虐待和忽视儿童的重要方法的潜力。
Although home visiting has been used in many populations in prevention efforts, the impact of scaled-up home-visiting programs on abuse and neglect remains unclear. The objective of this study was to assess the impact of voluntary participation in an established statewide home-visiting program for socially high-risk families on child maltreatment as identified by Child Protective Services (CPS). Propensity score matching was used to compare socially high-risk families with a child born between January 1, 2008 and December 31, 2011 who participated in Connecticut’s home-visiting program for first-time mothers and a comparison cohort of families who were eligible for the home-visiting program but did not participate. The main outcomes were child maltreatment investigations, substantiations, and out-of-home placements by CPS between January 1, 2008 and December 31, 2013. In the unmatched sample, families who participated in home-visiting had significantly higher median risk scores (P < 0.001). After matching families on measured confounders, the percentages of families with CPS investigations (21.1% vs. 20.9%, P =.86) were similar between the two groups. However, there was a 22% decreased likelihood of CPS substantiations (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.64–0.95) for families receiving home visiting. First substantiations also occurred later in the child’s life among home-visited families. There was a trend toward decreased out-of-home placement (HR 0.73, 95% CI 0.53–1.02, P =.06). These results from a scaled-up statewide program highlight the potential of home visiting as an important approach to preventing child abuse and neglect.
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影响因子：
8
作者：
Filene JH;Kaminski JW;Valle LA;Cachat P
通讯作者：
Cachat P
影响因子：
5.1
作者：
Chaffin, Mark;Bard, David
通讯作者：
Bard, David
影响因子：
8
作者：
Avellar, Sarah A.;Supplee, Lauren H.
通讯作者：
Supplee, Lauren H.
影响因子：
5
作者：
Schneeweiss, S;Seeger, JD;Glynn, RJ
通讯作者：
Glynn, RJ
影响因子：
1.9
作者：
COCHRAN, WG
通讯作者：
COCHRAN, WG