Longitudinal experiences of children remaining at home after a first-time investigation for suspected maltreatment.
Longitudinal experiences of children remaining at home after a first-time investigation for suspected maltreatment.
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首次调查疑似虐待后留在家中的儿童的纵向经历。
DOI：
10.1016/j.jpeds.2012.02.039
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Keenan,HeatherT
中科院分区：
文献类型：
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作者：
Campbell,KristineA;Thomas,AndreaM;Cook,LawrenceJ;Keenan,HeatherT
CAPTIVETo describe纵向变化的风险为儿童留在家里后，第一次调查涉嫌maltreatment.STUDY CAPTIVEGNA回顾性队列研究的儿童留在家里后，第一次调查虐待使用的家庭与儿童保护服务的全国代表性样本。结果包括贫困，社会支持，照顾者抑郁，亲密伴侣暴力（IPV），药物/酒精依赖，体罚和儿童行为问题在基线，18和36个月后的首次儿童保护服务调查。我们提出了纵向模型（1）估计患病率的风险因素在每个时间点;（2）检查风险特定的服务转介和纵向变化之间的关联风险因素prevalence. AUTS我们的样本代表1 057 056美国儿童留在家里的第一次调查虐待。 近100 000名（9.2%）儿童在36个月内接受了家庭外安置。 贫困（44.3%）、社会支持差（36.3%）、照顾者抑郁（24.4%）、IPV（22.1%）、内化（30.0%）和外化（35.8%）儿童行为问题的患病率高于基线时的一般人群患病率，并在接下来的36个月内保持较高水平。转介到特定风险的服务发生在少数情况下，但与IPV，药物/酒精依赖，并externalizing儿童行为problems.CONCLUSIONSChildren的纵向显着减少留在家里后，第一时间调查虐待生活与持续的风险因素重复虐待。适当的服务转介并不常见，但随着时间的推移，可能与有意义的风险降低有关。儿科医生和政策制定者可以通过提供适当的服务和转诊来改善这些家庭的结果。
OBJECTIVETo describe longitudinal change in risk for children remaining at home following a first-time investigation for suspected maltreatment.STUDY DESIGNA retrospective cohort study of children remaining at home following first-time investigation for maltreatment using a nationally representative sample of households involved with Child Protective Services. Outcomes include poverty, social support, caregiver depression, intimate partner violence (IPV), drug/alcohol dependence, corporal punishment, and child behavior problems at baseline, 18, and 36 months following first-time Child Protective Services investigation. We present longitudinal models to (1) estimate prevalence of risk factors at each timepoint; and (2) examine associations between risk-specific service referrals and longitudinal change in risk factor prevalence.RESULTSOur sample represented 1 057 056 US children remaining at home following first-time investigation for maltreatment. Almost 100 000 (9.2%) children experienced out-of-home placement within 36 months. The prevalence of poverty (44.3%), poor social support (36.3%), caregiver depression (24.4%), IPV (22.1%), and internalizing (30.0%) and externalizing (35.8%) child behavior problems was above general population prevalence at baseline and remained high over the next 36 months. Referral to risk-specific services occurred in a minority of cases, but was associated with significant longitudinal reductions in IPV, drug/alcohol dependence, and externalizing child behavior problems.CONCLUSIONSChildren remaining at home following a first-time investigation for maltreatment live with persistent risk factors for repeat maltreatment. Appropriate service referrals are uncommon, but may be associated with meaningful reduction in risk over time. Pediatricians and policy makers may be able to improve outcomes in these families with appropriate service provision and referrals.