CHILD ABUSE REPORTING EXPERIENCE STUDY (CARES)

美国每年受虐待的儿童人数 继续增加。尽管这一令人震惊的统计数据，初级保健 从业人员（PCP）并不经常报告涉嫌虐待儿童的情况 （SCAN）向政府儿童保护机构（CPS）提供。原因有 还不明白。这项研究将首次提供 小学SCAN管理的全面描述和分析 护理实践。 本研究是一项前瞻性描述性研究， 16,000例儿童伤害将在儿科研究中收集数据， 办公室设置（PROS）网络使用的协议源自 在区域实践研究网络（PBRN）中进行了试点。四百 PROS PCP将分别收集有关40次连续伤害访问的信息。他们 将报告医疗诊断，人口统计信息，以及他们的 涉嫌虐待儿童给PCP的后续电话将 进一步了解这些损伤的处理方法。该数据 将被用来构建小插图。一个虐待儿童小组的反应 这些小插曲的专家将被用来评估五氯苯酚的管理， 涉嫌滥用和误报率和误报率， CPS 收集的数据将用于实现以下具体目标 关于PCP对SCAN的护理：（1）确定PCP相关因素， 影响虐待的识别;（2）识别PCP相关因素， 影响任何可疑伤害的管理;以及（3）评估 PCP治疗儿童伤害。 将使用多变量逻辑回归建模来开发一个稳健的 关于SCAN的PCP决策模型。这项研究将提供最 在初级保健中对SCAN的全面描述，从而提供重要的 虐待儿童领域的研究和政策所需的数据 识别和管理。

The number of children who are maltreated each year in the US continues to increase. Despite this alarming statistic, primary care practitioners (PCPs)are not frequent reporters of suspected child abuse (SCAN)to government child protection agencies (CPS). The reasons for this are not yet understood. This proposed research will provide the first comprehensive description and analysis of the management of SCAN in primary care practices. This study is a prospective descriptive study of practitioner management of 16,000 childhood injuries. Data will be collected in the Pediatric Research in Office Setting (PROS)Network using a protocol that is derived from one that was piloted in a regional practice-based research network (PBRN). Four hundred PROS PCP will each gather information about 40 consecutive injury visits. They will report medical diagnosis, demographic information, and their level of suspicion for child physical abuse. Follow-up telephone calls to the PCP will elicit further information about the management of these injuries. This data will be used to construct vignettes. The response of a panel of child abuse experts to these vignettes will be used to evaluate the PCP management of suspected abuse and the rate of false positive and false negative reports to CPS. The data collected will be used to address the following specific aims concerning the care of SCAN by PCPs: (1) Identify PCP related factors that affect identification of maltreatment; (2) Identify PCP related factors that affect management of any suspicious injuries; and, (3) Assess the validity of PCP management of childhood injuries. Multivariate logistic regression modeling will be used to develop a robust model of PCP decision-making concerning SCAN. This study will provide the most thorough description ever of SCAN in primary care, thus providing important data needed for both research and policy in the area of child abuse identification and management.