Intimate Partner Violence and Child Health

亲密伴侣暴力与儿童健康

• 批准号: 7359890
• 负责人: MEGAN H BAIR-MERRITT
• 金额: $ 12.33万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-06 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7359890
• 关键词: Address; Affect; Aggressive behavior; Anxiety; Award; Battered Women; Birth; Child; Child Development; Child health care; Childhood; Cohort Studies; Conflict (Psychology); Data; Data Analyses; Emotional; Epidemiology; Equation; Etiology; Exposure to; Family; Female; Frequencies; Goals; Health; Healthcare; Individual; Intervention; Interview; Lead; Learning; Legal Intervention; Life; Link; Mediating; Mediator of activation protein; Mental Depression; Methods; Mission; Modeling; Outcome; Parenting behavior; Pattern; Perception; Program Development; Public Health; Qualitative Research; Research; Risk; Role; Severities; Shapes; Social Work; Structure; Testing; Time; Typology; Violence; Woman; Work; analytical method; base; career; child well being; cohort; design; intimate partner violence; male; multidisciplinary; pediatrician; peer; physical abuse; skills; social; therapy design

DESCRIPTION (provided by applicant): How can the negative impact of intimate partner violence (IPV) on child health be minimized? IPV often continues in families despite social or legal interventions to stop the violence. Children therefore remain vulnerable to adverse health outcomes. This suggests that, to protect children's health, we must shape IPV interventions to reduce risks and to increase protective factors even if IPV continues. This requires a theoretically-guided, empirically-based understanding of the mechanisms by which IPV adversely influences child health, with a focus on the mediating influences. The goal of the proposed research is to gain such an understanding. The overarching framework guiding this research is that IPV leads to poor child health indirectly through its influence on maternal emotional health and parenting, which in turn affect child outcomes. Two related considerations include that patterns (based on variables such as severity, frequency and directionality) of IPV exist and that these patterns likely affect children differently. This proposal outlines two studies. The first is a cohort study of children followed from birth to middle childhood in which advanced analytical methods including structural equation modeling will be used to: Aim 1: Define the latent construct of IPV, assessing typologies of IPV and identifying patterns of IPV over time; Aim 2: Determine the relationship between these IPV constructs and children's health and health care use; Aim 3: Assess the role of maternal emotional health and parenting as mediators of the relationship between IPV and child health. A second qualitative study involving semi-structured interviews with abused women with young children will: Aim 4: Characterize abused women's perceptions of the relationship among IPV, their emotional health, their parenting and their child's health. These aims fit with NICHD's mission of "all children achieving their potential for healthy and productive lives." The proposed career development program for this candidate, a pediatrician with a degree in epidemiology, focuses on: 1) understanding the etiology and epidemiology of IPV; 2) obtaining a theoretical understanding of the impact of family conflict on children's health; 3) learning higher level data analysis methods; and 4) acquiring qualitative research skills. The candidate's long-term career goal is to lead multidisciplinary efforts to facilitate the healthy development of children exposed to IPV. Upon completion of this award, she will submit an R01 application for a longitudinal cohort study collecting primary data on the health of a local cohort of children with and without IPV exposure. From a public health perspective, childhood is a critical time period in establishing an individual's lifetime health trajectory; IPV has the potential to significantly compromise children's health. A better understanding of the IPV-child health relationship will facilitate the design of effective, targeted interventions.

描述（由申请人提供）：如何最大限度地减少亲密伴侣暴力（IPV）对儿童健康的负面影响？尽管采取了社会或法律的干预措施来制止暴力，但家庭中的IPV往往继续存在。因此，儿童仍然容易受到不利健康后果的影响。这表明，为了保护儿童的健康，我们必须制定IPV干预措施，以减少风险并增加保护因素，即使IPV继续存在。这需要一个理论指导下的，基于实验的理解IPV对儿童健康产生不利影响的机制，重点是中介影响。这项研究的目的就是为了获得这样的理解。指导这项研究的总体框架是，IPV通过影响母亲的情绪健康和养育子女间接导致儿童健康状况不佳，这反过来又影响儿童的结果。两个相关的考虑因素包括IPV的模式（基于严重程度、频率和方向性等变量）存在，并且这些模式可能对儿童产生不同的影响。 该提案概述了两项研究。第一项是对从出生到童年中期的儿童进行的队列研究，其中将使用包括结构方程模型在内的先进分析方法：目标1：定义IPV的潜在结构，评估IPV的类型学并确定IPV随时间的模式;目标2：确定这些IPV结构与儿童健康和医疗保健使用之间的关系;目标3：评估产妇的情绪健康和养育作为中介的IPV和儿童健康之间的关系的作用。第二项定性研究涉及对有幼儿的受虐待妇女进行半结构化访谈，目的4：描述受虐待妇女对IPV、她们的情绪健康、她们的养育子女和她们的子女健康之间关系的看法。这些目标符合NICHD的使命，即“所有儿童都能发挥潜力，过上健康和富有成效的生活。“这位候选人的职业发展计划是一位拥有流行病学学位的儿科医生，重点是：1）了解IPV的病因学和流行病学; 2）从理论上了解家庭冲突对儿童健康的影响; 3）学习更高层次的数据分析方法; 4）获得定性研究技能。候选人的长期职业目标是领导多学科的努力，以促进儿童暴露于IPV的健康发展。完成该奖项后，她将提交R 01申请，进行纵向队列研究，收集当地有和没有IPV暴露的儿童队列健康的主要数据。 从公共卫生的角度来看，童年是建立个人一生健康轨迹的关键时期; IPV有可能严重损害儿童的健康。更好地了解IPV与儿童健康的关系将有助于设计有效的、有针对性的干预措施。