Intimate Partner Violence and Child Health

项目摘要 怎样才能最大限度地减少亲密伴侣暴力对儿童健康的负面影响？IPV经常 尽管进行了社会或法律干预以制止暴力，但家庭中的暴力仍在继续。因此，孩子们留了下来 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，我们必须塑造IPV 即使IPV继续存在，也要采取干预措施来降低风险并增加保护因素。这需要一个 以理论为指导，以经验为基础的对IPV负面影响机制的理解 儿童健康，重点关注中介影响。拟议研究的目标是获得这样一个 理解。指导这项研究的总体框架是IPV会导致儿童健康状况不佳 它通过对产妇情绪健康和育儿方式的影响间接影响儿童的结果。 两个相关的注意事项包括模式(基于严重性、频率和 这些模式对儿童的影响可能是不同的。 这项提案概述了两项研究。第一项是对儿童从出生到中期的队列研究。 将使用包括结构方程建模在内的先进分析方法的童年：目标1： 界定IPV的潜在结构，评估IPV的类型，并确定IPV随时间的变化模式；目标2： 确定这些IPV结构与儿童健康和保健使用之间的关系；目标3： 评估母亲情绪健康和父母教养方式作为IPV和IPV之间关系的中介的作用 儿童健康。第二项定性研究涉及对年轻受虐妇女的半结构化访谈 儿童将：目标4：描述受虐妇女对IPV之间关系的看法，他们的情感 健康，他们的养育方式和他们孩子的健康。这些目标符合NICHD的使命：“所有儿童都能实现 他们在健康和富有成效的生活中的潜力。 为这位候选人提出的职业发展计划，是一名拥有 流行病学，重点是：1)了解IPV的病原学和流行病学；2)获得理论上的 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)获得质的研究技能。候选人的长期职业目标是领导 多学科努力，促进接触IPV的儿童的健康发展。在完成后 获奖后，她将提交R01申请，进行纵向队列研究，收集有关 当地一群接触和不接触IPV的儿童的健康状况。 从公共卫生的角度来看，童年是建立个人健康的关键时期 终身健康轨迹；IPV有可能严重危害儿童的健康。更好的 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。

Project Summary 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.