What Happens Next: Households After a First-Time Finding of Child Abuse

描述（由申请人提供）：克里斯汀·坎贝尔博士是一名普通儿科医生，临床重点是儿童虐待，并在结果和有效性方面进行研究培训。她设计了这个职业发展奖，以支持她的短期职业目标，即在有虐待史的儿童和家庭的纵向评估方面获得专业知识，并了解我们目前对这些家庭的干预措施的多维影响。该奖项的完成将支持她的长期目标，即成为一名独立的临床科学家，致力于研究改善有虐待或忽视儿童历史的儿童和家庭的结果。坎贝尔博士的短期和长期职业目标与了解和改善儿童及其家庭终身健康的NICHD使命是一致的。在博士的指导下。Michael Dean和Heather Keenan， Campbell博士建立了一个多学科咨询团队和教学项目，提供定量和定性研究方法、社会和经济政策评估以及与儿童虐待儿科相关的研究伦理方面的培训。该培训计划与3个独立但相互关联的研究项目相关联，为儿童保护服务（CPS）首次发现虐待或忽视儿童后，儿童和照顾者共同生活的经历提供了多方面的视角。在具体目标1中，坎贝尔博士将研究家庭特征（社会支持、经济资源和家庭环境）的纵向变化与使用国家儿童和青少年福祉调查首次发现儿童虐待或忽视后36个月内重复转到CPS和儿童福祉之间的关系。在具体目标2中，坎贝尔博士将通过犹他州CPS和医疗补助数据库的联系，比较有和没有CPS发现儿童虐待或忽视的儿童的短期和长期医疗保健利用情况。在具体目标3中，坎贝尔博士将通过一系列半结构化的定性访谈，探讨首次发现儿童虐待或忽视后，CPS参与家庭的预期和意外后果。这些研究的发现将扩大我们对80%遭受虐待后仍与家人在一起的儿童的理解，并将为未来的研究提供信息，以减少再犯，改善有虐待或忽视儿童历史的儿童和家庭的结局。通过这项研究支持的多学科培训将加强候选人在设计和评估虐待后儿童和家庭干预措施方面提供地方和国家领导的能力。

DESCRIPTION (provided by applicant): Dr. Kristine Campbell is a general pediatrician with a clinical focus in child abuse and research training in outcomes and effectiveness. She has designed this career development award to support her short-term career goal of gaining expertise in the longitudinal assessment of children and families with a history of abuse and understanding the multi-dimensional effects of our current interventions on these families. Completion of this award will support her long-term goal of becoming an independent clinician-scientist dedicated research that will improve outcomes among children and families with a history of child abuse or neglect. Dr. Campbell's short and long-term career goals are consistent with the NICHD mission to understand and improve the lifelong health of children and their families. Under the mentorship of Drs. Michael Dean and Heather Keenan, Dr. Campbell has developed a multidisciplinary advisory team and didactic program to provide training in quantitative and qualitative research methods, social and economic policy evaluation, and research ethics related to child abuse pediatrics. This training plan is linked to 3 independent but interrelated research projects, providing a multi-faceted perspective on the experiences of children and caregivers living together after a first finding of child abuse or neglect by Child Protective Services (CPS). In Specific Aim 1, Dr. Campbell will examine the association between longitudinal change in household characteristics (social support, financial resources, and home environment) and repeat referrals to CPS and child well-being over the 36 months following a first-time finding of child abuse or neglect using the National Survey of Child and Adolescent Well-Being. In Specific Aim 2, Dr. Campbell will compare the short and long-term healthcare utilization of children with and without a CPS finding of child abuse or neglect through linkage of Utah CPS and Medicaid databases. In Specific Aim 3, Dr. Campbell will explore the anticipated and unanticipated consequences of CPS involvement in households after a first-time finding of child abuse or neglect through a series of semi-structured qualitative interviews. Findings from these studies will expand our understanding of the 80% of children who remain with their families after abuse, and will inform future research to reduce recidivism and improve outcomes for children and families living with a history of child abuse or neglect. The multi-disciplinary training supported through this research will strengthen the candidate's ability to provide future local and national leadership in design and evaluation of interventions for children and families after abuse. PUBLIC HEALTH RELEVANCE: In the United States, a first finding of child abuse offers a legally mandated opportunity to provide interventions to families at high risk for recurrent violence and abuse. In many cases, however, our response to child abuse fails to resolve the household conditions that contribute to lifelong physical, emotional, and social sequelae of childhood abuse. This award will improve our understanding of the experiences of children and caregivers with a history of abuse and build an evidence base for effective interventions for these families.