Understanding the Impact of Post-Separation Abuse on Children's Health and Flourishing Outcomes

了解分居后虐待对儿童健康和成长结果的影响

• 批准号: 10605434
• 负责人: Kathryn Jane Spearman
• 金额: $ 5.02万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-12 至 2026-01-11
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10605434
• 关键词: Abuse Reporting; Address; Adult; Affect; Age; Area; Assessment tool; Attention; Behavior; Behavioral; Caring; Child; Child Development; Child Health; Child Rearing; Child Welfare; Childhood; Chronic; Communities; Complex; Cross-Sectional Studies; Curiosities; Data; Development; Device or Instrument Development; Discipline of Nursing; Economics; Emotional; Emotions; Ensure; Environment; Exposure to; Face; Family; Foundations; Health; Health Professional; Health Surveys; Healthcare; Individual; Intervention; Interview; Knowledge; Learning; Legal; Logistic Regressions; Measures; Methods; Minor; Modeling; Morbidity - disease rate; Mothers; National Institute of Child Health and Human Development; Outcome; Pattern; Perception; Phase; Policy Maker; Prevalence; Process; Productivity; Psyche structure; Psychometrics; Public Health; Research; Research Personnel; Resources; Risk; Risk Assessment; Risk Factors; Safety; Sampling; Schools; Secure; Strategic Planning; Structure; Surveys; Survivors; System; Testing; Time; Validity and Reliability; Woman; adverse childhood events; arm; care systems; career; court; discount; divorce/separation; experience; health care availability; health care service; health data; health disparity; innovation; interest; intimate partner violence; outcome prediction; recruit; response; traumatized children; violence exposure

PROPOSAL SUMMARY Maternal survivors of IPV and their children often face ongoing abuse and harassment, safety concerns, lack of financial resources, and legal constraints around custody following separation from an abusive partner that may impact children’s health, school engagement, and flourishing and impede their children’s access to health care. The purpose of this exploratory mixed-methods study is to develop knowledge of post-separation abuse and examine how post-separation abuse predicts pediatric health and flourishing outcomes. The specific aims are: 1) Understand post-separation experiences of maternal IPV survivors including post-separation abuse, their children’s health and flourishing, and the structural context of family court, 2) Examine if the prevalence of children’s special health care needs, unmet health needs, school engagement, and flourishing differs for children exposed to post-separation abuse as compared to US children overall, 3a) Test construct validity and reliability of new items developed from the qualitative phase as measures of post-separation abuse, 3b) Determine if post-separation abuse predicts children’s health and flourishing outcomes. The study will begin with a qualitative arm using iterative thematic inquiry to explore maternal survivors experiences of post- separation abuse and their children’s health (n=30). The qualitative arm will also identify new items of post- separation abuse not captured by existing measures of coercive control (WEB) and the risk of lethality (DA) to create a new scale (Maternal Child Experiences of Post-Separation Abuse, or “MCEPSA” Scale) that will be tested in the exploratory quantitative arm. In the second quantitative phase, cross-sectional surveys will be administered to mothers (n=150) to assess their children’s (age 6-17) unmet health needs, special health care needs, school engagement, and flourishing utilizing items from the NSCH, and then compare prevalence rates of children in our recruited sample to national prevalence data from the NSCH using test of proportions. In addition, we will conduct preliminary psychometric testing of the new items from the qualitative arm. Further, the study will use logistic regression to examine which measure (WEB, DA, MCEPSA) of post separation abuse best predicts children’s unmet health needs and special health care needs and to determine if the new items in the MCEPSA are significant above and beyond the WEB and DA in predicting children’s special health care needs and unmet health needs. Finally, the results of the quantitative and qualitative phases will be integrated, and the quantitative data will be presented along with themes and quotes from the qualitative data. This mixed-methods study will document health disparities and provide foundational knowledge for nursing, policy makers, public health professionals, and judicial decision-makers to understand how post-separation abuse and the structural context including family court processes combine in complex ways to affect children’s health and flourishing. The study will identify potential areas of intervention in order to develop differential systems responses to promote positive health for children exposed to post-separation abuse.

提案摘要 IPV 的母亲幸存者及其子女经常面临持续的虐待和骚扰、安全问题、缺乏 财务资源以及与施虐伴侣分居后有关监护权的法律限制 可能会影响儿童的健康、学校参与和成长，并阻碍他们的孩子获得健康 关心。这项探索性混合方法研究的目的是加深对分居后虐待的了解 并研究分居后虐待如何预测儿科健康和繁荣的结果。具体目标 是： 1) 了解 IPV 母亲幸存者的分居经历，包括分居后虐待， 孩子的健康和成长，以及家庭法庭的结构背景，2) 检查是否存在 儿童的特殊医疗保健需求、未满足的健康需求、学校参与度和繁荣程度因人而异 与美国总体儿童相比，遭受分居后虐待的儿童，3a) 测试结构有效性和 从定性阶段开发的新项目的可靠性，作为分居后虐待的衡量标准，3b) 确定分居后虐待是否预示着儿童的健康和成长。研究即将开始 定性部门使用迭代主题调查来探索孕产妇幸存者的经历 分离虐待及其子女的健康（n=30）。定性部门还将确定后期的新项目 现有强制控制措施 (WEB) 未涵盖的分离滥用和致死风险 (DA) 创建一个新量表（母子分居后虐待经历，或“MCEPSA”量表） 在探索性定量组中进行了测试。在第二个定量阶段，将进行横断面调查 向母亲 (n=150) 提供，以评估其子女（6-17 岁）未满足的健康需求、特殊医疗保健 需求、学校参与度和 NSCH 项目的蓬勃利用，然后比较患病率 使用比例检验将我们招募的样本中的儿童与 NSCH 的全国患病率数据进行比较。在 此外，我们将对定性部门的新产品进行初步心理测试。更远， 该研究将使用逻辑回归来检查离职后的哪种衡量标准（WEB、DA、MCESPA） 虐待最能预测儿童未满足的健康需求和特殊医疗保健需求，并确定新的 MCEPSA 中的项目在预测儿童特殊健康方面的重要性高于 WEB 和 DA 护理需求和未满足的健康需求。最后，定量和定性阶段的结果将是 整合后，定量数据将与定性数据的主题和引用一起呈现。 这项混合方法研究将记录健康差异并提供护理基础知识， 政策制定者、公共卫生专业人员和司法决策者了解分居后如何 虐待和包括家庭法庭程序在内的结构性背景以复杂的方式结合起来影响儿童的 健康繁荣。该研究将确定潜在的干预领域，以制定差异化的政策 系统应对措施，以促进遭受分居后虐待的儿童的积极健康。