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.

建议书摘要 IPV的产妇幸存者和他们的孩子经常面临持续的虐待和骚扰，安全问题，缺乏 财务资源，以及与虐待伴侣分居后关于监护权的法律限制 可能会影响儿童的健康、学校参与度和身心健康，并阻碍儿童获得健康 关心。这项探索性的混合方法研究的目的是发展对分离后虐待的认识。 并研究分居后虐待如何预测儿科健康和蓬勃发展的结果。具体目标 1)了解母体免疫缺陷病毒幸存者分离后的经历，包括分离后的虐待， 他们的孩子的健康和成长，以及家庭法庭的结构背景，2)检查是否患病率 儿童的特殊健康护理需求、未得到满足的健康需求、学校参与度和成就感因 与美国儿童总体相比，暴露于分离后虐待的儿童，3a)测试结构效度和 从定性阶段发展的新项目的可靠性，作为离职后滥用的衡量标准，3b) 确定分居后虐待行为是否预示着儿童的健康和成功结局。这项研究将开始 以质的臂采用迭代专题调查的方式探索孕产妇幸存者的后遗症经历 分离虐待及其子女健康(n=30)。定性部门还将确定新的员额项目-- 未被现有强制控制措施(Web)捕获的隔离滥用和致命性风险(DA) 创建一个新的量表(母婴分离后虐待经历，或“MCEPSA”量表)，将 在探索性量化臂上进行了测试。在第二个定量阶段，将进行横断面调查 对母亲(n=150)进行管理，以评估其子女(6-17岁)未得到满足的健康需求，特别卫生保健 需求、学校参与度和利用NSCH项目的蓬勃发展，然后比较患病率 我们招募的样本中的儿童使用比例检验从NSCH获得的全国患病率数据。在……里面 此外，我们将从定性的角度对新项目进行初步的心理测试。此外， 这项研究将使用Logistic回归来检验职位分离的哪种衡量标准(WEB、DA、MCEPSA 虐待最好地预测儿童未得到满足的健康需求和特殊的健康护理需求，并确定新的 在预测儿童特殊健康方面，MCEPSA中的条目在网络和DA之外具有显著意义 护理需求和未得到满足的健康需求。最后，定量和定性阶段的结果将是 综合起来，量化数据将与定性数据的主题和引文一起提出。 这项混合方法研究将记录健康差距，并为护理提供基础知识， 政策制定者、公共卫生专业人员和司法决策者了解分居后 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在一起，影响儿童的 健康兴旺。这项研究将确定潜在的干预领域，以发展差异化 促进遭受分离后虐待的儿童的积极健康的系统反应。