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的产妇幸存者及其子女往往面临持续的虐待和骚扰，安全问题，缺乏 经济资源，以及与虐待伴侣分离后围绕监护权的法律的限制， 可能会影响儿童的健康，学校参与和蓬勃发展，并阻碍他们的孩子获得健康 在乎这项探索性混合方法研究的目的是发展分离后虐待的知识 并研究分离后虐待如何预测儿科健康和蓬勃发展的结果。具体目标 1）了解产妇IPV幸存者的分离后经历，包括分离后虐待， 他们的孩子的健康和繁荣，以及家庭法院的结构背景，2）检查是否普遍存在的 儿童的特殊医疗保健需求，未满足的健康需求，学校参与和蓬勃发展的不同， 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 定性阶段制定的新项目作为离职后虐待措施的可靠性，3 b） 确定分离后的虐待是否预示着儿童的健康和繁荣的结果。研究将开始 定性臂使用迭代主题调查，探讨产妇幸存者的经验后， 分离虐待与子女健康的关系（n=30）。质量部门还将确定新的项目， 现有的强制控制措施（WEB）和致命风险（DA）没有捕捉到分离滥用行为， 创建一个新的量表（分离后虐待的母婴经历，或“MCEPSA”量表）， 在第二个定量阶段，将进行横断面调查， 对母亲（n=150）进行评估，以评估其子女（6-17岁）未得到满足的健康需求， 需求，学校参与，以及NSCH中蓬勃发展的利用项目，然后比较患病率 采用比例检验，将招募样本中的儿童与来自NSCH的全国患病率数据进行比较。在 此外，我们亦会对质性研究的新项目进行初步的心理测试。此外， 本研究将使用逻辑回归分析来检验离职后哪些测量（WEB、DA、MCEPSA） 虐待最能预测儿童未得到满足的健康需求和特殊保健需求，并确定新的 MCEPSA中的项目在预测儿童特殊健康方面显著高于WEB和DA 保健需求和未满足的保健需求。最后，定量和定性阶段的结果将 综合，并提出了沿着的定量数据与主题和报价从定性数据。 这项混合方法的研究将记录健康差异，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 虐待和包括家庭法院程序在内的结构性背景联合收割机以复杂的方式结合在一起， 健康和繁荣。这项研究将确定潜在的干预领域， 联合国系统采取对策，促进遭受分离后虐待的儿童的积极健康。