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及其子女的母亲生存经常面临持续的虐待和骚扰，安全问题，缺乏 与虐待合作伙伴分开后，财政资源和围绕监护权的法律限制 可能会影响儿童的健康，学校的敬业度和荧光，并阻碍孩子的健康状况 关心。这项探索性混合方法研究的目的是发展分离后滥用的知识 并检查分离后滥用后如何预测儿科健康和繁荣结果。具体目标 是：1）了解母体IPV幸存的分离后经历，包括分离后滥用， 他们的孩子的健康和荧光，以及家庭法院的结构背景，2）检查是否患病率是否流行 儿童的特殊医疗保健需求，未满足的健康需求，学校敬业度和荧光差异 与美国儿童总体相比，暴露于分离后虐待的儿童，3A）测试构建有效性和 从定性阶段开发的新项目的可靠性，作为分离后滥用的度量，3b） 确定分离后的滥用预测儿童的健康和蓬勃发展的结果。该研究将开始 使用迭代主题查询的定性臂，探索后的遗产生存经历 分离虐待及其子女的健康（n = 30）。定性部门还将确定新的新项目 - 分离滥用不是由现有的强制控制措施（Web）和致死性的风险（DA）捕获的 创建一种新的量表（母婴分离后滥用的经历，或“ MCEPSA”量表）将是 在探索性定量臂中进行了测试。在第二个定量阶段，横截面调查将是 管理给母亲（n = 150），以评估孩子的（6-17岁）未满足的健康需求，特殊的医疗保健 需要使用NSCH的物品的需求，学校参与和荧光，然后比较患病率 使用比例测试，我们从NSCH中招募的样本到全国患病率数据的儿童。在 此外，我们将对定性部门的新项目进行初步心理测试。更远， 该研究将使用逻辑回归来检查分离后分离的测量（Web，DA，MCEPSA） 虐待最能预测儿童未满足的健康需求和特殊的医疗保健需求，并确定新的 在预测儿童特殊健康方面 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 集成的，定量数据将与定性数据中的主题和报价一起介绍。 这项混合方法研究将记录健康分布，并为护士提供基础知识， 政策制定者，公共卫生专业人员和司法决策者，以了解分离后如何 虐待和结构性背景，包括以复杂方式影响儿童的家庭法院流程 健康和荧光。该研究将确定潜在的干预领域，以发展差异 系统的反应，以促进暴露于分离后滥用后的儿童积极健康。