Testing the Efficacy of Early Head Start in Preventing Child Maltreatment: A Fift

项目摘要 拟议研究的目的是通过开展严格的 研究早期开端（EHS）对虐待和忽视儿童的影响。EHS是一级预防 为低收入婴儿、幼儿及其家庭制定的计划。尽管EHS已被证明是积极的， 与虐待有关的影响风险和保护因素，防止虐待的有效性， 忽视没有得到很好的研究。拟议的项目解决了虐待预防方面的关键差距 科学：（a）使用随机实验设计;（B）纵向跟踪大型研究样本 （c）利用记录在案的虐待报告， （d）确定关键的短期方案调解人，防止后来的虐待;以及 (e)区分方案对不同类型虐待（忽视、身体虐待和性虐待）的影响。 巨大的公共卫生影响、社会成本和有害的短期和长期健康 虐待和忽视儿童的后果有详细记录， 预防计划是疾病预防控制中心的优先领域。作为为高危婴儿提供服务的最大项目之一， 在该国的幼儿，这项研究的结果有显着的政策影响的潜力，提供 有证据表明，EHS计划可以减少危险和昂贵的虐待儿童。如今，EHS仅提供 5%的合格儿童;进一步支持其有效性将有助于扩大和宣传工作 这可以大大减少这个国家受虐待儿童的数量。此外，非常年轻的 接受EHS服务的儿童最容易受到与虐待有关的伤害和死亡，因此最需要帮助 有效的循证预防服务。本研究将解决五个研究问题：（1）是 EHS是否能有效减少参与儿童和家庭中的虐待儿童现象？(2)做积极的 EHS对早期儿童和父母结果的影响是否会介导后期项目对儿童虐待的影响？（三） EHS在防止特定儿童或家庭亚组的虐待方面是否更有效？(4)什么 EHS计划的特点与更好的预防结果有关？(5)儿童如何在EHS 在虐待的时间、类型、严重程度和/或长期性方面， 经验丰富？这项研究将使用最近一项试点研究中测试的方法， 3001名儿童及其照顾者参加了17个EHS项目，他们参加了一项国家随机临床试验 从1996年开始的计划影响。这项研究将把虐待数据与广泛的结果数据联系起来 在国家EHS研究中收集的数据（采访，观察，以及当儿童被 14、24、36和60个月大）。来自儿童福利案例档案的定性数据将使研究能够解决 方法问题阻碍了先前关于防止虐待和忽视儿童的研究。

Project Summary The purpose of the proposed research is to advance the science of violence prevention by conducting a rigorous study of the impact of Early Head Start (EHS) on child abuse and neglect. EHS is a primary prevention program for low-income infants, toddlers, and their families. Although EHS has been shown to positively impact risk and protective factors associated with maltreatment, its effectiveness in preventing abuse and neglect has not been well-studied. The proposed project addresses critical gaps in maltreatment prevention science by: (a) using a randomized experimental design; (b) following a large study sample longitudinally (birth to age 15) to assess long-term prevention outcomes; (c) utilizing documented reports of maltreatment as a measure program effectiveness; (d) identifying key short term program mediators of later maltreatment; and (e) differentiating program impacts for different types of abuse (neglect, physical abuse, and sexual abuse). The considerable public health impact, societal costs, and detrimental short and long-term health consequences of child abuse and neglect are well documented, and the identification of effective maltreatment prevention programs is a priority area for the CDC. As one of the largest programs serving at-risk infants and toddlers in the country, results from this study have significant potential for policy impact by providing evidence that the EHS program can reduce dangerous and costly child maltreatment. Today, EHS serves only 5% of eligible children; further support for its effectiveness will lend weight to expansion and advocacy efforts that could significantly reduce the number of children maltreated in this country. Further, the very young children served by EHS are most vulnerable to injury and death related to maltreatment, and thus most in need of effective evidence based prevention services. The present study will address five research questions: (1) Is EHS effective in reducing child maltreatment among participating children and families? (2) Do the positive impacts of EHS on early child and parent outcomes mediate later program effects on child maltreatment? (3) Is EHS more effective in preventing maltreatment for specific subgroups of children or families? (4) What characteristics of EHS programs are associated with better prevention outcomes? (5) How do children in EHS and the control group differ with regard to the timing, type, severity and/or chronicity of maltreatment experienced? This study will use methodology tested in a recent pilot study to obtain child welfare records for 3001 children and their caregivers in 17 EHS programs who participated in a national randomized clinical trial of program impacts starting in 1996. The study will link maltreatment data with the extensive outcome data collected in the national EHS study (interviews, observations, and direct child assessments when children were 14, 24, 36, and 60 months old). Qualitative data from child welfare case files will allow the study to address methodological issues that have hampered prior research on the prevention of child abuse and neglect.