Estimating Surveillance Bias in Child Maltreatment Reporting During Home Visiting Program Involvement.
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ABSTRACT:
SUBMITTER: Holland ML
PROVIDER: S-EPMC10722865 | biostudies-literature | 2022 Sep
REPOSITORIES: biostudies-literature
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Estimating Surveillance Bias in Child Maltreatment Reporting During Home Visiting Program Involvement.
Holland Margaret L ML Esserman Denise D Taylor Rose M RM Flaherty Serena S Leventhal John M JM
Child maltreatment 20220902 1
It is unclear if surveillance bias (increased reports to Child Protective Services [CPS] related to program involvement) has a substantial impact on evaluation of home visiting (HV) prevention programs. We estimated surveillance bias using data from Connecticut's HV program, birth certificates, CPS, and hospitals. Using propensity score matching, we identified 15,870 families similar to 4015 HV families. The difference-in-differences approach was used to estimate surveillance bias as the change ...[more]
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Project description:Background: Children are believed to be more likely to be reported for maltreatment while they are working with mental health or social service professionals. This "surveillance bias" has been claimed to inflate reporting by fifty percent or more, and has been used to explain why interventions such as home visiting fail to reduce official maltreatment reporting rates. Methods: We use national child abuse reporting data (n = 825,763), supplemented by more detailed regional data from a multi-agency administrative data study (n = 7185). We determine the percentage of all re-reports made uniquely by mental health and social service providers within and across generations, the report sources which could be subject to surveillance bias. Results: At three years after the initial Child protective services (CPS) report, the total percentage of national reports uniquely made by mental health or social service providers is less than 10%, making it impossible that surveillance bias could massively inflate CPS reporting in this sample. Analysis of national data find evidence of a very small (+4.54%) initial surveillance bias "bump" among served cases which decays to +1.84% within three years. Our analysis of regional data showed similar or weaker effects. Conclusions: Surveillance bias effects appear to exist, but are very small.
| S-EPMC5615508 | biostudies-literature
Project description:BackgroundResearch is sparse on the community-level impacts of home visiting programs on child maltreatment.ObjectiveTo examine community-level associations between state-funded home visiting programs (i.e., IDHS-HV), federal-funded home visiting programs (i.e., MIECHV), and child maltreatment report (CMR) rates, overall and within subgroups of age, sex, and maltreatment type.Participants and setting3824 zip code-years during 2011-2018 in Illinois for IDHS-HV/CMR associations and 1896 zip code-years during 2015-2018 for MIECHV/CMR associations.MethodsWe measured county-level IDHS-HV rates (per 1000 children aged 0-5) since data were only available at that level. MIECHV rates (per 1000 children aged 0-5), CMR rates (per 1000 children), and all controls were measured at the zip code level. We used spatial linear models to handle spatial autocorrelation.ResultsAdjusted for controls, longitudinal increases of IDHS-HV rates were significantly associated with decreased overall CMR rates (coefficient: -0.28; 95 % CI: -0.45, -0.11), age 0-5 CMR rates (-0.52; -0.82, -0.22), age 6-11 CMR rates (-0.31; -0.55, -0.06), male CMR rates (-0.25; -0.45, -0.05), female CMR rates (-0.29; -0.49, -0.08), and neglect report rates (-0.13; -0.24, -0.02). In contrast, longitudinal increases of MIECHV rates were significantly associated with increased CMR rates within several subgroups.ConclusionsOur findings suggest that increasing state-funded home visiting services in communities may have benefits in lowering their CMR rates. Given the very low MIECHV service rates and the federal policy that requires MIECHV to target at-risk communities, the significant positive MIECHV/CMR associations we found might indicate MIECHV programs are typically in higher risk communities.
| S-EPMC10165847 | biostudies-literature
Project description:BackgroundYoung children living in historically marginalized families are at risk for becoming adolescents with obesity and subsequently adults with increased obesity-related morbidities. These risks are particularly acute for Hispanic children. We hypothesized that the prevention-focused, socioecological approach of the "Minding the Baby" (MTB) home visiting program might decrease the rate of childhood overweight and obesity early in life.MethodsThis study is a prospective longitudinal cohort study in which we include data collected during 2 phases of the MTB randomized controlled trial. First-time, young mothers who lived in medically underserved communities were invited to participate in the MTB program. Data were collected on demographics, maternal mental health, and anthropometrics of 158 children from birth to 2 years.ResultsMore children in the intervention group had a healthy BMI at 2 years. The rate of obesity was significantly higher (P < .01) in the control group (19.7%) compared with the intervention group (3.3%) at this age. Among Hispanic families, children in the MTB intervention were less likely to have overweight or obesity (odds ratio = 0.32; 95% confidence interval: 0.13-0.78).ConclusionsUsing the MTB program, we significantly lowered the rate of obesity among 2-year-old children living in low-socioeconomic-status communities. In addition, children of Hispanic mothers were less likely to have overweight or obesity at 2 years. Given the high and disproportionate national prevalence of Hispanic young children with overweight and obesity and the increased costs of obesity-related morbidities, these findings have important clinical, research, and policy implications.
| S-EPMC5810599 | biostudies-literature
Project description:This study evaluated the sustained effects of the Research-based Developmentally Informed Parent program (REDI-P) at fifth grade, six years after intervention. Participants were 200 prekindergarten children attending Head Start (55% White, 26% Black, 19% Latinx, 56% male, mean age of 4.45 years at study initiation) and their primary caregivers, who were randomly assigned to a control group or a 16-session home-visiting intervention that bridged the preschool and kindergarten years. In addition, the study explored moderation of sustained effects by parenting risks (e.g., less than high-school education, single-parent status, parental depression, and low parent-child warmth). Growth curves over the course of the elementary years examined outcomes in three domains: child academic performance, social-emotional adjustment, and parent-child functioning. At fifth grade, significant main effects for intervention were sustained in the domains of academic performance (e.g., reading skills, academic motivation, and learning engagement) and parent-child functioning (e.g., academic expectations and parenting stress). Significant moderation by parenting risk emerged on measures of social-emotional adjustment (e.g., social competence and student-teacher relationships); parenting risk also amplified effects on some measures of academic performance and parent-child functioning, with larger effects for children from families experiencing fewer risks. Implications are discussed for the design of preschool home visiting programs seeking to enhance the school success and social-emotional well-being of children living in poverty.
| S-EPMC8168937 | biostudies-literature
Project description:BackgroundResearch examining the effectiveness of home visiting programs that reduce child maltreatment or associated risks yield mixed findings; some find positive significant impacts on maltreatment, whereas others find small to no effects. The Michigan Model of Infant Mental Health Home Visiting (IMH-HV) is a manualized, needs-driven, relationship-focused, home-based intervention service that significantly impacts maternal and child outcomes; the effect of this intervention on child maltreatment has not been sufficiently evaluated.ObjectiveThe current study examined associations between treatment and dosage of IMH-HV and child abuse potential in a longitudinal, randomized controlled trial (RCT).Participants and settingParticipants included 66 mother-infant dyads (Mother M age = 31.93 years at baseline; child M age = 11.22 months at baseline) who received up to 1 year of IMH-HV treatment (Mdn = 32 visits) or no IMH-HV treatment during the study period.MethodsMothers completed a battery of assessments including the Brief Child Abuse Potential Inventory (BCAP) at baseline and at the 12-month follow-up assessment.ResultsRegression analyses indicated that after controlling for baseline BCAP scores, those who received any IMH-HV treatment had lower 12-month BCAP scores compared to those who received no treatment. Additionally, participation in more visits was associated with lower child abuse potential at 12 months, and a reduced likelihood of scoring in the risk range.ConclusionFindings suggest that greater participation in IMH-HV is associated with decreased risk for child maltreatment 1 year after initiating treatment. IMH-HV promotes parent-clinician therapeutic alliance and provides infant-parent psychotherapy which differentiate it from traditional home visiting programs.
| S-EPMC10012869 | biostudies-literature
Project description:ImportanceThe Family Connects (FC) program, a community-wide nurse home visiting program for newborns, has been shown to provide benefits for children and families through the first 2 years of life. Potential longer-term outcomes for child well-being remain unknown.ObjectiveTo determine the effect of randomization to FC on child maltreatment investigations and emergency medical care through 5 years of age.Design, setting, and participantsIn this randomized clinical trial, families of all 4777 resident births in Durham County, North Carolina, from July 1, 2009, to December 31, 2010, were randomly assigned to receive the FC program or treatment as usual. Impact evaluation was on an intent-to-treat basis and focused on a subsample of 549 families randomly selected from the full population and included review of hospital and Child Protective Services (CPS) administrative records. Statistical analysis was conducted from November 6, 2020, to April 25, 2021.InterventionsThe FC programs includes 1 to 3 nurse home visits beginning at the infant age of 3 weeks designed to identify family-specific needs, deliver education and intervention, and connect families with community resources matched to their needs. Ongoing program engagement with service professionals and an electronic resource directory facilitate effective family connections to the community.Main outcomes and measuresTwo primary trial outcomes were CPS-recorded child maltreatment investigations and emergency medical care use based on hospital records.ResultsOf the 4777 randomized families, 2327 were allocated to the intervention, and 2440 were allocated to services as usual. Among the children in the full study population, 2380 (49.8%) were female, 2397 (50.2%) were male, and 3359 (70.3%) were from racial/ethnic minority groups; of the 531 children included in the impact evaluation follow-up, 284 (53.5%) were female, 247 (46.5%) were male, and 390 (73.4%) were from racial/ethnic minority groups. Negative binomial models indicated that families assigned to FC had 39% fewer CPS investigations for suspected child maltreatment through 5 years of age (95% CI, -0.80 to 0.06; 90% CI, -0.73 to -0.01; control = 44 total investigations per 100 children and intervention = 27 total investigations per 100 children); intervention effects did not differ across subgroups. Families assigned to FC also had 33% less total child emergency medical care use (95% CI, -0.59 to -0.14; 90% CI, -0.55 to -0.18; control = 338 visits and overnight hospital stays per 100 children and intervention = 227 visits and overnight hospital stays per 100 children). Positive effects held across birth risk, child health insurance, child sex, single-parent status, and racial/ethnic groups. Effects were larger for nonminority families compared with minority families.Conclusions and relevanceThe findings of this randomized clinical trial suggest that, when implemented with high quality and broad reach, a brief postpartum nurse home visiting program can reduce population rates of child maltreatment and emergency medical care use in early childhood.Trial registrationClinicalTrials.gov Identifier: NCT01406184.
| S-EPMC8264647 | biostudies-literature
Project description:BackgroundIn 2016, Brazil scaled up the Criança Feliz Program (PCF, from the acronym in Portuguese), making it one of the largest Early Childhood Development (ECD) programs worldwide. However, the PCF has not been able to achieve its intended impact. We aimed to identify barriers and facilitators to achieving the PCF implementation outcomes across the RE-AIM dimensions (Reach, Effectiveness or Efficacy, Adoption, Implementation and Maintenance) during the COVID-19 pandemic.MethodsThis comparative case study analysis selected five contrasting municipalities based on population size, region of the country, implementation model, and length of time implementing the PCF. We conducted 244 interviews with PCF municipal team (municipal managers, supervisors, home visitors), families, and cross-sectoral professionals. A rapid qualitative analysis was used to identify themes across RE-AIM dimensions.FindingsFamilies' limited knowledge and trust in PCF goals were a barrier to its reach. While the perceived benefit of PCF on parenting skills and ECD enabled reach, the lack of referral protocols to address social needs, such as connecting food-insecure families to food resources, undermined effectiveness. Questions about whether the social assistance sector should be in charge of PCF challenged its adoption. Implementation barriers exacerbated by the COVID-19 pandemic included low salaries, temporary contracts, high turnover, infrequent supervision, lack of an effective monitoring system, and nonexistence or non-functioning multisectoral committees. The absence of institutionalized funding was a challenge for sustainability.InterpretationComplex intertwined system-level barriers may explain the unsuccessful implementation of PCF. These barriers must be addressed for Brazil to benefit from the enormous reach of the PCF and the evidence-based nurturing care principles it is based upon.FundingNIH/NICHD.
| S-EPMC10793162 | biostudies-literature
Project description:The purpose of this analysis was to understand public health nurses' experiences in preventing and addressing suspected child maltreatment within the context of home visiting. The principles of interpretive description guided study decisions and data were generated from interviews with 47 public health nurses. Data were analyzed using reflexive thematic analysis. The findings highlighted that public health nurses have an important role in the primary prevention of child maltreatment. These nurses described a six-step process for managing their duty to report suspected child maltreatment within the context of nurse-client relationships. When indicators of suspected child maltreatment were present, examination of experiential practice revealed that nurses developed reporting processes that maximized child safety, highlighted maternal strengths, and created opportunities to maintain the nurse-client relationship. Even with child protection involvement, public health nurses have a central role in continuing to work with families to develop safe and competent parenting skills.
| S-EPMC7882742 | biostudies-literature
Project description:This observational ecological study examined county-level associations between evidence-based home visiting (EHV) provisions and child maltreatment report (CMR) rates, using national county-level data from 2016-2018. We found that longitudinal changes of EHV provisions were significantly negatively associated with county CMR rates while controlling for potential confounders. Our model estimated that after EHV provisions were launched in counties, their CMR rates decreased (or after they were ceased, rates increased) by 2.21 per 1000 children overall, 2.88 per 1000 children aged 0-5, 2.59 per 1000 children aged 6-11, 2.13 per 1000 male children, and 2.24 per 1000 female children. When limiting attention to EHV provisions funded by the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, we found no significant association perhaps because MIECHV-funded EHV provisions were a small subset of all EHV provisions. These findings propose potential protective impacts of county EHV provisions on overall county CMR rates. Yet, the small effect sizes suggest that EHV provisions should be considered as a part of a complete response to child maltreatment rather than in isolation. Given that EHV is provided to a very small part of the population, nevertheless, our findings suggest that expanding coverage would increase effect sizes.
| S-EPMC9844259 | biostudies-literature
Project description:IntroductionChild maltreatment involves acts of omission (neglect) or commission (abuse) often by caregivers that results in potential or actual harm to a child. The Building Blocks trial (ISRCTN23019866) assessed the short-term impact of an intensive programme of antenatal and postnatal visiting by specially trained nurses to support young pregnant women in England. The Building Blocks: 2-6 Study will assess the medium-term impacts of the programme for mothers and children (n=1562), through the linkage of routinely collected data to the trial data, with a particular emphasis on the programme's impact on preventing child maltreatment.Methods and analysisWe have developed a bespoke model of data linkage whereby outcome data for the trial cohort will be retrieved by linked anonymous data abstraction from NHS Digital, Office for National Statistics and the Department for Education's National Pupil Database. Participants will be given reasonable opportunity to opt out of this study prior to data transfer. The information centres will match participants to the information held in their databases using standard identifiers and send extracts to a third-party safe haven. The study will have 80% power to detect a 4% difference (4%vs8%) for the binary primary outcome of child in need status (from birth to key stage 1) at a two-sided 5% alpha level by following up 602 children in each trial arm. Analysis will be by intention to treat using logistic multilevel modelling. A cost-and-consequences analysis will extend the time frame of the economic analysis from the original trial.Ethics and disseminationThe study protocol has been approved by the National Health Service Wales Research Ethics Committee and the Health Research Authority's Confidentiality Advisory Group. Methods of innovative study design and findings will be disseminated through peer-reviewed journals and conferences; results will be of interest to clinical and policy stakeholders in the UK.Trial registration numberISRCTN23019866.
| S-EPMC5734359 | biostudies-literature