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Reasons for reported suspicion of child maltreatment and responses from the child welfare - a cross-sectional study of Norwegian public dental health personnel.

ABSTRACT: BACKGROUND:To prevent child maltreatment, the identification of vulnerable children is essential. In Norway, public dental health personnel (PDHP) report suspicion of child maltreatment to child welfare services (CWS) at a relatively high rate. However, their reasons for reporting and the response from CWS have not been investigated. The objectives of this study were to (1) explore the reasons that PDHP send reports of concern, (2) examine how CWS responds to PDHP reports, and (3) assess whether different reasons for concern are associated with a given response from CWS. METHODS:A national cross-sectional study was conducted by an electronic survey distributed to public dental hygienists and dentists in Norway. Descriptive statistics were calculated in terms of mean (SD) distributions and frequency, expressed as % (n). To account for clustering of responses among respondents, binomial generalized estimating equation analysis was used to estimate odds ratios (ORs) and confidence intervals (CIs) of CWS responses across number of reports with different reasons for concern. RESULTS:Of a total of 1542 questionnaire recipients, 1200 (77.8%) responded to the survey. From 2012 to 2014, 42.5% of the respondents sent 1214 reports to CWS, with a mean number of 2.7 (SD?=?2.0) reports per respondent. The PDHP sent the reports due to suspicion of neglect or physical, sexual and/or psychological abuse. Non-attendance at dental appointments and grave caries were reported most frequently. Among the reports, 24.5% resulted in measures being taken by CWS, 20.7% were dropped, and 29.4% lacked information from CWS on the outcome. Reports due to suspicion of sexual abuse, (OR 1.979, 95% CI (1.047-3.742), P?=?0.036), grave caries (OR 1.628, 95% CI (1.148-2.309), P?=?0.006), and suspicion of neglect (OR 1.649, 95% CI (1.190-2.285), P?=?0.003) had the highest association with the implementation of measures. CONCLUSIONS:PDHP report on several forms of child maltreatment and contributes in detection of victimized children. However, the relatively low number of measures being taken by CWS and the number of reports that lack a response to reporters reveal a need for a closer cooperation between the services, as this would benefit both the children at risk and the services.

SUBMITTER: Brattabo IV

PROVIDER: S-EPMC5833052 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Reasons for reported suspicion of child maltreatment and responses from the child welfare - a cross-sectional study of Norwegian public dental health personnel.

Brattabø Ingfrid Vaksdal IV Bjørknes Ragnhild R Åstrøm Anne Nordrehaug AN

BMC oral health 20180302 1

<h4>Background</h4>To prevent child maltreatment, the identification of vulnerable children is essential. In Norway, public dental health personnel (PDHP) report suspicion of child maltreatment to child welfare services (CWS) at a relatively high rate. However, their reasons for reporting and the response from CWS have not been investigated. The objectives of this study were to (1) explore the reasons that PDHP send reports of concern, (2) examine how CWS responds to PDHP reports, and (3) assess ...[more]

PMID: 29499677

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Project description:BackgroundThis study provides an empirical test of the reasoned action approach (RAA) socio-cognitive theory with the aim of 1) predicting the intention of public dental health personnel (PDHP) to report suspected child-maltreatment to child welfare services (CWS); 2) estimating the effects of the theoretical constructs of RAA, including experiential and instrumental attitudes, injunctive and descriptive norms, and perceived capacity and autonomy regarding PDHP's behavioural intentions; and 3) exploring whether the RAA operates equivalently (i.e., is invariant) in male and female providers.MethodsThis national cross-sectional study was conducted in Norway. An electronic survey was distributed to 1542 dentists and dental hygienists working in the public dental health service. The survey included RAA items constructed in accordance with the recommendations for the RAA model. Structural equation modelling (SEM) was used to identify factors derived from the theory of RAA to predict PDHP reporting intentions.ResultsA total of 77.8% (1200) of those surveyed responded to the survey. The present study provided support for the utility of the RAA across both male and female providers in predicting their intention to report suspected child-maltreatment to the CWS. The final modified SEM model revealed that instrumental attitudes and perceived behavioural control (based on merged capacity and autonomy parameters) were the strongest predictors of intention to report, followed by the reporting of descriptive norms, injunctive norms and experiential attitudes. These factors explained 63.6% of the observed variance in the reporting intention.ConclusionsThe large amount of explained variance suggests that RAA is a well-functioning theory that predicts PDHP's reporting intentions to CWS across gender, and gives an understanding of the socio-cognitive factors involved. To strengthen reporting intention among dental personnel, this study suggests educators should focus on the value and positive consequences of reporting, the resources available and how to overcome obstacles; attention to normative expectations and individuals' feelings about reporting may also be helpful.

Project description:BackgroundEstimating the prevalence of child maltreatment is challenging due to the absence of a clear 'gold standard' as to what constitutes maltreatment. This systematic review aims to review studies using self-report maltreatment to capture prevalence rates worldwide.MethodsPubMed, Ovid SP and grey literature from the NSPCC, UNICEF, The UK Government, and WHO from 2000 to 2017 were searched. The literature review focused on the variation found in self-reported lifetime prevalence for each type of maltreatment between studies by continent and gender, and how methodological differences may explain differences found.ResultsSexual abuse is the most commonly studied form of maltreatment across the world with median (25th to 75th centile) prevalence of 20.4% (13.2% to 33.6%) and 28.8% (17.0% to 40.2%) in North American and Australian girls respectively, with lower rates generally for boys. Rates of physical abuse were more similar across genders apart from in Europe, which were 12.0% (6.9% to 23.0%) and 27.0% (7.0% to 43.0%) for girls and boys respectively, and often very high in some continents, for example, 50.8% (36.0% to 73.8%) and 60.2% (43.0% to 84.9%) for girls and boys respectively in Africa. Median rates of emotional abuse were nearly double for girls than boys in North America (28.4% vs 13.8% respectively) and Europe (12.9% vs 6.2% respectively) but more similar across genders groups elsewhere. Median rates of neglect were highest in Africa (girls: 41.8%, boys: 39.1%) and South America (girls: 54.8%, boys: 56.7%) but were based on few studies in total, whereas in the two continents with the highest number of studies, median rates differed between girls (40.5%) and boys (16.6%) in North America but were similar in Asia (girls: 26.3%, boys: 23.8%).ConclusionsMedian prevalence rates differ substantially by maltreatment category, gender and by continent. The number of studies and available data also varies and relatively little is known about prevalence for some forms of maltreatment, particularly outside of the North American context. Prevalence rates require caution in interpretation as some variation will reflect methodological differences, including the data collection methods, and how the maltreatment is defined.

Project description:ObjectivesTo examine associations between child maltreatment and health service use, both overall, by type and by the number of types of maltreatment reported.Design, settingCross-sectional, retrospective survey using the Juvenile Victimization Questionnaire-R2: Adapted Version (Australian Child Maltreatment Study); computer-assisted mobile telephone interviews using random digit dialling, Australia, 9 April - 11 October 2021.ParticipantsAustralians aged 16 years or more. The target sample size was 8500 respondents: 3500 people aged 16-24 years and 1000 respondents each from the five age groups (25-34, 35-44, 45-54, 55-64, 65 years or more).Main outcome measuresSelf-reported health service use during the past twelve months: hospital admissions, length of stay, and reasons for admission; and numbers of consultations with health care professionals, overall and by type. Associations between maltreatment and health service use are reported as odds ratios adjusted for age group, gender, socio-economic status, financial hardship (childhood and current), and geographic remoteness.ResultsA total of 8503 participants completed the survey. Respondents who had experienced child maltreatment were significantly more likely than those who had not to report a hospital admission during the preceding twelve months (adjusted odds ratio [aOR], 1.39; 95% confidence interval [CI], 1.16-1.66), particularly admission with a mental disorder (aOR, 2.4; 95% CI, 1.03-5.6). The likelihood of six or more visits to general practitioners (aOR, 2.37; 95% CI, 1.87-3.02) or of a consultation with a mental health nurse (aOR, 2.67; 95% CI, 1.75-4.06), psychologist (aOR, 2.40; 95% CI, 2.00-2.88), or psychiatrist (aOR, 3.02; 95% CI, 2.25-4.04) were each higher for people who reported maltreatment during childhood. People who reported three or more maltreatment types were generally most likely to report greater health service use.ConclusionsChild maltreatment has a major impact on health service use. Early, targeted interventions are vital, not only for supporting children directly, but also for their longer term wellbeing and reducing their health system use throughout life.

Dataset Information

Reasons for reported suspicion of child maltreatment and responses from the child welfare - a cross-sectional study of Norwegian public dental health personnel.

Publications

Reasons for reported suspicion of child maltreatment and responses from the child welfare - a cross-sectional study of Norwegian public dental health personnel.

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