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Intergenerational transmission of placement in out-of-home care: mediation and interaction by educational attainment
- Authors:
- BRANNSTROM Lars, VINNERLJUNG Bo, ALMQUIST Ylva B.
- Journal article citation:
- Child Abuse and Neglect, 123, 2022, p.105436.
- Publisher:
- Elsevier
Background: Persons with childhood experiences of out-of-home care (OHC) have elevated risks of having their own children taken into societal care. High educational attainment has been linked to favourable long-term outcomes in a host of previous studies on OHC alumni. This could be indicative of resilience, which may also have protective potential against intergenerational continuity of OHC placements. Objective: The present study examined the processes of mediation and interaction by educational attainment, here conceptualized as having completed upper secondary school, regarding the intergenerational transmission of placement in OHC. Participants and setting: Longitudinal data came from a Swedish cohort of parents (and their children) born in 1953 (n = 11,338). Methods: Associations between parental experience of OHC and their children's placement in OHC were analysed by means of binary logistic regression. Four-way decomposition was used to explore mediation and interaction by parental educational attainment. Results: The odds of having at least one child being placed in OHC was more than six-fold (OR = 6.67, 95% CI = 5.28; 8.06) in the OHC group compared to majority population peers. Mediation and/or interaction by educational attainment accounted for a substantial proportion of the overall association (53%). Interaction effects appeared to be more important for the outcome than mediation. Conclusions: Having completed upper secondary school seems to reflect processes of resilience with the potential to break the intergenerational transmission of placement in OHC. These findings suggest that the impact of enhanced educational attainment of OHC populations may have potential of extending into the fate of the next generation. (Edited publisher abstract)
Neglect subtypes in relation to rereport and foster care entry outcomes
- Authors:
- CHIANG Chien-Jen, et al
- Journal article citation:
- Child Abuse and Neglect, 123, 2022, p.105433.
- Publisher:
- Elsevier
Background: There have been mixed findings on whether neglect increases the risk of re-report and foster care entry compared with other child maltreatment types. Studies suggest that child neglect can be broken into subtypes which, in turn, may lead to different child welfare outcomes. Objective: The purpose of this study was to examine whether the re-report and foster care entry outcomes varied by child maltreatment type, specifically the subtypes of neglect. Participants and setting: Data were derived from a regional longitudinal study with linked CPS and state-level administrative data. Participants (n = 4867) included children with reports of physical abuse, sexual abuse, and six neglect subtypes. Cox regression models were used to assess the probability of recurrence and foster care entry outcomes. Results: Most neglect subtypes were more likely to be re-reported than physical abuse and sexual abuse, and physical neglect was more likely to be re-reported than lack of supervision (HR = 1.20). Children reported for physical neglect was more likely to be placed in foster care than children with reports of physical abuse and other subtypes of neglect. Conclusions: This study provides new insight on whether families with child neglect allegations are at increased risk of re-report or foster care entry outcomes compared with other child maltreatment allegations. Given the significant individual, system, and societal costs of neglect, we hope this study facilitates rigorous investigation of child neglect and the potentially modifiable factors or targets for intervening to prevent the re-report of child maltreatment and foster care entry. (Edited publisher abstract)
Re-referrals to Child Protective Services for children born to young parents
- Authors:
- BROWN Emily C.B., LOWRY Sarah J.
- Journal article citation:
- Child Abuse and Neglect, 123, 2022, p.105387.
- Publisher:
- Elsevier
Background: Children of teenage parents are at increased risk for child maltreatment but there is limited information about the risks teenage parenthood poses for maltreatment recurrence after prior Child Protective Service (CPS) involvement. Objective: Determine whether children born to teenage parents are at increased risk of maltreatment re-referral to CPS compared to children born to older parents. Participants and setting: Children under 6 years with substantiated reports of parental maltreatment between 2002 and 2018 were identified from National Child Abuse and Neglect Data System (NCANDS) data. Methods: Youngest known parental age at child's birth, in years, was categorized as <20, 20-24, 25-29, or ≥30 (referent group). The number of re-referrals within 5 years was the outcome of interest. Negative binomial regression analyses assessed whether being born to a teen parent was associated with a greater risk of re-referral. Results: In a study population of 2,680,961 children, having a teen parent, one aged 20–24 years, or 25–29 years at birth was associated with 19% (95% CI 1.18-1.19), 16% (95% CI 1.16-1.17), and 11% (95% CI 1.11-1.12) greater risk of re-referral compared to having a parent aged 30 years or older adjusting for child age, gender, race-ethnicity, state, and initial maltreatment type. Conclusion: The small, but significant increased risk for re-referral to CPS for child maltreatment in young children with at least one teenage or young parent at the time of birth compared to children with older parents suggests that specifically targeting young parents with appropriate services when initially referred to CPS may help reduce the risk of maltreatment recurrence. (Edited publisher abstract)
Implementation of a screening tool for child sex trafficking among youth presenting to the emergency department - a quality improvement initiative
- Authors:
- PETERSON Loralie J., et al
- Journal article citation:
- Child Abuse and Neglect, 125, 2022, p.105506.
- Publisher:
- Elsevier
Background: Identification of sex-trafficked youth in the emergency department (ED) is difficult and routine screening is uncommon. Objectives: this Quality Improvement (QI) Project aimed to increase ED screening and identification of high-risk youth using the Short Screen for Child Sex Trafficking (SSCST). Participants: Youth (11 through 17 years) seeking care at two metropolitan EDs with a high-risk chief complaint triggering a best practice alert (BPA). Methods: A BPA prompted administration of the SSCST and referral of screen ‘positive’ youth for comprehensive evaluation for child sex trafficking by the forensic nurse examiner (FNE). Targeted QI interventions defined three study periods (SP). Outcomes measures included screening 50% of high-risk youth with 50% of those youth referred for FNE evaluation. Results: Over three study periods, 5454/13,956 (39.1%) youth triggered a BPA for high-risk chief complaint; 4354 (78.6%) received the SSCST screen; 1336 (76.0%) of screen-positive youth were referred for FNE evaluation. Outcomes measures were exceeded during all three study periods. SSCST modifications to increase specificity led to a significant decrease in the percentage of positive screens (42.8% SP1 vs 29.4% SP3). Financial programmatic support and further staff training led to an increase in FNE evaluations (86.4 SP3 vs 5.7% of referred youth SP1). Identification of trafficked patients increased from 1.3% of screen-positive youth to 11.3% (SP1 vs SP3; p < 0.0001). Conclusions: Routine screening for child sex trafficking can be implemented in the ED setting and increases the identification of at-risk youth. (Edited publisher abstract)
Differential risks: how disability shapes risk in the transition to adulthood for youth who age out of foster care
- Author:
- MCCAULEY Erin
- Journal article citation:
- Children and Youth Services Review, 131, 2021, p.106293.
- Publisher:
- Elsevier
Objective: This study examines how disability is associated with risk during the transition to adulthood for youth who age out of foster care and considers how experiences in the child welfare system contribute to these associations. Background: The transition to adulthood is important for later socioeconomic standing, health, and wellbeing. Youth who age out of foster care with disabilities may require a high level of support during this transition yet may lack support. Method: This study employs linear probability models to estimate the association between disability and incarceration, homelessness, childbearing, and substance abuse between ages 17 and 21 using linked administrative data from the National Data Archive on Child Abuse and Neglect (N = 5,221). Results: Having a physical or sensory disability is associated with lower risk in the transition to adulthood. Alternatively, having an emotional or mental related disability is associated with increased risk of incarceration and homelessness, but the association with homelessness is accounted for by child welfare experiences. Conclusion: Due to the importance of foster care and child protective histories in explaining some risky outcomes for youth with emotional and mental disabilities, policy makers and practitioners should include those early stages of care when seeking it improve outcomes in the transition to adulthood for youth with disabilities who age out of foster care. (Edited publisher abstract)
Merging micro and macro practice: the point of view of social workers working with at-risk young adults
- Authors:
- SULIMANI-AIDAN Yafit, FELDMAN Guy
- Journal article citation:
- Children and Youth Services Review, 129, 2021, p.106174.
- Publisher:
- Elsevier
In recent years, partly in response to significant changes in the economic and political environment in which social workers operate, scholars have called for the integration of micro and macro practice in social work settings. Yet, little attention has been given to how social workers construct their practice to integrate these two types of interventions. This qualitative exploratory study examines the perceptions and experiences of frontline social workers who are expected to carry out micro and macro practice in their daily work. Drawing on in-depth interviews with 30 social workers who work with at-risk young adults in Israel, findings show that social workers support the integration between micro and macro practice and share a profound understanding of its importance in promoting their clients’ interests. However, findings show that social workers are confronted with various challenges and barriers while trying to engage in multilevel practice. Specifically, four types of challenges arose: (a) unequal or limited skills and knowledge associated with both practices; (b) limited hours of work and high workload; (c) incongruity between available supportive services and organizational expectations; and (d) the highly political nature of interventions at the macro level. Implications for policy and practice are discussed. (Edited publisher abstract)
Sexual offending and classification
- Author:
- THORNTON David
- Journal article citation:
- Aggression and Violent Behavior, 59, 2021, p.101436.
- Publisher:
- Elsevier
Attempts at classifying sexual offenses and the persons who commit them are reviewed relative to different ways that classifications can have value. Classifying offenses continues to be a productive exercise. The diversity of novel types of offending is being mapped and the identification of psychologically meaningful behavioral themes within broad categories of offense is promising as is the application of Routine Activities theory to target selection scripts. Classifying those who commit sexual offenses, despite considerable research effort being expended in the endeavor, has turned out to be less productive with typological models being largely superseded by dimensional systems. However, the development of standardized risk classes has value for improving communication in the sub-field of actuarial risk assessment and the development of theory-based prototypes has potential for theory development. (Edited publisher abstract)
Psychological and physical abuse towards four-year-old children as reported by their parents: a national Finnish survey
- Authors:
- LEPPAKOSKI Tuija, VUORENMAA Maaret, PAAVILAINEN Eija
- Journal article citation:
- Child Abuse and Neglect, 118, 2021, p.105127.
- Publisher:
- Elsevier
Background: In Finnish society, child maltreatment is a health and social problem with harmful consequences. Identifying families at risk may help preventing child maltreatment recurrence. Objective: The aim of this nationwide retrospective cross-sectional study was to describe the child- and family-related risk factors associated with physical and psychological abuse experienced by 4-year-old children. Methods: This study analyzed nationwide survey data collected by the Finnish Institute for Health and Welfare. Overall, 17,009 parents (46%) visiting at a child health clinic filled out the survey consent form. For 8720 children, one or both parents completed the questionnaire (24%). Analyses were carried out using χ2 tests and binary logistic regression. Results: Of the 4-year-olds, 44% had experienced at least one form of psychological abuse and 14% physical abuse. These forms of violence co-occurred in 25% of the reported cases (p < 001). Intimate partner violence (IPV) and child maltreatment co-occurred in 19.6% of psychological abuse (p < .001) and 22.5% of physical abuse cases (p < .001). Parents exposed to IPV was the risk factor most likely to predict an increased risk for both psychological abuse (OR 4.01, CI 3.41–4.72; p < .001), and physical abuse (OR 2.19, CI 1.81–2.64; p < .001). Approving of hair-pulling or pinching the child (i.e., using corporal punishment) was most likely to predict an increased risk of physical abuse (OR 13.70, CI 11.69–16.06; p < .001). Conclusions: The findings emphasize the importance of preventing all forms of child maltreatment by identifying families at risk and supporting parenthood according to families' needs. (Edited publisher abstract)
Adverse childhood experiences and risk of cancer during adulthood: a systematic review and meta-analysis
- Authors:
- HU Zhao, et al
- Journal article citation:
- Child Abuse and Neglect, 117, 2021, p.105088.
- Publisher:
- Elsevier
Background: Research findings on the relationship between adverse childhood experiences (ACEs) and the risk of cancer were inconsistent. Objective: The purpose of this study was to perform a quantitative synthesis of the preceding research findings. Participants and setting: System review and meta-analysis. Methods: Electronic database of PubMed, Embase, Web of Science and Cochrane Library were systematically searched to identify relevant observational studies published not later than September 9, 2020. Specifically, original articles that reported the risk of cancer in adult populations that experienced ACEs before the age of 18 were selected. All pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using a random-effects model. Publication bias was examined using funnel plots, and sensitivity analysis was used to explore the stability of the pooled results. Results: A total of 18 studies involving 406,210 participants were included in this review. Individuals with 2 or 3 kinds of ACEs (OR = 1.35, 95%CI:1.12,1.62) or at least 4 ACEs (OR = 2.17, 95%CI: 1.76,2.68) were at increased risk of cancer when compared with individuals with no ACEs. Of the different types of ACEs examined, physical abuse (OR = 1.23, 95%CI:1.05,1.43), sexual abuse (OR = 1.26, 95%CI:1.02,1.56), exposure to intimate partner violence (OR = 1.26, 95%CI:1.12,1.41) and financial difficulties in the family (OR = 1.16, 95%CI:1.00,1.33) were associated with the risk of any cancer. Conclusions: These findings suggest that multiple ACEs may be a risk factor for cancer development. Therefore, prevention of ACEs and interventions for supporting those affected by ACEs are necessary. (Edited publisher abstract)
Trends in survival of older care home residents in England: a 10-year multi-cohort study
- Authors:
- PUJOL Ferran Espuny, HANCOCK Ruth, MORCIANO Marcello
- Journal article citation:
- Social Science and Medicine, early cite 31 March 2021, p.113883.
- Publisher:
- Elsevier
Increases in longevity combined with a policy emphasis on caring for older people in their own homes could have widened or narrowed the survival gap between care home and community-dwelling resident older people. Knowledge of pre-Covid-19 trends in this gap is needed to assess the longer-term impacts of the pandemic. We provide evidence for England on recent trends in 1, 2 and 3-year mortality amongst care home residents aged 65+ compared with similar community-dwelling residents. We use the Clinical Practice Research Datalink, a nationally representative primary care database. For each of the ten years from 2006 to 2015, care home and community-dwelling residents aged 65+ were identified and matched in the ratio 1:3, according to age, gender, area deprivation and region. Cox survival analyses were used to estimate mortality risks for care home residents in comparison with similar community-dwelling people, adjusting for age, gender, area deprivation and region. The study sample consisted of ten overlapping cohorts averaging 5,495 care home residents per cohort. Adjusted mortality risks increased over the study period for care home residents while decreasing slightly for matched community-dwelling residents. The relative risks (RRs) of mortality associated with care home residence were higher for younger ages and shorter follow-up periods, in all years. Over the decade, the RRs increased, most at younger ages and for shorter follow-up periods (e.g. for the age group 65–74 years, 1-year average RR increased by 61% from 5.4 to 8.8, while for those aged 85-94 years and over, 3-year RR increased by 22% from 1.3 to 1.6). Thus the survival gap between older care home and community-dwelling residents has been widening, especially at younger ages. In due course, it will be possible to establish to what extent the Covid-19 pandemic has resulted in further growth in this gap. (Edited publisher abstract)