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Child Maltreatment Research Projects
Longitudinal Studies of Child Abuse and Neglect (LONGSCAN)
According to the Administration for Children and Families (US DHHS), approximately one million children are found to be victims of substantiated or indicated maltreatment yearly, with approximately 3 million children being referred for investigation of maltreatment each year. This multi-site longitudinal study of 1354 participants is designed to: 1) examine the impact of child abuse and neglect on young children at five sites (North Carolina, San Diego, Seattle, Chicago, and Baltimore) over a twenty-year period; 2) examine the extent to which children are victimized throughout their lifetimes; 3) identify the factors that increase the likelihood a child will experience chronic and severe abuse; 4) determine what life experiences exacerbate or ameliorate the negative impact of maltreatment; and 5) determine factors that might contribute to resilience in vulnerable children. The study sites follow a common protocol for data collection that includes face-to-face interviews with children and their primary caregivers at the time the children are 4, 6, 8, 12, 16, and 18 years old. Additional data sources include teacher questionnaires and CPS records. Based on data received at the Coordinating Center through 10/26/07, the cross-site dataset contains 1250 Age 4 Interviews, 1236 Age 6 Interviews, 1140 Age 8 Interviews, 976 Age 12 Interviews, 907 Age 14 Interviews, 626 Age 16 Interviews, and 310 Age 18 Interviews. Data collection is still in progress for Ages 14 -18. For more information, visit: http://www.iprc.unc.edu /longscan/. Key Personnel: Desmond Runyan, MD, DrPH (PI); Mark Everson, PhD; Jonathan Kotch, MD, MPH; Jon Hussey, PhD; Shrikant Bangdiwala, PhD; Terri Lewis, PhD; Richard Thompson, PhD; Alan Litrownik, PhD; Rae Newton, PhD; Howard Dubowitz, MD; Maureen Black, PhD; Diana English, PhD; Elizabeth Knight, MSW; Jamie Smith, MA; Lynn Martin, MS Other Organizations or Institutions Represented: Juvenile Protective Association of Chicago Funding: Administration on Children Youth and Families: Office of Child Abuse and Neglect Contact: Lynn Martin, MS
Neglect and Adolescents: A Multi-Site Longitudinal Study (NEGLECT) This study focuses on the impact of child neglect on the psychosocial functioning of adolescents. The study examines neglect and its effects on adolescents by adding an extensive face-to-face Age 14 Youth Interview to the already existing LONGSCAN protocol. The interview includes several modules of the National Institute of Mental Health Diagnostic Interview Schedule for Children (NIMH DISC). Data are being collected from the adolescents, the caregivers, and the adolescents’ teachers. Neglect-related data collected at earlier ages are also being analyzed as part of this study. Throughout the initial proposed study period, 888 participants already enrolled in LONGSCAN will turn 14 years of age. Currently, the North Carolina site has completed data collection and the Baltimore, San Diego, Seattle, and Chicago sites are collecting age 14 data. To date approximately 797 interviews have been completed. Key Personnel: Desmond Runyan, MD, DrPH; Mark Everson, PhD; Jonathan Kotch, MD, MPH; Jon Hussey, PhD; Shrikant Bangdiwala, PhD; Terri Lewis, PhD; Richard Thompson, PhD; Alan Litrownik, PhD; Rae Newton, PhD; Howard Dubowitz, MD; Maureen Black, PhD; Diana English, PhD; Elizabeth Knight, MSW; Carri Casteel, PhD; Jamie Smith, MA; Lynn Martin, MS Other Organizations or Institutions Represented: Juvenile Protective Association of Chicago, San Diego State University, University of Maryland at Baltimore, Washington State Department of Social Services Funding: National Institute of Child Health and Human Development Contact: Lynn Martin, MS
NEGLECT: Long-term Minority Investigator Research Supplement This study builds on the NEGLECT parent project to provide new information about the relationships between neglect, parenting practices, supervision, and adolescent outcomes. As a preliminary step to exploring measurement issues in maltreatment, Dr. Adrea Theodore has worked with her research mentor, Dr. Desmond Runyan, to evaluate data from the CarolinaSAFE study. (See page 23, this document). This data set contains information from 1,435 households in both North and South Carolina, the results of a survey of mothers regarding parenting behaviors. As a result of this survey, more information on the prevalence of child and adolescent maltreatment within the population were obtained; and these results were also compared with national statistics. There was considerable variance between official determinations of maltreatment and the data from this population-based sample. The second portion of this study, currently underway, will involve collating and analyzing the data on child neglect. The study will yield information on specific parenting behaviors that could be considered neglectful, as endorsed by the mothers themselves. More information about the nature of the experience of neglect for children and adolescents will be obtained also. Data from this part of the study will inform the specific aims of the parent project and create a foundation for further research using the LONGSCAN consortium sample. Key Personnel: Adrea Theodore, MD, MPH; Desmond Runyan, MD, DrPH; Mark Everson, PhD; Jonathan Kotch, MD, MPH; Jon Hussey, PhD; Shrikant Bangdiwala, PhD; Richard Thompson, PhD; Richard Calica, AM, BCD; Alan Litrownik, PhD; John Landsverk, PhD; Howard Dubowitz, MD; Maureen Black, PhD; Diana English, PhD; Elizabeth Knight, MSW; Christine Cox, PhD; Lynn Martin, MS Other Organizations or Institutions Represented: Juvenile Protective Association of Chicago, San Diego State University, University of Maryland at Baltimore, Washington State Department of Social Services Funding: National Institute of Child Health and Human Development Contact: Adrea Theodore , MD , MPH
World Studies of Abuse in Family Environments (WorldSAFE)
WorldSAFE is a multi-national effort to understand the extent and nature of family violence around the world. International comparisons have proven to be a fruitful method for generating new knowledge in other areas of public health. Child abuse and spouse abuse are known to be significant public health problems in the U.S., Canada, Australia, and some countries in Western Europe. Outside of these countries, there has been relatively little work undertaken to understand the prevalence and patterns of family violence. Examination of variations in the rates of family and community violence and the strength of social networks and families in an international study has been particularly useful in generating new knowledge. Data analysis continues and manuscripts are being written. Key Personnel: Desmond Runyan, MD, DrPH (PI); Wanda Hunter, MPH; Laura Sadowski, MD, MPH; Shrikant Bangdiwala, PhD; Dipty Jain, MBBS; Sergio Muñoz, PhD; Isabel Bordin, MD; M.K.C. Nair, MD; L. Jeyeseelan, MD; Laurie Ramiro, MA; Fatma Hassan, MD; Beatriz Vizcarra, PhD; R.M. Pandey, PhD; M.K. Mitra, MD; R.C. Ahuja, MD; Saradha Suresh, MD; Shuba Kumar, MD; S.S. Bhambal, MD; A.K. Upadhyay, MD; Abraham Peedicayil, MBBS; Rajmohan Pillai, MD; Bernadette Madrid, MD; Mai Lourdes Amarillo, MPH; Cristiane de Paula, MSc Other Organizations or Institutions Represented: Rush University Medical Center Funding: Oxfam Contact: Desmond Runyan, MD, DrPH
Carolina Studies of Abuse in the Family Environment (CarolinaSAFE) Child maltreatment remains a significant public health and social problem in the U.S. Official estimates rely on substantiated reports of maltreatment known to official social service agencies. CarolinaSAFE is a project undertaken to understand the actual burden of child abuse and neglect in the Carolinas using maternal self-report. Loosely based upon the WorldSAFE approach, the investigators interviewed 1,410 mothers in North and South Carolina through anonymous telephone interviews. The interviews were completed during the summer and fall of 2002. The questions represented a portion of the instrument used in the face-to-face interviews completed in other countries by WorldSAFE investigators. Because of legal reporting requirements in the U.S., the telephone interview is the only possible approach to collecting comparable data. These data support the need for continued interventions to prevent maltreatment. Data analysis and manuscript preparation continue on this project. Key Personnel: Desmond Runyan, MD, DrPH (PI); Shrikant Bangdiwala, PhD; Antoinette Laskey, MD; Gary Melton, PhD; Kenneth Dodge, PhD; Adrea Theodore, MD, MPH; Jen Jen Chang, MPH Other Organizations or Institutions Represented: Clemson University Funding: The Duke Endowment Contact: Desmond Runyan, MD, DrPH
The Period of PURPLE Crying® Pilot at Cape Fear Valley Medical Center The Period of PURPLE Crying®, developed by the National Center for Shaken Baby Syndrome, is an educational program designed to reduce Shaken Baby Syndrome by fostering a “cultural change” in the way parents and caregivers think of infant crying. A North Carolina leadership team has been created to oversee implementation of The Period of PURPLE Crying® by the Center for Child & Family Health and North Carolina and will distribute the program to approximately 125,000 families over the next five years. To pilot an assessment of the effectiveness of this project, mothers of newborns who have had the opportunity to participate in this educational program (N=50), their husbands or partners, and other caretakers of the infant will be asked in a telephone interview, four months after they participate in the program, if they: 1) remember the The Period of PURPLE Crying® messages; 2) used The Period of PURPLE Crying® materials that they received in the hospital; 3) communicated the messages and/or showed the materials to others; or 4) were influenced by the messages when the infant cried. A subset of these families will be interviewed a 2nd time to establish the reliability of the interview guide. Key personnel: Phyllis Fleming, PhD (PI); Desmond K. Runyan, MD, DrPH; Other institutions involved: Cape Fear Valley Hospital Funding: Cape Fear Valley Health Foundation Contact: Phyllis Fleming, PhD
The Period of PURPLE Crying®: Keeping Babies Safe in North Carolina Abusive Head Trauma in infants, or Shaken Baby Syndrome, is a leading cause of infant mortality in the U.S. Some work has been done to develop educational interventions for new parents to eliminate this threat to infant well-being. No rigorous evaluation of the effectiveness of these programs has been undertaken; although some estimate that more than 58% of new parents in the U.S. received some form of this educational intervention in 2007. In partnership with other organizations, starting in 2008, UNC IPRC will field a study of the effectiveness of educating new parents about shaking and how to respond to infant crying. Over 5 years, this effort is intended to reach the parents of over 600,000 new babies. This project also will develop and test a media campaign and provide the materials to be distributed to these households. Key personnel: Desmond Runyan, MD, DrPH (PI); Adam Zolotor, MD, MPH; Maryalice Nocera, MSN; Robert Murphy, PhD; Marilyn Barr, BA; Ronald Barr, MD, MPH; Frederick Rivara, MD, MPH; Heather Keenan, MDCM, PhD. Other Institutions Involved: National Center on Shaken Baby Syndrome Funding: Centers for Disease Control and Prevention The Duke Endowment (through the Center for Child and Family Health) Doris Duke Charitable Foundation Contact: Desmond Runyan, MD, DrPH
Epidemiology and Short Term Outcomes of Shaken Baby Syndrome Shaken Baby Syndrome is a specific form of child abuse in which the child is severely shaken, inflicting traumatic brain injury. The objective of this study, which began in 2000, was to: 1) document the epidemiology of shaken baby syndrome among children less than two years of age who are admitted to the pediatric intensive care unit with a traumatic brain injury (TBI); and 2) examine outcomes for survivors one and two years post injury. Key Personnel: Heather Keenan, MDCM, PhD (PI); Desmond Runyan, MD, DrPH; Maryalice Nocera, MSN, RN; Sara Sinal, MD; Robert Merten, MD Other Organizations or Institutions Represented: University of Utah Health Sciences Center Funding: National Center for Injury Prevention and Control Contact: Heather Keenan, MDCM, PhD
Inflicted traumatic brain injury in young children: a study of substantiated cases in a military population Physical abuse is the leading cause of serious head injury in young children. Most inflicted traumatic brain injury (TBI), commonly known as Shaken Baby Syndrome, occurs in children less than 1 year of age. Previous studies have indicated that infant military dependents may be at higher risk for inflicted TBI than their civilian counterparts. The primary goal of this study is to establish the rate of inflicted TBI among those children in the Infant Health Registry. The secondary goal is to compare socio-demographic features of families who have a child with an inflicted TBI to those who do not. The specific aims of this study are to: 1) determine the incidence of inflicted TBI among infants who have a parent sponsor in military service using the Department of Defense Infant Health Registry; and 2) examine demographic risk factors among military personnel that put children at risk for inflicted TBI. The linking of the datasets is currently being performed and initial analysis should be completed by March 2008. Key personnel: Heather Keenan, MDCM, MPH (PI); Desmond Runyan, MD, DrPH; Cmdr. Margaret Ryan, MD, MPH Other Organizations or Institutions Represented: University of Utah Health Sciences Center Department of Defense Center for Deployment Health Research Funding: National Center for Injury Prevention and Control Contact: Heather Keenan, MDCM, PhD
Adolescent pregnancy, intimate partner violence, and poor birth outcomes: consequences of childhood victimization? The LONGSCAN study (Longitudinal Studies in Child Abuse and Neglect) provides one of the largest, most comprehensive prospective studies on child maltreatment. This study uses an existing sample of adolescents from LONGSCAN to assess the link between childhood victimization and early pregnancy, victimization during pregnancy, and pregnancy outcomes. The specific aims of this study are to: 1) examine whether exposure to maltreatment or witnessing family violence or community violence are risk factors for becoming pregnant or making someone pregnant as an adolescent; 2) identify how modifiable risk and protective factors at the individual, family, and neighborhood level are associated with becoming pregnant or making someone pregnant as an adolescent; 3) examine, among females who have been pregnant, or males who have impregnated a partner, whether maltreatment and/or witnessed violence as a child or adolescent increases the likelihood of IPV during pregnancy; and 4) examine, among females who have been pregnant, whether negative maternal health behaviors related to pregnancy and birth outcomes are worse for adolescent mothers with a history of maltreatment and/or witnessed violence exposure relative to females who have not. Data collection continued throughout 2007. To date, 768 14-year-olds, 517 16-year-olds, and 258 18-year-olds have been interviewed. Initial analyses examining the relationship between physical abuse and neglect and subsequent high-risk sexual activity was begun and a related literature review written. Key Personnel: Maureen Black, PhD (PI); Desmond K. Runyan, MD, DrPH; Elizabeth Knight, MSW; Terri Lewis, PhD Funding: National Center for Injury Prevention and Control Other Organizations or Institutions Represented: None Contact: Elizabeth Knight, MSW
Youth employment and youth violence: is work a viable intervention? Adolescent violence is an enormous problem resulting in 2,640 deaths among persons under age 20 in 2001 and 4,605 deaths among young adults aged 20-26. This study proposes to examine an important policy issue in violence prevention -- whether and how employment of youth might serve as an intervention to deter the initiation of violent behavior among adolescents or alter the trajectory of youth beginning to engage in violent or violence-related behaviors. The specific aims of this study are to: 1) examine, cross-sectionally, the relationship between characteristics of adolescent employment and violent and violence-related behaviors in adolescents; 2) examine, longitudinally, the relationship between characteristics of adolescent employment and the development of violent and violence-related behaviors; and 3) examine how violent and violence-related behaviors in young adulthood (age 18-26) are related to adolescent employment experiences. Key Personnel: Other Organizations or Institutions Represented: North Carolina State University Johns Hopkins University Pacific Institute for Research and Evaluation Funding: None Contact: Carol W. Runyan, MPH, PhD
The Use of a Brief Motivational Interviewing Intervention to Enhance the Dissemination of Family-Focused Services Targeting the Prevention of Youth I: Aggression and Violence Youth violence is a major public health problem in the United States. There are many interventions that have been proven effective; however, the effectiveness of multi-systemic programs are hindered by barriers to dissemination. Boomerang, a local community-based program, has effectively overcome one barrier to dissemination, coordination and collaboration of leaders across multiple settings. The specific aims of this study are to: 1) pilot the use of motivational interviewing (MI) to enhance the engagement and retention of families in the family-focused services offered by Boomerang; 2) examine the effect of the MI-intervention on the behavior change in parents and youth, and; 3) collect pilot data regarding family satisfaction with the MI-intervention. The investigators recruited and utilized MI with families of youth that were suspended for violence related behaviors and referred to Boomerang. Investigators also collaborated with Boomerang to offer monthly parent training programs to these students. Key personnel: Deborah J. Jones, PhD (PI); Tami Pfeifer, MSW; Julie Wells, BA; Katherine Rossi, MSW Funding: National Center for Injury Prevention and Control (UNC IPRC Faculty Small Grant) Other Institutions or Organizations Involved: Chapel Hill/Carrboro YMCA Contact: Deborah J. Jones, PhD
Violence Exposure Trajectories and HIV/AIDS Risk Behavior among Maltreated Youth Adolescent exposure to violence, either as a witness or victim, is increasingly common or has been associated with a wide range of negative outcomes for youth, including increased likelihood of engaging in HIV/AIDS risk behaviors. This study will utilize advances in quantitative methods in combination with the methodological rigor of the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). The specific aims of this study are to: 1) examine the exposure to sexual abuse, family violence, and community violence among youth in LONGSCAN, the link between trajectories of youth violence exposure and HIV/AIDS risk behaviors, and contextual moderators of these behaviors; 2) use findings from the LONGSCAN analyses along with family and practitioner feedback to guide the development of a family-based HIV/AIDS prevention program for youth with violence exposure histories; 3) use study findings, and the associated prevention manual to serve as the pilot data for other research. In 2007, the investigators recruited and interviewed families of youth suspended for violence-related behaviors that were referred to Boomerang to determine whether motivational interviewing (MI) increased the likelihood parents would attend parent training sessions offered by the program and to examine the effect of the MI on parent training attendance and changes in parenting behavior. The investigators also collaborated with Boomerang to offer monthly parent training programs. Key Personnel: Deborah Jones, PhD (PI); Desmond K. Runyan, MD, DrPH; Seth Kalichman, PhD; Daniel Nagin, PhD Other Organizations and Institutions Represented: University of Connecticut Carnegie Mellon University Funding: Centers for Disease Control and Prevention (K award) Contact: Deborah J. Jones, PhD
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