Pediatric Inpatient Nurses' Perceptions of Child Maltreatment.

PURPOSE: The purpose of this study was to explore the perceptions of child maltreatment among inpatient pediatric nurses. DESIGN AND METHODS: A cross-sectional survey was used to obtain responses to an online survey designed to examine perceptions of child maltreatment from inpatient pediatric nurses. RESULTS: Many nurses surveyed (41.25%) indicated that they had not received adequate training or had never received training on child maltreatment identification and many (40%) also indicated they were not familiar with the applicable reporting laws. CONCLUSIONS: Due to the serious immediate and long term effects of child maltreatment, it is imperative that pediatric inpatient nurses have adequate training on how to identify potential abuse and neglect cases, as well as legal reporting requirements, since they are in a unique position to identify potential cases of maltreatment. PRACTICE IMPLICATIONS: There is a continuing need for training on child maltreatment identification and reporting laws for inpatient pediatric nurses.

Trauma Center Youth Violence Screening and Brief Interventions: A Multisite Pilot Feasibility Study.

Every day, 16 American youths between the ages of 10 and 24 years are murdered; 84% of these fatalities involve a firearm. Nearly half of traumatic youth deaths result from violence-related injuries. In 2013, 580,250 youth suffered nonfatal, assault-related injuries, necessitating emergency department treatment. The aim of this multisite pilot study was to examine the process, feasibility, and challenges of violence brief interventions (VBIs). The participants were youth between 15 and 25 years of age, at 2 major Level 1 trauma centers (TCs; TC1, TC2) in the Southeastern United States. Eligible participants (N = 38; TC1: n = 20, TC2: n = 18) received at least 1 VBI during their hospital stay, which provided information about individual screening results and elicited patients' perspectives on violent and risky behaviors. More participants at TC2 than at TC1 completed 2 VBI sessions. Barriers to and support of implementation were identified at both sites, and factors for improving implementation were identified, including the need for staff support through clinical guidelines and coordinated prevention and outreach programs. Further research is needed to identify factors for successful implementation of VBIs in TCs.

Psychological Science and Innovative Strategies for Informing Health Care Redesign: A Policy Brief.

Recent health care legislation and shifting health care financing strategies are transforming health and behavioral health (a broad term referring to mental health, substance use, and health behavior) care in the United States. Advances in knowledge regarding effective treatment and services coupled with incentives for innovation in health and behavioral health care delivery systems make this a unique time for mobilizing our science to enhance the success of health and behavioral health care redesign. To optimize the potential of our current health care environment, a team was formed composed of leaders from the Societies of Clinical Child & Adolescent Psychology, Pediatric Psychology, and Child and Family Policy and Practice (Divisions 53, 54, and 37 of the American Psychological Association). This team was charged with reviewing the scientific and policy literature with a focus on five major issues: (a) improving access to care and reducing health disparities, (b) integrating behavioral health care within primary care, (c) preventive services, (d) enhancing quality and outcomes of care, and (e) training and workforce development. The products of that work are summarized here, including recommendations for future research, clinical, training, and policy directions. We conclude that the current emphasis on accountable care and evaluation of the outcomes of care offer numerous opportunities for psychologists to integrate science and practice for the benefit of our children, families, and nation. The dramatic changes that are occurring in psychological and behavioral health care services and payment systems also require evolution in our practice and training models.

An evaluation of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program.

This study evaluated the effectiveness of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program, developed by the American Psychological Association in collaboration with the National Association for the Education of Young Children, as an economical primary prevention intervention for child maltreatment. Using an experimental design with random assignment to groups, program impact on participating parents' knowledge, behavior, and attitudes compared to those of a comparison group of parents receiving standard community-based support services was examined. As hypothesized, the ACT Parents Raising Safe Kids program achieved positive results in several areas related to effective parenting, including a reduction in the use of harsh verbal and physical discipline and an increase in nurturing behavior. Positive results were observable both at the conclusion of the ACT program and at three-month follow-up. Results further indicated a positive impact on parent expectations and social support for those parents with the greatest need in these areas. Qualitative data collected through focus groups demonstrated that parents themselves perceived numerous benefits to the ACT program, including assistance in controlling their anger, learning and implementing better parenting and discipline strategies, and recognizing when their child's behavior is developmentally appropriate. Overall, findings suggest that the ACT Parents Raising Safe Kids program is a promising primary prevention strategy that can be implemented across diverse community settings.

Science, practice, and policy related to adverse childhood experiences: Framing the conversation.

Adverse childhood experiences (ACEs) detrimentally affect health outcomes in childhood, adolescence, and adulthood. Over the past 2 decades, the recognition of ACEs by scientists and professionals across disciplines, policymakers, and the public has evolved and expanded. Although the initial articulation of ACEs in Felitti et al.'s landmark study has formed the basis of subsequent investigations on the long-term impact of childhood adversities on health and health risk behaviors, a wider public health framework, inclusive of psychology and other social sciences, also shapes current conceptualizations, research, practice, and policies. This article provides an overview of the special issue Adverse Childhood Experiences: Translating Research to Action. Given the rapid expansion and widespread application of ACEs, this special issue was developed to articulate critical concepts, to demonstrate the significance and relevance of psychological research and practice, and to catalyze further efforts to develop effective programs and policies informed by science. The 15 articles included reflect the continuum of critical work being conducted in research, practice, intervention and prevention programs, and public policy and serve to synthesize the growing body of empirical evidence. The overarching themes that emerged are framed as 3 essential questions: (a) How broadly should ACEs be defined?, (b) How should ACEs be assessed?, and (c) How can ACEs science translate into high quality services? As illustrated in these articles, policy and practice applications deriving from psychology as a hub science can substantially benefit the health and mental health of children, adolescents, and adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Association between Having a Preterm Birth and Later Maternal Mental Health: An Analysis of U.S. Pregnancy Risk Assessment Monitoring System Data.

INTRODUCTION: Although previous studies have found a relationship between having a preterm birth and maternal depression, methodologic issues may have limited the generalizability of results. Thus, the purpose of this study was to evaluate the relationship between having a preterm birth and postpartum depressive symptoms using a large, population-based sample of U.S. women. METHODS: This secondary data analysis used 2012-2014 U.S. Pregnancy Risk Assessment Monitoring System data (N = 89,366). Data on the exposure, preterm birth, were obtained from birth certificates. Infants born at 32 to less than 37 weeks' gestation were considered moderate to late preterm, infants born at 28 to less than 32 full weeks' gestation were considered very preterm, and infant born at less than 28 full weeks' gestation were considered extremely preterm. To assess the outcome, two Pregnancy Risk Assessment Monitoring System questions measuring postpartum depressive symptoms were used. Logistic regression was used to calculate unadjusted and adjusted odds ratios (ORs) and 95% confidence interval (CIs). RESULTS: After adjustment for confounders, the relationship between having a preterm birth and maternal hopelessness was statistically significant for those who had very preterm and extremely preterm births (moderate to late preterm OR, 1.19; 95% CI, 1.00-1.42; very preterm OR, 1.28; 95% CI, 1.04-1.58; extremely preterm OR, 1.81; 95% CI, 1.31-2.49). In addition, after adjustment, findings indicated no association between preterm birth and maternal loss of interest (extremely preterm OR, 0.85 95% CI, 0.60-1.19; very preterm OR, 1.04; 95% CI, 0.86-1.26; preterm OR, 0.95; 95% CI, 0.82-1.10). CONCLUSIONS: Given the statistically significant increased association between having a preterm birth and postpartum depressive symptoms, health professionals may consider implementing comprehensive screening for depression and other mental illnesses among women who give birth prematurely. Findings may also inform future interventions to emphasize the importance of postpartum care among women who have experienced preterm birth.

Responding to violence against women: social science contributions to legal solutions.

Violence against women represents a serious problem in America. Not only does intimate partner violence represent a significant threat to women, but it also counts among its victims, children living in the violent household. By its very nature, intimate partner or domestic violence may be approached as either a legal or a social problem. However, there is a shortage of legal approaches that have been informed by sound social science research. One promising framework for developing such integrated responses to intimate partner violence is therapeutic jurisprudence, which encourages legal professionals to work closely with social scientists to develop system responses based on empirical data. Such an approach contrasts sharply with the current practice of developing law based on assumptions, which frequently reflect traditional paternalistic and sexist attitudes toward women. This paper begins by examining the current theories and scientific knowledge on domestic violence with particular emphasis on the supporting data. A theoretical framework for conceptualizing domestic violence characterized as patriarchal terrorism as distinct from common couple violence is examined and offered as a means of explaining inconsistencies in research findings. Following a review of current legal responses to domestic violence, the paper concludes by outlining alternative strategies and recommendations for future efforts that are supported by current theory and research.

Risk factors of smoking among health care professionals.

BACKGROUND: Health care professionals (HCPs) play a vital role at various levels of smoking cessation programs to reduce tobacco use in general populations. However, their smoking habits may limit their ability to intervene with their patients who smoke. AIMS: To determine prevalence rates of current smoking and examine sociodemographic and work-related factors associated with current smoking among HCPs. METHODS: A statewide survey was conducted in a representative sample of 4 groups of HCPs, physicians, nurses, respiratory therapists, and occupational therapists, with active licenses in Texas in 2003. Weighted prevalence estimates of current smoking rates were computed. Survey logistic regression analysis was used to investigate associations between individual characteristics and current smoking. RESULTS: There were 3600 HCPs included in the analysis. The overall prevalence of current smoking was 9% with the highest prevalence (16%) recorded among respiratory therapists and the lowest prevalence (3%) recorded among physicians. In the multivariable logistic regression analysis non-Hispanic white HCPs were almost 4 times as likely to be current smokers (adjusted odds ratio= 3.95, 95% confidence interval = 1.24-12.59) and those working for 50 hours or more per week were twice as likely to be current smokers (adjusted odds ratio = 2.07, 95% CI = 1.20-3.57). Compared with physicians, all other HCP groups had significantly greater odds of currently smoking. HCPs who were female and resided or worked in rural settings had higher smoking rates in univariable analysis only (P < .05). CONCLUSIONS: Smoking is prevalent among certain HCP groups. Working long hours was identified as an important occupational factor associated with current smoking.

Data sharing to inform school-based asthma services.

BACKGROUND: This article examines results and lessons learned from a collaborative project involving a large urban school district, its county health department, multiple community partners, and the local university to establish an effective system for data sharing to inform monitoring and evaluation of the Charlotte Mecklenburg Schools (CMS) Asthma Education Program (AEP). METHODS: Databases maintained by nurses, program staff, and school personnel were integrated into a single AEP Evaluation Database. RESULTS: There were a number of positive findings, including evidence that students with an elevated level of need received priority from AEP. A series of dependent group t tests analyzing changes across time in students' grade-point averages and absences, as well as their implications, also demonstrated some improvements. Additional outcome analyses for the 296 students who received case management services demonstrated further program benefits in the areas of attendance, academic performance, behavior, and quality of life. CONCLUSIONS: Enhancing the ability of school-based programs to merge data across project partners will facilitate efforts not only to evaluate services but also to demonstrate program impact on a wide variety of health and academic outcomes for students.

Influencing policymaking for maltreated children and their families.

Public policy can be a powerful tool for children and their families. Accordingly, this article addresses how psychologists and other child-oriented researchers can leverage this tool to ensure that child and family issues, specifically issues related to child abuse and neglect, receive adequate attention. We encourage a bidirectional relationship between policymakers and experts in child maltreatment through which policymakers solicit and employ relevant expertise, and psychologists, in turn, provide useful information to policymakers. To facilitate such relationships, this article offers practical guidance to psychologists on understanding the policymaking process, gaining familiarity with relevant policy, communicating effectively with policymakers, and understanding the unique contributions that psychologists can make to the policy process.

YouthFriends: outcomes from a school-based mentoring program.

This evaluation explores the effectiveness of school-based mentoring as a universal prevention strategy. The impact of mentoring on students displaying risk factors is also addressed. The evaluation of YouthFriends, a school-based mentoring program, employed a pretest-posttest control group design. Students (n = 170) across five school districts provided data on eight dependent variables. At posttest, there was a statistically significant difference favoring YouthFriends over controls on sense of school membership. In addition, for students who had low scores at baseline, results indicated a statistically significant improvement unique to YouthFriends on community connectedness and goal-setting. Analyses of students' academic performance also indicated a positive effect for those YouthFriends who had low grades at baseline. Editors' Strategic Implications: Important lessons are provided for school administrators and mentoring program staff and evaluators. As a universal prevention program, school-based mentoring may produce few (and small) short-term effects. A greater understanding of the effects of dosage and quality of the mentoring is needed as we seek to evaluate the efficacy of school-based mentoring across a variety of student risk levels.