Adolescent Disclosure of Abuse In Primary Care Settings

青少年在初级保健机构中披露虐待行为

• 批准号: 6951205
• 负责人: ANGELA DIAZ
• 金额: $ 13.47万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-15 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6951205
• 关键词: academic achievement; adolescence (12-20); age difference; behavioral /social science research tag; child abuse; clinical research; communication behavior; computer human interaction; crime victims; data collection methodology /evaluation; diagnosis design /evaluation; health behavior; health care service utilization; high risk behavior /lifestyle; human population study; human subject; interview; patient oriented research; postdoctoral investigator; primary care physician; psychometrics; questionnaires; racial /ethnic difference; social psychology; socioeconomics

The purpose of this application is to support the career development of Angela Diaz, MD so that she becomes an independent research focusing much needed attention on the identification and treatment of abused adolescents. As Director of the Mount Sinai Adolescent Health Center (AHC), she recognizes the need for culturally sensitive and developmentally appropriate intervention programs for primary care settings. Such treatment must begin with full disclosure of victimization by adolescents and with diagnosis of the impact of abuse. The primary aim of this research project is to examine the reliability of different screening methodologies for child maltreatment and abuse during adolescence and subsequently test if there are variations in disclosure rates associated with the different screening methodologies. Standardized across all three screening methodologies will be the Comprehensive Childhood Maltreatment Inventory, a measure that has demonstrated reliability among young adults. In two separate phases, Dr. Diaz will first explore the reliability of three different screening methodologies in a primary care setting (self-administered, ACASI, and physician-directed inquiry) all using the CCMI. Dr. Diaz hypothesizes that all methods will have acceptable test-retest reliability; however , physician-directed inquiry will have the highest test-retest reliabilities as compared to other screening methodologies. Then, Dr. Diaz will use a randomized experimental design to determine if there are differences in adolescents' disclosure rates that are associated with a given screening methodology. Then, Dr. Diaz will use a randomized experimental design to determine if there are differences in adolescents' disclosure rates are associated with a given screening methodology. She hypothesizes that disclosure rates will be greatest where adolescents presenting in a primary care setting are directly asked about abuse and trauma by a physician as compared to the other screening methodologies. The secondary aim of this plan is to explore differences between those who disclose abuse as compared to whose who do not relative to demographics, psychosocial and health utilization variables. Dr. Diaz also hypothesizes that disclosers will report more risky psychosocial behaviors and higher rates of health utilization, regardless of disclosure condition. A Career Development Award would enable Dr. Diaz to take classes to enhance and develop her skills in research design, data analysis, and psychometric methods. In addition, she would receive primary mentoring throughout this award from Terence M. Keane, Ph.D., a noted researchers that has developed and validated many of the leading diagnostic and assessment tools utilized in the evaluated of trauma exposure and PTSD. Thus, the training opportunity would enable Dr. Diaz to acquire mentored research skills to enhance the health and well- 0being of abused adolescents, and learn how to assess abuse and diagnose its effects.

该应用程序的目的是支持医学博士安吉拉·迪亚兹（Angela Diaz）的职业发展，以便她成为一项独立的研究，将非常需要关注的关注点关注虐待青少年的识别和治疗。作为西奈山青春期健康中心（AHC）的主任，她认识到需要对初级保健环境的文化敏感和发展适当的干预计划。这种治疗必须从青少年完全披露受害并诊断出虐待的影响开始。该研究项目的主要目的是检查青春期儿童虐待和虐待的不同筛查方法的可靠性，并随后测试与不同筛查方法相关的披露率是否有差异。在所有三种筛查方法中的标准化将是全面的儿童虐待清单，这一措施表现出了年轻人的可靠性。在两个单独的阶段中，Diaz博士将使用CCMI首先探索初级保健环境中三种不同筛查方法的可靠性（自我管理，ACASI和医师指导的查询）。迪亚兹博士假设所有方法都具有可接受的重测可靠性；但是，与其他筛查方法相比，医师指导的调查将具有最高的重测可靠性。然后，Diaz博士将使用随机的实验设计来确定青少年披露率是否与给定筛查方法相关的差异。然后，迪亚兹博士将使用随机的实验设计来确定青少年的披露率是否与给定的筛查方法有关。她假设，与其他筛查方法相比，医生直接询问了在初级保健环境中出现的青少年滥用和创伤的披露率将是最大的。该计划的次要目的是探索那些披露虐待的人之间的差异，而与人口统计学，社会心理和健康利用变量相比，那些没有滥用的人。迪亚兹博士还假设披露者将报告更风险的社会心理行为和更高的健康利用率，无论披露条件如何。职业发展奖将使迪亚兹博士能够上课，以增强和发展她在研究设计，数据分析和心理测量方法方面的技能。此外，她将在整个奖项中获得主要的指导，从Terence M. Keane博士那里获得著名的研究人员，该研究人员已经开发并验证了用于评估创伤暴露和PTSD的许多领先的诊断和评估工具。因此，培训机会将使迪亚兹博士获得指导的研究技能，以增强受虐待青少年的健康和良好的0，并学习如何评估滥用和诊断其影响。