Intimate Partner Violence and Child Health

亲密伴侣暴力与儿童健康

• 批准号: 7359890
• 负责人: MEGAN H BAIR-MERRITT
• 金额: $ 12.33万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-06 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7359890
• 关键词: Address; Affect; Aggressive behavior; Anxiety; Award; Battered Women; Birth; Child; Child Development; Child health care; Childhood; Cohort Studies; Conflict (Psychology); Data; Data Analyses; Emotional; Epidemiology; Equation; Etiology; Exposure to; Family; Female; Frequencies; Goals; Health; Healthcare; Individual; Intervention; Interview; Lead; Learning; Legal Intervention; Life; Link; Mediating; Mediator of activation protein; Mental Depression; Methods; Mission; Modeling; Outcome; Parenting behavior; Pattern; Perception; Program Development; Public Health; Qualitative Research; Research; Risk; Role; Severities; Shapes; Social Work; Structure; Testing; Time; Typology; Violence; Woman; Work; analytical method; base; career; child well being; cohort; design; intimate partner violence; male; multidisciplinary; pediatrician; peer; physical abuse; skills; social; therapy design

DESCRIPTION (provided by applicant): How can the negative impact of intimate partner violence (IPV) on child health be minimized? IPV often continues in families despite social or legal interventions to stop the violence. Children therefore remain vulnerable to adverse health outcomes. This suggests that, to protect children's health, we must shape IPV interventions to reduce risks and to increase protective factors even if IPV continues. This requires a theoretically-guided, empirically-based understanding of the mechanisms by which IPV adversely influences child health, with a focus on the mediating influences. The goal of the proposed research is to gain such an understanding. The overarching framework guiding this research is that IPV leads to poor child health indirectly through its influence on maternal emotional health and parenting, which in turn affect child outcomes. Two related considerations include that patterns (based on variables such as severity, frequency and directionality) of IPV exist and that these patterns likely affect children differently. This proposal outlines two studies. The first is a cohort study of children followed from birth to middle childhood in which advanced analytical methods including structural equation modeling will be used to: Aim 1: Define the latent construct of IPV, assessing typologies of IPV and identifying patterns of IPV over time; Aim 2: Determine the relationship between these IPV constructs and children's health and health care use; Aim 3: Assess the role of maternal emotional health and parenting as mediators of the relationship between IPV and child health. A second qualitative study involving semi-structured interviews with abused women with young children will: Aim 4: Characterize abused women's perceptions of the relationship among IPV, their emotional health, their parenting and their child's health. These aims fit with NICHD's mission of "all children achieving their potential for healthy and productive lives." The proposed career development program for this candidate, a pediatrician with a degree in epidemiology, focuses on: 1) understanding the etiology and epidemiology of IPV; 2) obtaining a theoretical understanding of the impact of family conflict on children's health; 3) learning higher level data analysis methods; and 4) acquiring qualitative research skills. The candidate's long-term career goal is to lead multidisciplinary efforts to facilitate the healthy development of children exposed to IPV. Upon completion of this award, she will submit an R01 application for a longitudinal cohort study collecting primary data on the health of a local cohort of children with and without IPV exposure. From a public health perspective, childhood is a critical time period in establishing an individual's lifetime health trajectory; IPV has the potential to significantly compromise children's health. A better understanding of the IPV-child health relationship will facilitate the design of effective, targeted interventions.

描述（由申请人提供）：如何最大限度地减少亲密伴侣暴力（IPV）对儿童健康的负面影响？尽管有社会或法律干预来制止暴力，IPV 仍经常在家庭中持续存在。因此，儿童仍然容易受到不良健康后果的影响。这表明，为了保护儿童的健康，即使 IPV 继续存在，我们也必须制定 IPV 干预措施以降低风险并增加保护因素。这需要以理论为指导、以实证为基础，了解 IPV 对儿童健康产生不利影响的机制，并重点关注中介影响。拟议研究的目标是获得这样的理解。指导这项研究的总体框架是，IPV 通过影响母亲的情绪健康和养育方式，间接导致儿童健康状况不佳，进而影响儿童的结局。两个相关的考虑因素包括 IPV 的模式（基于严重性、频率和方向性等变量）的存在，并且这些模式可能对儿童产生不同的影响。 该提案概述了两项研究。第一个是对从出生到童年中期的儿童进行的队列研究，其中将使用包括结构方程模型在内的先进分析方法来： 目标 1：定义 IPV 的潜在结构，评估 IPV 的类型并识别 IPV 随着时间的推移的模式；目标 2：确定这些 IPV 结构与儿童健康和医疗保健使用之间的关系；目标 3：评估母亲情绪健康和养育方式作为 IPV 与儿童健康之间关系的中介作用。第二项定性研究涉及对有幼儿的受虐待妇女进行半结构化访谈，该研究将： 目标 4：描述受虐待妇女对 IPV、她们的情绪健康、养育方式和孩子健康之间关系的看法。这些目标符合 NICHD 的使命：“让所有儿童发挥其潜力，过上健康和富有成效的生活”。 该候选人是一名拥有流行病学学位的儿科医生，拟议的职业发展计划重点关注：1) 了解 IPV 的病因学和流行病学； 2）从理论上理解家庭冲突对儿童健康的影响； 3）学习更高层次的数据分析方法； 4) 获得定性研究技能。候选人的长期职业目标是领导多学科努力，促进接触 IPV 的儿童的健康发展。完成该奖项后，她将提交 R01 申请，进行一项纵向队列研究，收集有关当地暴露和未暴露 IPV 的儿童队列的健康主要数据。 从公共卫生的角度来看，童年是建立个人一生健康轨迹的关键时期； IPV 有可能严重损害儿童的健康。更好地了解 IPV 与儿童健康的关系将有助于设计有效、有针对性的干预措施。