Preventing Medical Neglect of Children in Child Welfare

儿童福利中防止儿童医疗忽视

基本信息

批准号：
8306760
负责人：
JANET U SCHNEIDERMAN
金额：
$ 12.34万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-01 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8306760
关键词：
Address Adherence Adolescent Affect Applications Grants Appointment Area Attention deficit hyperactivity disorder Authorship Award Behavior Biological Caregivers Characteristics Child Child Abuse Child Abuse and Neglect Child Welfare Childhood Chronic Clinic Clinical Research Communities Conflict of Interest County Data Data Analyses Enrollment Ethical Issues Ethics Evidence based intervention Family Family Research Family Study Family dynamics Gatekeeping Genetic Research Goals Health Health Personnel Health Services Healthcare Home environment Hour Human Human Subject Research Incidence Indium Individual Information Systems Institutional Review Boards Intervention Interview Journals Knowledge Lead Literature Los Angeles Medicaid Medical Medical Records Mentors Mentorship Methods Modeling Nature Outcome Outcome Measure Parenting behavior Phase Physician Executives Prevention Process Psychology Public Health Publications Publishing Recommendation Recording of previous events Recurrence Reporting Research Research Personnel Research Project Grants Research Subjects Research Training Risk Risk Factors Site Social Work Structure System Therapeutic Studies Training United States United States Dept. of Health and Human Services Vulnerable Populations Work base child neglect design experience foster care foster child help-seeking behavior lectures maltreatment medical schools meetings neglect patient oriented research pediatrician physical conditioning prevent prospective responsible research conduct therapy development

项目摘要

DESCRIPTION (provided by applicant): The primary goal of my scientific work is to provide empirically derived knowledge to address medical neglect of children in the child welfare system: 1) by developing a better conceptual understanding of the variables that affect the caregivers' medical neglect of children through exploring both the antecedents and consequences of this neglect (developing a preliminary explanatory model); and 2) by developing an intervention for caregivers that addresses the protective and risk factors for medical neglect and increases caregivers' ability to engage in behaviors that lead to better healthcare outcomes for their children. I will meet five training goals: 1) Increase knowledge of child neglect, specifically medical neglect; 2) Increase my conceptual and empirical focus on family dynamics/parenting; 3) Develop ability to utilize a research mixed method approach; 4) Develop community-based interventional research skillset; and 5) Train in the responsible conduct of research. A 4-phase research agenda, in which findings from each phase inform the next research project, is proposed. The research sites are in Los Angeles County, one of the largest child welfare systems in the United States. Phase one includes a secondary quantitative analysis of data from an adolescent neglect study to explore the relationship of medical neglect to other types of maltreatment, and to identify differences in caregivers who have children who suffer from medical neglect from caregivers who have children with other types of maltreatment or without reported maltreatment. For phase two, a qualitative study using a semi-structured interview of child welfare caregivers is planned to discover the key factors that influence caregivers' help-seeking, accessing, and using/adhering to pediatric healthcare. Phase three includes a prospective medical chart review using mixed methods to identify factors that predict attendance at return appointments at a child welfare primary pediatric clinic (medical home). Finally, phase four will include a qualitative study of caregivers, pediatricians and child welfare professionals to identify factors likely to influence the feasibility and acceptability of interventions (derived from the conceptual model developed in phases 1-3) directed at caregivers to decrease medical neglect. The public's health is compromised because children in the child welfare system have significantly poorer physical health than Medicaid-eligible children not in foster care and do not receive adequate health care services while in the child welfare system. This study develops interventions for caregivers in the child welfare system, as child welfare caregivers are beginning to be recognized as gatekeepers for accessing pediatric healthcare

描述（由申请人提供）：我的科学工作的主要目的是提供经验得出的知识，以解决儿童福利系统中对儿童的医学忽视：1）通过对影响照顾者医疗忽视儿童的变量的更好的概念性理解，通过探索这种忽视的忽视和后果（开发一种初步的解释性模型）； 2）通过为护理人员开发干预措施，以解决医疗忽视的保护和危险因素，并提高看护人从事行为的能力，从而为孩子带来更好的医疗保健结果。我将达到五个培训目标：1）增加对儿童忽视的知识，特别是医学忽视； 2）增加我对家庭动态/育儿的概念和经验的关注； 3）发展使用研究混合方法的能力； 4）开发基于社区的介入研究技能； 5）训练负责任的研究。提出了一个4阶段的研究议程，其中每个阶段的调查结果告知下一个研究项目。研究地点位于洛杉矶县，洛杉矶县是美国最大的儿童福利系统之一。第一阶段包括对青少年疏忽研究的数据进行二级定量分析，以探讨医疗忽视与其他类型的虐待的关系，并确定患有患有其他类型虐待儿童或没有报告虐待的孩子的儿童患有医疗疏忽的孩子的看护人的差异。对于第二阶段，计划对儿童福利护理人员进行半结构化访谈进行定性研究，以发现影响护理人员寻求帮助，获得和使用/遵守儿科保健的关键因素。第三阶段包括使用混合方法的前瞻性医学图表审查，以确定预测儿童福利初级儿科诊所（医疗之家）回报率的因素。最后，第四阶段将包括对护理人员，儿科医生和儿童福利专业人员的定性研究，以确定可能影响干预措施的可行性和可接受性的因素（源自第1-3阶段中开发的概念模型），该因素针对护理人员减少医疗疏忽。公众的健康受到了损害，因为儿童福利系统中的儿童的身体健康明显较差，而不是在儿童福利系统中不接受医疗补助资格的儿童，并且在寄养方面没有足够的医疗保健服务。这项研究开发了儿童福利系统中护理人员的干预措施，因为儿童福利护理人员开始被认为是获得儿科医疗保健的守门人