A Family Centered Approach to Intimate Partner Violence

以家庭为中心的应对亲密伴侣暴力的方法

• 批准号: 10524555
• 负责人: Gunjan Tiyyagura
• 金额: $ 16.61万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10524555
• 关键词: 3 year old; Accident and Emergency department; Address; Adoption; Adult; Advocate; Affect; American; Belief; Caregiver well-being; Caregivers; Caring; Cessation of life; Child; Child Abuse; Child Advocacy; Child Care; Child Health; Clinic; Clinical; Clinical Trials; Consensus; Data; Decision Making; Detection; Development; Early Diagnosis; Enrollment; Ensure; Evaluation; Event; Exposure to; Faculty; Family; Family Study; Family Violence; Future; Goals; Health; Home; Household; Injury; Intervention; Interview; Knowledge; Lead; Leadership; Legal; Legal system; Link; Location; Medical; Mentors; Mentorship; Methods; Modeling; Parents; Patient Self-Report; Pediatrics; Pilot Projects; Primary Health Care; Process; Provider; Randomized; Recording of previous events; Reporting; Research; Research Personnel; Research Project Grants; Risk; Risk Factors; Roentgen Rays; Sampling; Secondary Prevention; Sentinel; Services; Shaken baby syndrome; Shelter facility; Surveys; System; Training; Visit; Woman; acceptability and feasibility; base; care seeking; care systems; career development; child physical abuse; child protective service; clinical decision support; community engaged research; compare effectiveness; design; experience; health care settings; high risk; implementation science; implementation strategy; improved; improved outcome; innovation; intervention mapping; intimate partner violence; lens; pediatrician; physical abuse; pilot trial; practical application; programs; research clinical testing; response; screening; skills; social; standard of care; theories; treatment as usual; violence exposure

PROJECT SUMMARY Intimate partner violence (IPV) among caregivers is an important risk factor for the physical abuse of children. IPV affects 1 in 4 American women, with children present during almost half of the episodes of IPV. IPV may serve as a “sentinel” event and can provide an opportunity for both early detection and secondary prevention of abuse in a child who lives in an affected household. Physical abuse affects about 120,000 children annually in the US, with the youngest children (<3 years old), who are usually unable to provide a history, at the highest risk. Physical child abuse occurs in 30-60% of homes with IPV. We have shown that occult or inapparent injuries are often detected by x-rays when young children living with IPV undergo evaluation for abuse. Yet, most children who live with recognized IPV are not evaluated, perhaps because the care of abused children and adults is separated into different, often competing care systems. Family-Centered Care (FCC), a process in which the needs of children and caregivers are considered together, may improve caregiver engagement with the evaluation of children for physical abuse and with IPV-related services. The objective of the proposed research is to develop and evaluate an FCC model to improve evaluations for physical abuse of IPV-exposed children and to engage the IPV victim in attending to her own needs. First, we will conduct qualitative interviews of local stakeholders (including victims of IPV) and national leaders and will observe the current process of evaluating IPV-exposed children by child protective services and by medical providers to identify barriers to and facilitators of these evaluations. Using these data, we will use a systematic decision- making process to develop an FCC model to improve the medical evaluation of IPV-exposed children and an implementation strategy to enhance its use. A successful FCC model might link the child’s medical visit with providing an advocate to connect the abused caregiver with IPV services based on preliminary data. Finally, we will conduct a pilot trial in which we will compare our model of FCC with usual care for its acceptability and the feasibility of subsequent studies of its efficacy. Our central hypothesis is that an FCC model that simultaneously addresses the needs of children and caregivers will improve caregiver engagement, improve recognition of child abuse, and reduce the risk of subsequent IPV. I will also pursue formal training to acquire advanced skills and knowledge in community-engaged research, the practical application of implementation science, the conduct and evaluation of clinical trials, and the development of independent research grants. My mentors are experts in clinical and community-engaged research, child abuse pediatrics, familyviolence, and implementation science with extensive experience mentoring junior faculty. In addition to guidance on career development, they will provide hands-on mentorship for the proposed studies. They will ensure that I achieve my long-term goal of becoming an independent investigator who improves child abuse detection and identifies best practices to strengthen FCC for IPV.

项目概要 照顾者之间的亲密伴侣暴力（IPV）是儿童身体虐待的一个重要风险因素。 IPV 影响四分之一的美国女性，几乎一半的 IPV 发作期间都有儿童在场。 作为“哨兵”事件，可以为早期发现和二级预防提供机会 居住在受影响家庭中的儿童遭受身体虐待，每年影响约 120,000 名儿童。 在美国，最小的孩子（<3 岁）通常无法提供病史，风险最高。 30-60% 的 IPV 家庭中发生了对儿童的身体虐待。我们已经表明，隐匿性或不明显的伤害是常见的。 当患有 IPV 的幼儿接受虐待评估时，通常会通过 X 光检查发现。 与公认的 IPV 一起生活的人不会受到评估，也许是因为对受虐待儿童和成人的照顾 分为不同的、通常相互竞争的以家庭为中心的护理系统 (FCC)，在此过程中， 儿童和看护者的需求得到共同考虑，可以提高看护者与儿童的互动 评估儿童是否受到身体虐待并提供 IPV 相关服务。 拟议研究的目标是开发和评估 FCC 模型，以改进对 首先，我们将对接触 IPV 的儿童进行身体虐待，并让 IPV 受害者关注自己的需求。 对当地利益相关者（包括 IPV 受害者）和国家领导人进行定性访谈，并将观察 儿童保护服务机构和医疗服务提供者评估 IPV 暴露儿童的当前流程 利用这些数据障碍，我们将使用系统化的决策来识别和促进这些评估。 制定 FCC 模型的流程，以改进 IPV 暴露儿童的医学评估和 加强其使用的实施策略 成功的 FCC 模式可能会将孩子的医疗就诊与此联系起来。 根据初步数据，提供倡导者将受虐待的看护者与 IPV 服务联系起来。 将进行一项试点试验，其中我们将比较我们的 FCC 模型与常规护理的可接受性和 我们的中心假设是 FCC 模型同时具有其功效的可行性。 满足儿童和护理人员的需求将提高护理人员的参与度，提高对儿童的认可 滥用，并降低后续 IPV 的风险。 我还将接受正式培训，以高级获取社区参与研究的技能和知识， 实施科学的实际应用、临床试验的进行和评估以及开发 我的导师是临床和社区参与研究、虐待儿童方面的专家。 儿科、家庭暴力和实施科学，在指导初级教师方面拥有丰富的经验。 除了职业发展指导外，他们还将为拟议的研究提供实践指导。 他们将确保我实现成为一名改善儿童状况的独立调查员的长期目标 滥用检测并确定加强 IPV FCC 的最佳实践。