Date of Award

January 2013

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

John M. Leventhal

Subject Area(s)

Medicine, Public health

Abstract

Jennifer Y. Duffy, Marcia Hughes, Andrea G. Asnes, and John M. Leventhal. Department of Pediatrics, Yale University, School of Medicine, New Haven, CT and Center for Social Research, University of Hartford, Hartford, CT

Aim: For high-risk families in a statewide home visiting program, we examined the relationship between parental risk factors and the number and substantiation status of reports made to CPS.

Methods: We reviewed CPS reports from 2006-2008 for families in Connecticut's prevention program. Based on the first CPS report, 6 sociodemographic risk factors were recorded for each caregiver. These risk factors were summed into risk scores for each caregiver. Maltreatment type, number of reports, number of caregivers and report substantiation were recorded. Odds ratios were calculated.

Results: Of 1,125 families, 131 (11.6%) had CPS reports. Neglect was the most common maltreatment type and the report substantiation rate was 20%. Comparing families with a substantiated versus unsubstantiated first report, high paternal risk score (OR = 3.29; CI: 1.04-10.36), maternal domestic violence (OR 5.11; CI: 2.12-12.32), paternal domestic violence (OR = 5.73; CI: 1.86-17.66), and maternal criminal history (OR = 2.86; 1.10-7.42) were associated with an increased likelihood of substantiation. Comparing children with 1 report versus those who had >1 report children with > 3 caregivers trended towards being more likely to have >1 CPS report (OR = 2.53; CI: 0.98-6.54); p = 0.05.

Conclusions: In a prevention program for first-time families, domestic violence, paternal risk, maternal criminal history and number of caregivers were associated with maltreatment outcomes. These results suggest that targeted efforts towards domestic violence prevention may impact child abuse prevention. In addition, >3 caregivers in a household may serve as a marker of in-home chaos and aid to identify higher-risk families within an already high-risk group.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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