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1.
J Elder Abuse Negl ; : 1-19, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38828526

ABSTRACT

Lack of feedback about reports made to Adult Protective Services (APS) is an important barrier to elder mistreatment reporting. To better understand barriers and facilitators to APS-reporter communication, we conducted an environmental scan of state policies and practices. We gathered publicly available information from 52 states and territories on APS administrative structure, reporting, intake, investigation, and feedback processes; performed a secondary analysis of focus groups with Emergency Medical Services providers and APS staff; and interviewed 44 APS leaders in 24 states/territories. Results revealed variation in information-sharing with reporters. Qualitative analyses revealed three overarching themes related to whether, when, and how information is shared. Results were used to develop a model illustrating factors influencing APS decisions on sharing information. This model incorporates the type of reporter (professional or nonprofessional), their relationship with the APS client (brief or ongoing), and the potential risks and benefits of sharing information with the reporter.

2.
Psychodyn Psychiatry ; 52(2): 189-205, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38829226

ABSTRACT

In the fall of 2019, a much-publicized court case brought to national attention the issues of patient-doctor confidentiality when it comes to reporting the deaths of newborns in the United States. It is unclear whether the recent overturning of Roe v. Wade will lead to more cases like this. This article discusses issues of countertransference, as well as the ethical and legal implications were it to be a psychiatrist, in active treatment of such a patient, who would be required to make such a report. More specifically, as in the publicized court case, the patient could be a minor at the time, receiving treatment from a child psychiatrist. The implications of such a case include how countertransference affects the perception of fatal child neglect compared to intentional neonaticide; the ethical dilemma of generating a mandated report with the goal of child safety when such a report could lead to real legal consequences for a minor child; and considerations regarding continued treatment of a patient after such a report is made. It is likely that countertransference, shaped by attitudes toward mothers and idealized views on mothering, may play a large role in all these circumstances.


Subject(s)
Child Abuse , Countertransference , Mandatory Reporting , Humans , Child Abuse/legislation & jurisprudence , Child Abuse/ethics , Mandatory Reporting/ethics , United States , Infant, Newborn , Child , Female
3.
Clin Child Fam Psychol Rev ; 27(2): 300-316, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38761324

ABSTRACT

Mandated participation in parent education programs is a common practice across the United States for families who are undergoing divorce or who are involved in the child welfare or juvenile justice systems. Mandates to participate in parenting programs create substantial challenges for families, service providers, and service systems. Furthermore, the type and quality of the parenting services accessed vary widely, and their impacts need to be better understood. To address this need, an overview of the current state of the empirical literature on the impacts and outcomes of mandated parenting interventions for divorce and in child welfare and juvenile justice settings is provided, and suggestions to the field are offered to refine research related to mandated parenting programs. Given the challenges that mandated parenting programs pose, an alternative approach that views parenting through a public health lens is highlighted to build on the growing body of research on the impacts of population-wide applications of parenting support programs, and as a possible way to decrease the number of parents who are required to attend parenting programs. Opportunities to advance universal parenting support within a range of community settings, including primary care, early childhood education, and community mental health systems are offered. Gaps in knowledge regarding mechanisms of action of universal supports and impacts on the number of parents mandated to treatment are highlighted, and future directions for research in this area are suggested.


Subject(s)
Parenting , Parents , Humans , Parents/education , Child , Mandatory Programs , Divorce , Juvenile Delinquency/prevention & control , Education, Nonprofessional , United States , Child Welfare
4.
Article in English | MEDLINE | ID: mdl-38770764

ABSTRACT

Objective: To understand obstetric provider perspectives on child protective services (CPS)-mandated reporting requirements and how they affect care for pregnant and postpartum patients with opioid use disorder (OUD). Methods: Key informant interviews were conducted virtually with obstetricians, nurse practitioners, and social workers caring for obstetric patients (n = 12). Providers were asked about their experience as mandated reporters working with patients with OUD. Transcripts were independently coded by two staff, and content analysis was used to identify themes. Results: Our analysis resulted in six thematic areas, including CPS-mandated strengths, concerns related to CPS reporting requirements, implementation of mandates, supporting patients after CPS report, communication between stakeholders, and the impact on care. Providers noted that the fear of CPS involvement causes some patients to delay or not engage in care. Other patients are hesitant to accept medications for OUD for fear of CPS involvement. The inconsistencies in how reporting mandates are applied and how CPS handles cases make communication about the policies challenging for providers and create anxiety for patients. Conclusions: The results of this study indicate that mandated reporting requirements and the potential for CPS involvement are perceived to have minimal positive effects on perinatal individuals with OUD and may negatively affect patients and their care. Clinicaltrials.gov number: NCT04240392.

5.
Addict Behav ; 154: 108022, 2024 07.
Article in English | MEDLINE | ID: mdl-38564985

ABSTRACT

OBJECTIVE: Despite experiencing alcohol-related consequences, college students continue to drink at high rates. Hypothetical evaluations of alcohol-related consequences (i.e., evaluations of where potential/hypothetical consequences lie on a spectrum from extremely positive to extremely negative) may contribute to the maintenance of drinking patterns among students. The purpose of the present study was to describe hypothetical evaluations in a sample of students mandated to an alcohol intervention, examine changes over time, and investigate the influence of both baseline and time-varying experienced consequences. METHOD: This study was a secondary data analysis from a longitudinal randomized controlled trial. Participants were 474 mandated students (Mage = 18.65; 55.5 % male, 77.6 % White). Students completed an initial baseline assessment of demographics, alcohol use, consequences, and hypothetical evaluations, and 3-month and 9-month follow-up assessments that included hypothetical evaluations and experienced consequences. RESULTS: Hierarchical linear modeling (HLM) analyses revealed significant change in hypothetical evaluations over time such that they became less negative. A piecewise model demonstrated that this change happened between baseline and 3-month, with no additional change between 3-month and 9-month. The experience of consequences at baseline did not significantly moderate changes in either time interval. Time-varying consequences also had no significant effect on same-timepoint hypothetical evaluations. CONCLUSIONS: This study is the first to examine changes in hypothetical evaluations over time among mandated college students. Counter to expectations, hypothetical evaluations became less negative at 3-month follow-up. Though preliminary, findings add to the understanding of hypothetical evaluations of alcohol-related consequences.


Subject(s)
Alcohol Drinking in College , Time Perception , Humans , Male , Adolescent , Female , Alcohol Drinking/epidemiology , Students , Universities
6.
Child Maltreat ; : 10775595241240755, 2024 Mar 28.
Article in English | MEDLINE | ID: mdl-38544477

ABSTRACT

Because COVID triggered elevated rates of child abuse, but diminished rates of child abuse reporting, we explored predictors of nurses' attitudes toward reporting suspected child abuse during the COVID pandemic. In particular, we expected that compassion fatigue and compassion satisfaction would mediate the effects of COVID-related stressors (i.e., exposure to COVID patient death and suffering; COVID-related family income loss; frequent direct care of COVID patients; and parental burnout) on nurses' negative attitudes toward reporting suspected child abuse. Employing chain-referral sampling, we recruited a sample of 244 registered nurses (83% White; 87% women). Supporting hypotheses, compassion fatigue mediated the effects of job-related COVID stressors (exposure to COVID patient death and suffering; COVID-related family income loss; and frequent direct care of COVID patients) on nurses' negative attitudes toward reporting suspected child abuse. In addition, among nurses who were also parents, nurses' self-reported parental burnout mediated the relation between compassion fatigue and negative attitudes toward reporting suspected child abuse. In addition, compassion satisfaction mediated the effect of nurses' parental burnout on nurses' negative attitudes toward reporting suspected child abuse.

7.
J Clin Nurs ; 33(7): 2662-2673, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38366766

ABSTRACT

AIM: To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self-efficacy of reporting child abuse and neglect. DESIGN: A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. METHODS: A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. RESULTS: Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self-efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self-efficacy of reporting child abuse and neglect. CONCLUSION: This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. IMPACT: This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self-efficacy in reporting suspected child abuse and neglect. REPORTING METHODS: The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. PATIENT OR PUBLIC CONTRIBUTION: There is no patient or public contribution as the study only looked at nurses.


Subject(s)
Child Abuse , Self Efficacy , Humans , Child Abuse/diagnosis , Female , Adult , Male , Child , Surveys and Questionnaires , Mandatory Reporting , Middle Aged , Clinical Competence/standards , Clinical Competence/statistics & numerical data , Health Knowledge, Attitudes, Practice , Nursing Staff, Hospital/psychology
8.
J Stud Alcohol Drugs ; 2024 Feb 16.
Article in English | MEDLINE | ID: mdl-38363070

ABSTRACT

OBJECTIVE: World Health Organization (WHO) risk drinking levels (i.e., low, moderate, high, or very high risk) have been used as a drinking reduction endpoint in clinical trials. Yet, prior work has not attempted to quantify reductions in WHO risk levels among mandated students, who may also benefit from reduced drinking. We sought to validate WHO risk drinking levels in differentiating students' alcohol-related outcomes, depressive symptoms, and academic performance. Defining risk via typical drinks per drinking day versus drinks per day was compared, and gender differences were examined. METHOD: Baseline data were drawn from three intervention trials for students mandated to intervention and who were not abstinent (N=1436). Sex-specific WHO risk levels were generated and dummy coded, with low risk as the reference. Regression models examined associations of risk levels with positive AUDIT scores, peak drinking, consequences, depressive symptoms, and grade point average. RESULTS: Defining WHO risk via drinks per drinking day evenly dispersed students across categories, whereas drinks per day categorized most as low risk. More women than men were classified as very high risk across definitions. Students classified as low risk differed from those classified as moderate, high, and very high risk in screening positive on the AUDIT, peak drinking, and consequences. WHO risk levels did not differentiate depressive symptoms. Differences in grade point average were inconsistent across risk definitions. CONCLUSIONS: WHO risk drinking levels differentiated alcohol use and consequences and, therefore, hold promise for clinical use and for quantifying drinking reductions among mandated college students.

9.
Child Abuse Negl ; 147: 106587, 2024 01.
Article in English | MEDLINE | ID: mdl-38043457

ABSTRACT

BACKGROUND: Mandated reporting policies, a core response to the identification of child maltreatment, are widely debated. Currently, there are calls to abolish or scale back these policies to include only certain professionals. These calls warrant evaluation of whether there are any differences in child welfare outcomes based on report source. OBJECTIVE: To determine if the initial report source predicts immediate and long-term risk of re-referral, substantiation, and placement. PARTICIPANTS AND SETTING: We used yearly National Child Abuse and Neglect Data System (NCANDS) hotline report and placement data. Children (0-14y) with a first ever hotline report in 2012-2014 were followed for three years. The final sample included 2,101,397 children from 32 states. METHODS: We use descriptive and bivariate statistics to show initial report outcomes by reporter source type and logistic regression models to evaluate the effect of report source on immediate and subsequent report outcomes. RESULTS: Professional sources varied in levels of substantiation and placement, with law enforcement, medical, and social service sources showing much higher rates. Reports from professional sources have higher odds of initial report substantiation and foster care entry, and slightly lower odds of later re-report than nonprofessional sources. We found no differences between professional and nonprofessional sources in subsequent foster care entry. CONCLUSIONS: Reports from professional, nonprofessional, and unclassified sources have varying levels of risk in some of their short- and long-term outcomes. To the degree that child protective services embrace a long-term preventative role, reports by nonprofessional report sources may provide opportunities for prevention.


Subject(s)
Child Abuse , Child , Humans , Child Welfare , Social Work , Mandatory Reporting , Foster Home Care , Child Protective Services
10.
J Child Sex Abus ; 32(8): 979-996, 2023.
Article in English | MEDLINE | ID: mdl-37975619

ABSTRACT

This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming.


Subject(s)
Child Abuse, Sexual , Child Abuse , Adult , Child , Humans , Child Abuse, Sexual/prevention & control , Sexual Behavior , Survivors
11.
Bioethics ; 37(9): 862-868, 2023 11.
Article in English | MEDLINE | ID: mdl-37789803

ABSTRACT

A number of authors criticise opt-out (or 'deemed consent') systems for failing to secure valid consent to organ donation. Further, several suggest that mandated choice offers a more ethical alternative. This article responds to criticisms that opt-out does not secure informed consent. If we assume current (low) levels of public awareness, then the explicit consent secured under mandated choice will not be informed either. Conversely, a mandated choice policy might be justifiable if accompanied by a significant public education campaign. However, if this entitles us to assume that members of the public are informed, then an opt-out system would also be justified in the same circumstances. The alleged advantages of mandated choice seem to rest on an unfair comparison, between mandated choice with a public education campaign and an opt-out system without one. While it may be that some countries with opt-out systems should do more to inform their publics, I see no reason to assume that this cannot be done. Indeed, advocates of mandated choice seem committed to thinking it possible to raise awareness. If opt-out systems adopt the same methods, such as writing to every individual, this should also address concerns about whether consent is informed.


Subject(s)
Organ Transplantation , Tissue and Organ Procurement , Humans , Informed Consent , Policy , Repressor Proteins , Tissue Donors
12.
J Clin Transl Sci ; 7(1): e205, 2023.
Article in English | MEDLINE | ID: mdl-37830009

ABSTRACT

Introduction: iLookOut, a web-based child abuse training for early childcare professionals (ECPs), has been shown to improve knowledge and attitudes related to correctly identifying and reporting suspected cases of child abuse. The overarching goal of the present study is to examine "what works for whom" for iLookOut in order to identify strategies for optimizing learner outcomes. Methods: This prospective study enrolled 12,705 ECPs who completed iLookOut (November 2014-December 2018). We used structural equation models to test whether learner demographic and professional characteristics were differentially associated with implementation outcomes (i.e., acceptability and appropriateness) and whether these mediated subsequent indicators of training effectiveness (i.e., gains in knowledge). Results: Consistent with previous research, individuals with lower baseline knowledge scores showed greater knowledge gains (ß = -.57; p < .001). Greater knowledge gains were seen for learners who reported higher acceptability (ß = .08; p < .001) or appropriateness (ß = .14; p < .001). Implementation outcomes strongly associated with knowledge gains included acceptability for female learners and appropriateness for learners who had not completed high school or had >15 years of experience in childcare settings. Where mediation was found, for the majority of groups, appropriateness emerged as the driving mediator. Conclusion: Implementation outcomes emerged as important drivers of knowledge change for most groups. The iLookOut Core Training's use of a multimedia learning environment, video-based storylines, and game-based techniques were endorsed by learners and correlated with increases in knowledge. Future work should explore why aspects of the iLookOut training are rated as less acceptable or appropriate by some groups and what changes would improve efficacy for low performing learners.

13.
J Cardiovasc Electrophysiol ; 34(12): 2434-2442, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37814483

ABSTRACT

INTRODUCTION: Atrial tachyarrhythmia recurrence during the blanking period (early ATA) after pulmonary vein isolation (PVI) is associated with an increased risk of later recurrence, but its relationship with pulmonary vein reconduction (PVR) is poorly understood. The objective of the present study was to evaluate the relationship between early ATA and PVR. Second, to provide data on the optimal blanking period by (a) evaluating how the predictive values of ATA for PVR are affected by blanking period duration, and (b) assessing the temporal development in atrial fibrillation (AF) burden. METHODS: In this RACE-AF substudy, 91 patients with paroxysmal AF undergoing PVI randomized to radiofrequency or cryoballoon ablation were included. All patients received an implantable cardiac monitor and underwent a protocol-mandated repeat procedure after 4-6 months for assessment of PVR. ATA ≥ 30 s. ≤ 90 days after PVI constituted early ATA. RESULTS: PVR was found in 37/54 (69%) patients with early ATA and in 11/37 (30%) patients without (p < .001). The positive predictive value of ATA for PVR was independent of blanking period duration (range 0-90 days). In both patients with and without PVR, AF burden was higher in the first month after PVI, but AF burden from the second month was similar to AF burden after the conventional blanking period. CONCLUSION: Early ATA indicates PVR, and the positive predictive value is independent of the blanking period duration. Altogether, the results of this study support substantially shortening the blanking period after PVI for paroxysmal AF.


Subject(s)
Atrial Fibrillation , Catheter Ablation , Cryosurgery , Pulmonary Veins , Humans , Atrial Fibrillation/diagnosis , Atrial Fibrillation/surgery , Atrial Fibrillation/etiology , Pulmonary Veins/surgery , Treatment Outcome , Heart Atria , Tachycardia , Catheter Ablation/adverse effects , Catheter Ablation/methods , Cryosurgery/adverse effects , Cryosurgery/methods , Recurrence
14.
Child Abuse Negl ; 145: 106404, 2023 11.
Article in English | MEDLINE | ID: mdl-37598611

ABSTRACT

BACKGROUND: Research shows general increases in child maltreatment reports in the U.S. However, less is understood about how reporting varies across states and changes over time, from a perspective of referral sources. While recent studies during COVID-19 reported a reduction in maltreatment referrals, predominantly school referrals, little research has examined changes in maltreatment referrals by referral sources before the pandemic and how different referral sources are associated with case outcomes, particularly out-of-home placement. OBJECTIVES: This study examined 1) variations across states and changes over time in maltreatment reporting by referral source and 2) the relationship between referral sources type and two case outcomes: substantiated maltreatment and out-of-home placement. PARTICIPANTS AND SETTING: We used 2008-2018 data (N = 24,349,293) from the National Child Abuse and Neglect Data System. METHODS: We used descriptive trend analysis and pooled, fixed effects binary logistic regression. RESULTS: We found gradual increases in reporting during 2008-2018, with substantial variations across states and referral sources. States rely differently on certain reporter types, while we see the largest increase in education referrals and a small decrease in social services referrals. Regression results showed that education referrals were less likely to result in out-of-home placement; law enforcement referrals were most likely to be substantiated, while social service referrals were most likely to result in out-of-home placement. CONCLUSION: This study makes unique contributions to literature by expanding our knowledge of referral sources and examining the likelihood of substantiation and out-of-home placement by referral source type. We provide child welfare policy and practice implications.


Subject(s)
COVID-19 , Child Abuse , Child , Humans , United States/epidemiology , COVID-19/epidemiology , Child Welfare , Social Work , Referral and Consultation
15.
Children (Basel) ; 10(6)2023 May 31.
Article in English | MEDLINE | ID: mdl-37371211

ABSTRACT

BACKGROUND: Child maltreatment (CM) makes up a significant portion of events under the larger umbrella term of adverse childhood experiences (ACEs). Therefore, we need to develop a competent healthcare workforce that is prepared to assess and report CM in order to create a comprehensive framework for assessing and addressing ACEs. The objective of the present study was to examine the obstacles to reporting CM among a sample of future physicians. METHODS: Two samples of medical students and residents (N = 196) completed the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale and rated how likely they would be to report suspected CM. RESULTS: Medical students were found to have more negative feelings about and perceive more obstacles to reporting CM compared to residents in our sample. Scores on the Reporting Responsibilities subscale were not significantly associated with increased likelihood of reporting CM. However, lower scores on the Concerns about Reporting subscale were related to an increased likelihood of reporting CM. CONCLUSIONS: Future physicians who perceived fewer obstacles to reporting CM reported being more likely to report suspected CM. Misinformed fears about outcomes such as retaliation, removal of the child from the home, and being sued may interfere with future physicians' adherence to mandated reporting responsibilities. Efforts should be made early in physician education to identify and address common myths and misconceptions around mandated reporting and its outcomes.

16.
Ciênc. Saúde Colet. (Impr.) ; 28(6): 1703-1715, jun. 2023. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1439837

ABSTRACT

Resumo A violência infantil é um problema que afeta crianças no mundo todo. O presente estudo objetiva identificar e analisar os principais resultados apresentados em artigos publicados no Brasil sobre as práticas profissionais desenvolvidas em situações de maus-tratos infantis. Para tanto, realizou-se uma revisão integrativa da literatura, com buscas nas bases de dados Google Acadêmico, no SciELO Brasil, nos Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior do Ministério da Educação (CAPES/MEC), no MEDLARS ONLINE (Medline), na Biblioteca Virtual em Saúde (BVS Saúde) e nos Periódicos Eletrônicos em Psicologia (Pepsic), abrangendo publicações de 2017 a 2022. Após a leitura dos títulos e resumos, 24 artigos foram selecionados para a análise. Os resultados apontam a dificuldade na proteção integral da criança devido à deficiência na formação do profissional, que influencia na identificação e notificação do abuso infantil. O presente estudo revela o lugar que os maus-tratos infantis ocupam na formação dos profissionais e subsidia pesquisas futuras sobre práticas profissionais para o enfrentamento da violência infantil.


Abstract Child abuse is a problem that affects children all over the world. The present study therefore aimed to identify and analyze the main findings relating to professional practices for dealing with situations of child maltreatment in articles published in Brazil. To this end, we conducted an integrative literature review of articles published between 2017 and 2022 based on searches of the following databases: Google Scholar, SciELO Brasil, the periodicals database of the Agency for the Improvement of Higher Education Personnel (CAPES), MEDLINE, the Virtual Health Library, and Electronic Journals in Psychology (PePSIC). A total of 24 publications were selected for the review after screening the titles and abstracts. The findings reveal several challenges to ensuring the protection of children caused by shortcomings in professional training, which have a negative influence on the identification and reporting of child maltreatment. The present study reveals the lack of priority given to the issue of child maltreatment in professional training and provides important inputs to inform future research on professional practices for dealing with child violence.

17.
J Interpers Violence ; 38(19-20): 10771-10794, 2023 10.
Article in English | MEDLINE | ID: mdl-37212364

ABSTRACT

Faculty, staff, and students employed by or who serve as representative of universities in the United States are required by the Title IX federal law to report all instances of sexual harassment, discrimination, and sexual assault on college campuses. Despite the well-intended purpose of the Title IX regulations, less is known about campus communities' experiences and perceptions of this "mandated reporting," and its influence on disclosure. This exploratory mixed-methods study examines student (n = 88) and faculty and staff (n = 77) thoughts, concerns, and experiences regarding this policy at a mid-sized Northeastern University. Participants were recruited utilizing a campus lab system, with supplemental recruitment through student-life offices on campus. Data were collected via an anonymous survey hosted on the Qualtrics platform. Descriptive statistics were conducted for quantitative responses, whereas thematic analysis was utilized to analyze open text responses. Descriptive statistics demonstrate that the majority of participants (students and faculty/staff) were aware of their "mandated reporter" status. Additionally, students and faculty/staff varied regarding their support of the policy and the majority of faculty/staff had not had students disclose sexual violence to them and thus, had not reported any incidences of sexual violence to the university. Results of the thematic analysis further highlight the complexity of students and faculty/staff views' regarding the "mandated reporter" policy illustrating positive and negative perceived impacts of this policy, as well as several suggestions for improvement. Implications for research and practice are framed within the literature on Title IX, sexual harassment, and violence in the context of universities.


Subject(s)
Sex Offenses , Sexual Harassment , Humans , United States , Faculty , Policy , Students , Universities
18.
Matern Child Health J ; 27(Suppl 1): 104-112, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37253899

ABSTRACT

OBJECTIVES: Some states, including Massachusetts, require automatic filing of child abuse and neglect for substance-exposed newborns, including infants exposed in-utero to clinician-prescribed medications to treat opioid use disorder (MOUD). The aim of this article is to explore effects of these mandated reporting policies on pregnant and postpartum people receiving MOUD. METHODS: We used modified grounded research theory, literature findings, and constant comparative methods to extract, analyze and contextualize perinatal experiences with child protection systems (CPS) and explore the impact of the Massachusetts mandated reporting policy on healthcare experiences and OUD treatment decisions. We drew from 26 semi-structured interviews originally conducted within a parent study of perinatal MOUD use in pregnancy and the postpartum period. RESULTS: Three themes unique to CPS reporting policies and involvement emerged. First, mothers who received MOUD during pregnancy identified mandated reporting for prenatally prescribed medication utilization as unjust and stigmatizing. Second, the stress caused by an impending CPS filing at delivery and the realities of CPS surveillance and involvement after filing were both perceived as harmful to family health and wellbeing. Finally, pregnant and postpartum individuals with OUD felt pressure to make medical decisions in a complex environment in which medical recommendations and the requirements of CPS agencies often compete. CONCLUSIONS FOR PRACTICE: Uncoupling of OUD treatment decisions in the perinatal period from mandated CPS reporting at time of delivery is essential. The primary focus for families affected by OUD must shift from surveillance and stigma to evidence-based treatment and access to supportive services and resources.


What is already known on this subject? Child protection systems (CPS) reporting is associated with barriers to prenatal care and family resources and services. Some state policies in the United States mandate reporting to CPS for prenatal substance exposure, including prescribed medications for opioid use disorder.What this study adds? This study centers the experiences of pregnant and postpartum people with opioid use disorder with mandated reporting policies for prenatal substance exposure, describes the harms to families associated with these policies, and makes recommendations for policy change. Findings emphasize the need to uncouple medical decisions from CPS reporting and involvement.


Subject(s)
Child Abuse , Opioid-Related Disorders , Female , Humans , Infant, Newborn , Pregnancy , Analgesics, Opioid/therapeutic use , Massachusetts , Mothers , Opiate Substitution Treatment/methods , Opioid-Related Disorders/drug therapy , Postpartum Period
20.
J Dent Hyg ; 97(1): 33-42, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36854576

ABSTRACT

Purpose The prevalence of intimate partner domestic violence (DV) increased in frequency during the global COVID-19 pandemic. The purpose of this pilot study was to assess dental hygienists' knowledge, attitudes, and readiness to manage patients experiencing DV in the state of Minnesota.Methods A cross-sectional study design was used on a convenience sample of dental hygienists. The validated Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) was used to collect the data. Survey items included demographic variables and measured attitudes and knowledge regarding intimate partner DV. Paper surveys were distributed to attendees at the Minnesota Dental Hygienist Association Annual Meeting. ANOVA and linear regression models were used to assess associations between domestic violence knowledge scores and respondent demographics and attitudes.Results Eighty-eight surveys were distributed; 31 surveys were completed and met the inclusion criteria for data analysis. The overall mean knowledge score was 11.6 from a possible score of 17. No significant differences were found by age, degree type, or years in practice and domestic violence knowledge or attitudes. Most respondents (64.5%) indicated a lack of preparedness to ask appropriate questions regarding DV and only a little more than half knew how to respond to disclosures of DV (51.6%) or were aware of the state's legal requirements for reporting DV (58.0%).Conclusion Participants demonstrated moderate knowledge of DV and recognized the importance of identifying and providing support for DV victims. However, participants were unsure of current state-mandated guidelines for reporting DV. Future exploration of reporting mandates will better support dental hygienists in their professional obligations identifying victims of DV.


Subject(s)
COVID-19 , Domestic Violence , Humans , Pilot Projects , Cross-Sectional Studies , Dental Hygienists , Minnesota , Pandemics
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