Building a community-academic partnership to improve screening for intimate partner violence: Integrating advocates in healthcare clinic settings.

AIMS: To develop an innovative community-academic partnership to advance, test and promote intimate partner violence screening and referral protocols by comparing the effect of integrating intimate partner violence advocates versus enhancing medical training in medical clinic settings serving women from vulnerable populations. Detecting intimate partner violence in healthcare settings allows for survivors to connect to safety and referral resources prior to violence escalating. Screening for intimate partner violence and connecting patients to referral resources requires creating a safe and trusting relationship between healthcare providers and patients. Developing screening and referral protocols responsive to survivors' needs requires involvement of clinic staff, survivors and community agencies that support survivors. DESIGN: Three phases of the project include Discovery, Implementation and Dissemination. Mixed-methodology will help in understanding current practices and effects of interventions. METHODS: Actions included in each phase: Discovery: 1) nurse-led focus groups of clinic staff, providers and survivors to understand current clinic practices; 2) retrospective chart review of the number of screens performed, positive screens detected and interventions performed. IMPLEMENTATION: 1) randomization of patients to be interviewed by a trained advocate or by healthcare provider with enhanced training; and 2) assess the number of screenings and referrals performed in each arm and 3) evaluate outcomes of intervention. Dissemination through: presentations, manuscripts and policy recommendations at the institutional and regional level. This IRB-approved proposal was funded in July 2021 by an Advancing a Healthier Wisconsin grant. DISCUSSION: The partnership has improved channels of communication and understanding between diverse clinical care providers, survivors and community agency staff as they navigate the complex challenges to the development and integration of screening and referral protocols. IMPACT: This project will provide evidence of the most effective intimate partner violence screening and referral methodology that can be utilized in a wide variety of medical settings.

Supporting Children Who Experience Domestic Violence: Evaluating the Child Witness to Domestic Violence Program.

Impacting 1 in 4 children in the United States, childhood exposure to domestic violence predicts myriad negative sequelae. Intervening post exposure is critical to help children and their protective parent heal and avoid long-term negative consequences. Children aged 2-17 and their mothers who were victims of domestic violence participated in a 12-week group program delivered by domestic violence agency staff that provides psychoeducation on the impact of trauma and domestic violence and aims to improve parent and child well-being. The impact of the Child Witness to Domestic Violence (CWDV) program was tested in an intervention group (n = 69 children, 33 mothers) who participated in CWDV and control group (n = 80 children, 39 mothers) consisting of children whose mothers received adult-focused domestic violence services but were not enrolled in CWDV or other child-focused services. Multiple regression analyses controlling for child gender, child age, mother's age, and the outcome of interest at time 1 found that participation in CWDV program significantly predicted better child functioning as indicated by less hyperactivity (B = -.85, p = .06), fewer negative emotional symptoms (B = -1.14, p = .01), and fewer total behavioral difficulties (B = -2.48, p = .02) as well as higher maternal hope (B = .57, p = .03). These data provide promising evidence of the impact of a brief, replicable group intervention that promotes healing and well-being among children and parents exposed to domestic violence. Limitations include a quasi-experimental design and reliance on maternal report.

Executive function and parenting in the context of homelessness.

There is mounting evidence that maternal executive function (EF) plays a critical role in parenting behavior. However, the majority of the research on this topic has been conducted in low-risk samples. The purpose of the present study was to investigate whether individual differences in maternal EF are associated with parenting behavior in the high-risk, high adversity context of family homelessness. The study included 94 mothers and their children, ages 4 to 6 years, living in emergency homeless shelters. Mothers completed a battery of "hot" and "cool" EF tasks as well as a self-report questionnaire of perceived stress. Parenting measures were based on observed parent-child interactions that were later coded for harsh and positive parenting practices. Results indicated that hot EF in mothers was related to positive parenting. The relation between maternal planning ability, assessed by a cool EF task, and harsh parenting was also significant, but only for mothers reporting higher levels of stress. These findings add to a growing body of research suggesting that the influence of EF and other forms of cognitive control on parenting need to be interpreted within the context of environmental stress and adversity. (PsycINFO Database Record

Statewide Dissemination of Sesame Street Resources for Families Affected by Incarceration.

The number of children with an incarcerated parent has increased nearly 80% in the past 20 years. Despite the growing need, few educational resources exist to promote the emotional health of young children with incarcerated parents. To address this need, Sesame Street recently released developmentally appropriate, multimedia resources, and piloted the dissemination of those resources in 10 states. The current study describes the process used in one pilot state to disseminate the resources; documents the reach of those dissemination efforts, including the number of resource kits distributed, number of community-based and clinical providers reached, and location of providers across the state; and examines providers' impressions of the utility of the resources and their perspectives on how the resources support children and families affected by incarceration. This study has important implications for translating research evidence for community providers and practitioners who aim to promote the emotional health of young children affected by incarceration.

Visiting Mom: A pilot evaluation of a prison-based visiting program serving incarcerated mothers and their minor children.

We describe an evaluation of a prison visiting program, Extended Visiting (EV), for incarcerated mothers and their children. Mothers (N = 24) and caregivers (N = 19) were interviewed regarding experiences with the program. Mothers identified benefits including maintaining a relationship with children, physical contact, motivation, privacy, peer support, and personal growth. Caregivers echoed mothers' appreciation for the opportunity to maintain mother-child relationships and physical contact. Mothers identified barriers including desire for overnight visits and more age-appropriate activities. Caregivers perceived travel time and costs and children's adverse reactions as barriers. When comparing EV to typical visiting, participants unanimously preferred EV.

Comparing Emotion Recognition Skills among Children with and without Jailed Parents.

Approximately five million children in the United States have experienced a co-resident parent's incarceration in jail or prison. Parental incarceration is associated with multiple risk factors for maladjustment, which may contribute to the increased likelihood of behavioral problems in this population. Few studies have examined early predictors of maladjustment among children with incarcerated parents, limiting scholars' understanding about potential points for prevention and intervention. Emotion recognition skills may play a role in the development of maladjustment and may be amenable to intervention. The current study examined whether emotion recognition skills differed between 3- to 8-year-old children with and without jailed parents. We hypothesized that children with jailed parents would have a negative bias in processing emotions and less accuracy compared to children without incarcerated parents. Data were drawn from 128 families, including 75 children (53.3% male, M = 5.37 years) with jailed parents and 53 children (39.6% male, M = 5.02 years) without jailed parents. Caregivers in both samples provided demographic information. Children performed an emotion recognition task in which they were asked to produce a label for photos expressing six different emotions (i.e., happy, surprised, neutral, sad, angry, and fearful). For scoring, the number of positive and negative labels were totaled; the number of negative labels provided for neutral and positive stimuli were totaled (measuring negative bias/overextension of negative labels); and valence accuracy (i.e., positive, negative, and neutral) and label accuracy were calculated. Results indicated a main effect of parental incarceration on the number of positive labels provided; children with jailed parents presented significantly fewer positive emotions than the comparison group. There was also a main effect of parental incarceration on negative bias (the overextension of negative labels); children with jailed parents had a negative bias compared to children without jailed parents. However, these findings did not hold when controlling for child age, race/ethnicity, receipt of special education services, and caregiver education. The results provide some evidence for the effect of the context of parental incarceration in the development of negative emotion recognition biases. Limitations and implications for future research and interventions are discussed.