Assessing Concerns and Care Needs of Expectant Parents: Development and Feasibility of a Structured Interview.

Many adverse situations for parenting and healthy child development can be detected before a child's birth. The aim of this project was to develop and test an instrument to use in prenatal home visits, to improve the identification of adverse situations and care needs during pregnancy. The preSPARK is based on a valid and reliable broad-scope structured interview called SPARK (Structured Problem Analysis of Raising Kids). The preSPARK focuses on 12 topics ranging from aspects of the period before pregnancy to future parents' expectations. The preSPARK was tested in daily practice for feasibility and discriminative capacity. User experience was assessed from the perspective of the professional. In total, 64 home visits using the preSPARK were carried out by 21 nurses. About 24% of the expectant parents needed intensive help or immediate action on one or more topics. The risk assessment showed 29% of the participants were at high risk, 40% at increased risk, and 31% at low risk for future parenting and child developmental problems. The nurses indicated that the preSPARK provides a good structure for home visits and gives insight in interrelated factors. The preSPARK is feasible in daily practice and clarifies risks and care needs of expectant parents.

Self-reported adverse childhood experiences and quality of life among children in the two last grades of Dutch elementary education.

BACKGROUND: Adverse Childhood Experiences (ACEs) may have a life-long impact on mental health and are related to physical disease, such as diabetes and cardiovascular diseases in adulthood. Research on ACEs suffers from recall bias when performed with adults. OBJECTIVE: To estimate the prevalence of ACEs and the interrelationships between ACEs as reported by children, and to determine the impact on their self-reported quality of life (QoL). Children's opinions on the ACE-Questionnaire were also obtained. METHOD: A cross-sectional study was conducted with a child version of the ACE-Questionnaire. This questionnaire assesses parental separation or divorce, physical and emotional child abuse and neglect, sexual violence, domestic violence, household substance abuse, psychological issues or suicide, and incarceration of a household member. QoL was measured with the Kidscreen-10. PARTICIPANTS AND SETTING: The questionnaire was completed by 644 children at a mean age of 11 years (range 9-13 years), in the two last grades of regular elementary schools, recruited throughout the Netherlands. RESULTS: Data were weighted by ethnicity to obtain a representative sample of children in Dutch elementary education. Of all children, 45.3% had one or more out of ten ACEs. Child maltreatment was experienced by 26.4%. ACEs often co-occurred. A higher number of ACEs correlated with a lower mean level of QoL (p <  0.001). Mean QoL was 8.5 points lower (Cohen's d = 0.8) in children who experienced child maltreatment. Children's opinions on the questionnaire were positive in 82.4%. CONCLUSION: Prevention of ACEs, professional training and trauma-focus in schools are urgently needed.

Prevalence of family violence in adults and children: estimates using the capture-recapture method.

BACKGROUND: Reliable prevalence estimates of family violence in adults and children are difficult to obtain. Most are based on surveys or registration counts, whose research designs and methods are often questionable, making the results difficult to compare. This article presents an alternative approach. METHODS: The capture-recapture method (CRC), which makes it possible to estimate unknown numbers in a partly hidden population, was applied to data from eight collaborating organizations in Haarlem, The Netherlands. RESULTS: Uniform data registration took place over a 7-month period. The 1-year prevalence rate for adult victims of family violence was estimated to be 2.0% of the adult population (95% CI: 1.3-3.1). For victims of child abuse, it was 1.5-2.5%, and for child witnesses of spouse-abuse, it was 1.2-2.1%, though small numbers made these results more uncertain. Only approximately 20% of all victims in the study were known to one or more of the participating organizations. Our results accorded quite well with results obtained by general health surveys in the Netherlands. CONCLUSIONS: CRC appears to be a valid and feasible research method for estimating the prevalence of family violence and child abuse. It can be used to complement other methods, especially in young children, in whom valid results are otherwise difficult to obtain.