Publications

Poverty is consistently associated with a higher risk of experiencing child maltreatment, and children from poor families are the majority of children involved in child protective services (CPS). However, the mediators in the relationship from income to CPS involvement are not entirely understood. Using theoretically-informed mediating path models and data from the second National Survey of Child and Adolescent Well-Being (NSCAW II), this study tests the role of harsh physical punishment as a mediator between family income and CPS involvement. CPS involvement was measured by subsequent report of maltreatment and removal to out-of-home care. The direct paths from income to re-report and to removal were significant; with higher income associated with lower risk of report and removal. Lower income was significantly associated with higher rates of harsh physical punishment. However, harsh punishment did not mediate the relationship between income and the outcomes. These results suggest that even within a population primarily comprised of low-income families, lower income is a risk for subsequent reports and removals as well as a risk for higher rates of harsh physical punishment. However, in this sample harsh physical punishment is not the mechanism that results in higher subsequent-reports or removal rates.

Children with developmental disabilities are at heightened risk for maltreatment. However, little is known regarding the prevalence of maltreatment among specific groups, such as autism spectrum disorder (ASD) and/or intellectual disability (ID). Information about maltreatment in these groups can aid in the development of supports and prevention strategies for vulnerable children and their families.Using record linkage between the Department of Social Services (DSS) and the Autism and Developmental Disabilities Monitoring (ADDM) network, this study compares the prevalence and characteristics of maltreatment among children with ASD-only (n = 316), ASD and comorbid ID (ASD+ID; n = 291), ID-only (n = 1,280), and controls (n = 3,101). Behavioral correlates of maltreatment are examined.Controlling for demographic factors, this study found significantly higher odds of reported and substantiated maltreatment among children with ASD-only (odds ratio = 1.86 for reported, 1.51 for substantiated), ASD+ID (odds ratio = 2.35 for reported, 1.97 for substantiated), and ID-only (odds ratio = 2.45 for reported, 2.49 for substantiated) relative to a population control group, with large effects. In particular, children with ASD+ID and ID-only were between two and three times more likely to experience maltreatment. All groups were more likely to experience physical neglect, and children in the ASD+ID and ID-only groups were more likely to experience all forms of abuse. Children in the ASD-only group were more likely to experience physical abuse. Maltreated children in the ASD-only and ID-only groups experienced more cases of physical abuse and neglect, and were victimized by more perpetrators compared to other maltreated youth. Maltreatment was associated with higher likelihood of aggression, hyperactivity, and tantrums for children with ASD.Children with ASD and/or ID are at heightened risk for maltreatment. Empirically-supported assessment and intervention approaches for identifying and addressing traumatic stress related to maltreatment in ASD are urgently needed.

For interventions, like the Transition to Independence Process (TIP) Model, to be implemented effectively, efficient and accessible quality assurance tools are needed. The purpose of this article is to describe the process of developing an online staff self-report quality assurance tool for a key process in the TIP Model: the TIP Solution Review (TSR) and to provide data on the acceptability and perceived impact of both the measure and the TSR process. We used an iterative approach to pilot test and seek feedback from multidisciplinary teams trained in TIP. Initially, a team of 7 completed the online TSR Quality Assurance Scale, followed by a focus group. The tool was refined and administered to three additional TIP Model trained teams (n = 23 practitioners) in 3 different states. Team supervisors (n = 3) were then interviewed about their perceptions of the TSR process and the new tool. Thematic analyses were conducted on open-ended survey questions and interview and focus group responses. Findings suggest the new tool and TSR processes are acceptable and feasible. Staff feedback provided for further TSR process refinement. The process of developing, refining and evaluating a tool to capture the TSR (an important TIP quality improvement process) led to increased TSR process specification. Findings have implications for systematically guiding how intervention developers structure supervision and preparation of intervention planning and delivery. Future research will more rigorously test the tool to establish its empirical properties and effectiveness in assessing adherence to TSR procedures.

Compared to younger youth and middle-aged and older adults, older youth and young adults (16–25 year olds) are more likely to experience serious mental health challenges, including schizophrenia, bipolar, and major depressive disorders.1 These young people are at increased risk for high school dropout (or “pushout”), unemployment and under-employment, poverty, housing instability, homelessness, justice involvement, and suicide.2 They are also least likely to utilize mental health services, which tend to feel stigmatizing, incongruent, and ineffective to young people. Accessible, attractive, and effective services spanning both child and adult sectors are needed to engage this unique population. To address these challenges, Thresholds, the largest community mental health provider in Illinois, successfully developed and implemented two multidisciplinary sister teams serving young people within a Medicaid and commercial fee-for-service insurance billing environment.

Virtually every social worker knows about the core role of state central registries in the child welfare system. Less well known is how the very registries that protect children can also threaten the economic security of their families and, in so doing, undermine child safety.

Using qualitative data-mining methods, this study analyzed 39 child welfare case records in order to identify examples of skillful practice. Conducted in partnership with a public child welfare agency in northern California, the study found that child welfare workers are implementing many of the practices promoted by statewide and national child welfare practice frameworks. Broad categories of skillful practice identified included: (1) effective communication by social workers, (2) support for client self-determination, and (3) active intervention strategies. Study findings provide support for incorporating case record review processes in training and supervision in order to integrate practice-based expertise with research-based evidence.

Childhood exposure to domestic violence (CEDV) is widely understood as potentially harmful to children. Accordingly, many child welfare systems in the United States construe CEDV as maltreatment when the exposure results in harm or threatened harm to the child. The purpose of the current study was to investigate substantiated child welfare referrals directly related to CEDV to better understand the prevalence and patterns of CEDV-related maltreatment and how child welfare workers respond under the “harm or threatened harm” standard. Data were drawn from 23,704 substantiated referrals between 2009 and 2013 in a large Midwestern child welfare system. Approximately 20% of substantiated referrals were CEDV related. A plurality of CEDV-related referrals included both a male caregiver and female caregiver who were co-substantiated for maltreatment. The most common maltreatment types substantiated for these referrals were neglect based rather than abuse based, and just under a quarter (23%) of CEDV-related referrals were formally opened for services. Referrals involving co-occurring substance abuse were most likely to be opened for services based on predicted probabilities derived from multilevel modeling. Implications for policy and practice are considered.

This paper presents a protocol for a funded study of technical assistance strategies used to support the use of evidence, and, in particular, how participatory processes contribute to the use of evidence to improve outcomes for populations. Findings from the study will increase understanding of the relationships between technical assistance, stakeholder participation and evidence use in child and family services. The authors argue that publishing such a protocol can increase transparency between researchers and practitioners and raise awareness of the need for research on how stakeholder participation can strengthen evidence use in child welfare service settings. The authors also reflect on the potential value and limitations of published protocols. This study will systematically gather input from stakeholders with expertise in technical assistance to develop a compilation of strategies that can be used to support the use of evidence. The study will identify strategies that include stakeholder involvement and assess which strategies under what conditions facilitated the use of research evidence. The study will address four research questions: What technical assistance strategies are used to support the use of research evidence? What are the consensus-driven terms and definitions of identified strategies? To what extent do technical assistance strategies involve stakeholders and for what purpose?

The field of implementation science was developed to better understand the factors that facilitate or impede implementation and generate evidence for implementation strategies. In this article, we briefly review progress in implementation science, and suggest five priorities for enhancing the impact of implementation strategies. Specifically, we suggest the need to: (1) enhance methods for designing and tailoring implementation strategies; (2) specify and test mechanisms of change; (3) conduct more effectiveness research on discrete, multi-faceted, and tailored implementation strategies; (4) increase economic evaluations of implementation strategies; and (5) improve the tracking and reporting of implementation strategies. We believe that pursuing these priorities will advance implementation science by helping us to understand when, where, why, and how implementation strategies improve implementation effectiveness and subsequent health outcomes.

This article explores the commercial and creative impact of diversified corporations on artistic production. Drawing on original data from 70 seasons of Broadway musical theater, I examine the relationship between measures of corporate involvement in theater production and measures of content innovation and success. Contrary to my hypotheses, I find that musicals produced by diversified corporations are not systematically less innovative than musicals produced solely by non-corporate producers, as levels of innovation vary across measures. However, average levels of innovation on Broadway have declined over time due, in part, to the growing number of diversified-corporate musicals in the market. With respect to success, I observe two systematic trends. First, relative to non-corporate musicals, diversified-corporate musicals achieved equivalent to exceptional success as they were establishing themselves in Broadway’s theater market. Second, the relative success of diversified-corporate musicals declined as their prevalence in Broadway’s theater market grew. Together, these findings highlight the non-trivial ways in which an artistic market can change when corporate involvement in artistic production grows.

Prior studies of the health effects of recessions have shown mixed results. Ecological studies often report a positive relationship between economic downturns and population health while individual-level studies often show that conditions related to recessions are deleterious. Our study examines the spatially and temporally heterogenous effects of the Great Recession (TGR) on adverse birth outcomes, a contemporaneous measure of population health that is highly responsive to changing social conditions. We use restricted birth cohort data from California (2004–2012) merged with both county- and tract-level socio-demographic data, to explore birth selectivity and temporal and unemployment effects during TGR on adverse birth outcomes. We find that gestational exposure – more specifically, second trimester exposure – during or adjacent to the months of TGR was generally deleterious for birth outcomes, more so, in some cases, for mothers with lower levels of education, and that increases in county-level unemployment were generally deleterious for birth outcomes. Although recessionary effects on population health are problematic and may have far-reaching effects, it appears that these effects may be largely universal, even given potential selective fertility favoring advantaged groups.

We evaluated the Fatal Encounters (FE) database as an open-source surveillance system for tracking police-related deaths (PRDs). We compared the coverage of FE data to several known government sources of police-related deaths and police homicide data. We also replicated incident selection from a recent review of the National Violent Death Reporting System. FE collected data on n = 23,578 PRDs from 2000–2017. A pilot study and ongoing data integration suggest greater coverage than extant data sets. Advantages of the FE data include circumstance of death specificity, incident geo-locations, identification of involved police-agencies, and near immediate availability of data. Disadvantages include a high rate of missingness for decedent race/ethnicity, potentially higher rates of missing incidents in older data, and the exclusion of more comprehensive police use-of-force and nonlethal use-of-force data—a critique applicable to all extant data sets. FE is the largest collection of PRDs in the United States and remains as the most likely source for historical trend comparisons and police-department level analyses of the causes of PRDs.

Many hospitalized patients experience barriers to effective patient–provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability. Speech-language pathologists have begun to address patients’ short-term communication needs with an array of augmentative and alternative communication (AAC) strategies. This study used a between-groups experimental design to evaluate the impact of providing patients with AAC systems so that they could summon help and communicate with their nurses. The study examined patients’ and nurses’ perceptions of the patients’ ability to summon help and effectively communicate with caregivers. Patients who could summon their nurses and effectively communicate—with or without AAC—had significantly more favorable perceptions than those who could not. This study suggests that AAC can be successfully used in acute care settings to help patients overcome access and communication barriers. Working with other members of the health care team is essential to building a “culture of communication” in acute care settings.

High-quality, early caregiver-child interaction facilitates language, cognitive, and health outcomes. Children in low socioeconomic status households experience less frequent and lower-quality language interactions on average than their middle to high socioeconomic status peers. Early caregiver-implemented intervention may help to improve outcomes for these children. This article describes how we used community-based participatory research (CBPR) to develop and implement a community-based, caregiver-implemented early language intervention, including the challenges, solutions, and lessons learned in the process of CBPR. We adopted an ethnographic approach to document and analyze our CBPR experiences in multiple phases of the project, including intervention design, training, implementation, and evaluation. Developing the CBPR partnership, co-designing and implementing the study, and managing systems- level concerns like obtaining funding were central challenges for the researcher-community team. The CBPR model enhances early language intervention research by facilitating understanding of families in underserved communities and increasing the cultural relevancy of intervention materials.

Children’s skill levels in language, mathematics, literacy, self-regulation, and social–emotional adjustment at kindergarten entry are believed to play an important role in determining school success through their long-term association with academic and social skills in primary and secondary education. Hence, children’s school readiness is a national priority. To date, there is some evidence that specific individual school readiness skills relate to specific outcomes, but much of that research has not addressed concerns regarding generalization due to the high levels of correlations among the school readiness skills. The interrelationships among school readiness domains and patterns of skill acquisition – during the first three years of primary education in which basic skills are the focus and in the later years of primary or secondary education when higher-order skills are the focus – have not been explored adequately. Using the NICHD Study of Early Child Care and Youth Development dataset (n = 1364), this research conducted growth curve analyses to examine a comprehensive set of readiness indicators in kindergarten and identify which domains were stronger predictors of academic and social trajectories through grade 3 and from grades 3 to 5. Results highlight the importance of examining multiple school readiness domains simultaneously rather than separately, and moving beyond outcomes (skill levels) at a particular grade to consider which kindergarten skills predict gains over time (skill acquisition) both within- and across-domains. Empirical and methodological implications are considered for educational research, policy, and practice.

Korean-American women experience a higher incidence of cervical cancer than non-Hispanic White women as well as other Asian-American women. A prominent cause of such a disproportional health risk among Korean-American women is a lack of awareness and knowledge of cervical cancer screening. Identifying factors related to cervical cancer screening awareness and literacy is critical for increasing cervical cancer screening among this population. Researchers surveyed 230 Korean-American women in a metro area in a Southeastern state, USA. Based on Anderson’s Behavioral Model of Health Services Use, predisposing, enabling, and need factors were explored to predict cervical cancer screening awareness and literacy. Monthly income, education, English proficiency, and annual checkups had significantly positive associations with cervical cancer screening awareness. Having an acquaintance giving support and receiving an annual checkup had significantly positive relationships with cervical cancer screening literacy. This study recommends culture specific guidelines to promote annual checkups through primary care physicians and the transfer of information about cervical cancer screening through acquaintances giving support.

This study explores the experiences of domestic violence victims with their Temporary Assistance for Needy Families (TANF) applications and the subsequent assessment processes in the state of Georgia, focusing on the conditions related to their disclosure of abuse and their postdisclosure experiences. This study interviewed five victims of domestic violence, four local victim advocates, and three nationally recognized experts regarding domestic violence screening in TANF programs using semistructured interviews. Data were analyzed using grounded theory techniques. The findings showed that the participants perceived TANF application and assessment processes as (i) inaccessible and (ii) unhelpful, lacking special considerations for domestic violence victims. Conditions related to victims’ disclosure of abuse included (i) safety concerns, (ii) working relationships between local victim support agencies and TANF offices, (iii) a safe environment to disclose abuse, and (iv) advocacy. After disclosing their domestic violence history to their TANF caseworkers, the victims reported experiencing (i) a lack of continued assessment and support related to domestic violence and (ii) a compulsion to make final decisions regarding continuing or discontinuing their TANF applications. The current study contributes to the field of social work by providing a better understanding of how and to what extent victims of domestic violence are actually supported within the TANF system and by yielding practice and policy implications for effectively assisting the victims of domestic violence within the TANF system.

Explore acceptability of engaging family/friends in patients’ type 2 diabetes (T2D) self-management using text messaging. Participants (N = 123) recruited from primary care clinics for a larger trial evaluating mobile phone support for T2D completed self-report measures and a hemoglobin A1c test and then had the option to invite an adult support person to receive text messages. We examined characteristics and reasons of participants who did/did not invite a support person, responses to the invitation, and feedback from patients and support persons. Participants were 55.9 ± 10.1 years old, 55% female, 53% minority, and 54% disadvantaged (low income, less than high school degree/GED, uninsured, and/or homeless). Participants who invited a support person (48%) were slightly younger, more likely to be partnered, and reported more depressive symptoms and more emergency department visits in the year prior to study enrollment as compared to participants who did not (all p <.05). Participants’ reasons for inviting a support person included needing help and seeing benefits of engaging others, while reasons for not inviting a support person included concerns about being a “burden” and support person’s ability or desire to text. Support persons reported the texts increased awareness, created dialogue, and improved their own health behaviors. Patients inviting a support person had higher need and thus may stand to benefit most. Most support persons were open to engagement via text messages. Across race and socioeconomic status, text messaging may engage support persons to increase health-related support—particularly for patients with higher levels of need.

Social inclusion has historically been one of the key goals of the welfare state. Over the past two decades, an increasing number of policies have aimed to promote inclusion by connecting low-income families to mainstream financial services and enabling them to save and acquire assets. Building on the concept of the “paradox of inclusion,” this article examines whether and how policies that aim to include low-income families in asset accumulation do so in ways that risk reinforcing their exclusion. The article focuses on a case study of a matched savings program in the heart of a major American city, gathering evidence through in-depth interviews with 24 clients in the program and ethnographic observations at the agency implementing the program.

While youth generally experience stressors from developmental milestones, Black youth also face racialized stressors. Racial socialization has been found to help Black youth cope with racialized stressors, but research has yet to show its contribution to coping beyond general socialization practices. This study examines how racial socialization contributes beyond that of general coping socialization to coping behaviors. Fifty-eight third-eighth-grade (Mage = 11.3, SD = 1.54) youth reported general coping socialization and racial socialization practices and coping behaviors. Results indicate that for engagement coping, racial socialization messages contributed significantly to parent-provided engaged socialization strategies. Implications are considered for the ways in which Black youth experience stress and require culturally specific practices for successful coping with frequently encountered stressors.