ObjectivesThis study examines the characteristics and outcomes of child welfare investigations reported by hospital-based and community-based healthcare professionals.MethodsA sample of 7590 child maltreatment-related investigations from the Ontario Incidence Study of Reported Child Abuse and Neglect-2018, a cross-sectional study, was analysed. Bivariate analyses compared characteristics of hospital and community healthcare-reported investigations. Chi-square automatic interaction detector analyses were used to predict the most influential factors in the decision to provide a family with services following a child welfare investigation from each referral source.ResultsCommunity healthcare-reported investigations were more likely to have a primary concern of physical abuse while hospital-reported investigations were more likely to be focused on assessing risk of future maltreatment. Hospital-reported investigations were more likely to involve noted primary caregiver (eg, mental health issues, alcohol/drug abuse, victim of intimate partner violence (IPV)) and household risk factors. The most significant predictor of service provision following an investigation was having a caregiver who was identified as a victim of IPV in hospital-reported investigations (χ2=30.237, df=1, adj. p<0.001) and having a caregiver for whom few social supports was noted in community healthcare-reported investigations (χ2=18.892, df=1, adj. p<0.001).ConclusionHealthcare professionals likely interact with children who are at high risk for maltreatment. This study’s findings highlight the important role that healthcare professionals play in child maltreatment identification, which may differ across hospital-based and community-based settings and has implications for future collaborations between the healthcare and child welfare systems.
IntroductionThe accurate identification and appropriate investigation of child maltreatment is a key priority for promoting the optimal health and development of children. Healthcare providers are often well-positioned professionals to report suspected child abuse and neglect, and, therefore, interact regularly with child welfare workers. Little research has examined the relationship between these two groups of professionals.MethodsWe interviewed healthcare providers and child welfare workers in order to examine the referral and child welfare investigation processes to understand strengths and identify areas of improvement for future collaboration. Thirteen child welfare workers from child welfare agencies and eight healthcare providers from a pediatric tertiary care hospital in Ontario, Canada were interviewed to meet the study’s objectives.ResultsHealthcare providers spoke about positive experiences making reports, factors impacting reporting decisions, areas for improvement (e.g., difficulties communicating, lack of collaboration, and disruption of therapeutic alliance), training, and professional roles. For interviews with child welfare workers, identified themes included healthcare professionals’ perceived expertise and understanding the role of child welfare. Both groups brought up the need for increased collaboration as well as systemic barriers and legacies of harm.DiscussionOur core finding was a reported lack of communication between the groups of professionals. Other identified barriers in collaboration included a lack of understanding of each other’s roles, hesitation for healthcare providers making reports, as well as legacies of harm and systemic inequities in both institutions. Future research should build on this examination by including the voices of healthcare providers and child welfare workers to identify sustainable solutions for increased collaboration.
The COVID-19 pandemic globally disrupted education, forcing a shift to remote learning that excludes many learners. This paper examines student perspectives of the changes to their education. In October 2020, students worldwide participated in the Digital Inclusion Challenge, a hackathon-style event hosted by Convergence.Tech, a digital transformation company. Participants described barriers to learning and proposed solutions to increase inclusivity and effectiveness. Using thematic analysis, student-identified barriers and their proposed solutions were coded and explored. Overall, themes of four barriers to digital inclusion in education and themes of six solutions were identified. The findings demonstrate what students value in their education, and what they felt they had lost in the transition to online and remote learning. This research contributes to knowledge on the severe impacts of the loss of in-person learning and explores technological and conceptual innovations ideated by youth. Further, it provides insight into global student experiences in accessing education during the pandemic and offers considerations for future research.
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