Differential response (DR), also referred to as alternative response (AR), family assessment response (FAR), or multiple track response, was developed to incorporate family-centered, strengths-based practices into child protective services (CPS), primarily by diverting lower risk families into an assessment track rather than requiring the traditional CPS investigation. Since the program's inception, researchers have conducted several large evaluation studies of DR programs, and a large body of research and program literature has been published touting the success and benefits of DR. In response to significant concerns about the clarity and consistency of DR program models and the validity and generalizability of its associated research, the authors undertook a comprehensive, three-pronged evaluation to provide guidance in shaping the ongoing development of DR programs. This report summarizes the methodology, findings, conclusions, and recommendations from the review.
This article reviews and analyzes extant literature on the prevention of child maltreatment. We give an overview of protective factors that research finds to be efficacious in maltreatment prevention and pay particular attention to research that shows how health-based models and community-based models can leverage family and community strengths to that end. We go on to offer recommendations for potential future prevention programming, including an approach with untapped potential—the Prevention Zones framework. Finally, we discuss policy considerations and implications specific to the goal of increasing programming and services that leverage family and community strengths.
In searching for a "disruptive" new paradigm to prevent child abuse, we are drawn to an older approach with unfulfilled promise. In 1993, the United States Advisory Board on Child Abuse and Neglect published their report Neighbors Helping Neighbors: A New National Strategy for the Protection of Children. The top priority recommendation of the Board was to develop programs that facilitated the development and safety of neighborhoods by establishing Prevention Zones to improve social and physical environments with high rates of child maltreatment. This paper explores how Prevention Zones might be re-imagined today, integrated with services like home-visiting and medical homes, and applied to serious child maltreatment such as abusive head trauma.
We searched the US National Library of Medicine's PubMed, Google Scholar and the American Psychological Association's Psychinfo databases during September 2019 for citations and abstracts on abusive head trauma (AHT) and shaken baby syndrome prevention dated 1 January 2000 to 31 August 2019. We identified 53 empirical studies and performed a structured review to identify the effects of prevention, if any, on AHT. We identified three lines of investigation that have focused on: (i) strategies which teach parents how to respond to newborn crying and the dangers of shaking babies; (ii) community and public health factors; and (iii) professional education and practice. Most studies were observational, although a small number used sophisticated designs such as prospective or randomised controlled trials. We note other strengths and weaknesses of these articles and suggest future directions for research in each of these areas based on the current level of scientific inquiry. Key Practitioner Messages Research on AHT prevention is limited, although a growing research base supports teaching parents how to respond to newborn crying and about the dangers of shaking babies. Social care systems addressing provision of material and other support have positive effects on AHT rates. Professional education should improve practitioners' identification of families with increased risk and enhance AHT identification and treatment. Those wishing to prevent AHT should consider multilevel approaches and their own community needs, practice setting, and patient/client risk profiles when designing strategies.
Introduction: Up to 98% of practicing family physicians, and over 75% of resident physicians in Canada experience abusive incidents. Despite the negative consequences of abusive incidents, few residents report these events to their supervisors or institution. We sought to estimate the prevalence of abusive incidents experienced or witnessed by Saskatchewan family medicine residents (FMRs) and identify their responses to these events. Methods: Anonymous survey invitations were emailed to all 110 Saskatchewan FMRs in Saskatchewan in November and December 2020. Demographic characteristics, frequency of witnessed and experienced abusive incidents, sources of incidents and residents’ responses were collected. Incidents were classified as minor, major, severe, or as racial discrimination based on a previously published classification system. Results: The response rate was 34.5% (38/110). Ninety-two percent (35/38) of residents witnessed a minor incident and 91.7% (32/36) of residents experienced a minor incident. Seventy-one percent (27/38) of residents witnessed racial discrimination while 19.4% (7/36) of residents experienced racial discrimination. Patients were the most common source of abusive incidents. Twenty-nine percent of residents reported abusive incidents to their supervisors. Most residents were aware of institutional reporting policies. Conclusions: Most Saskatchewan FMRs experienced or witnessed abusive incidents, but few were reported. This study provided the opportunity to reassess policies on abusive incidents, which should consider sources of abuse, confidence in reporting, and education.
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