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Child Abuse Prevention – Programmatic Interventions. Charles Oberg, MD, MPH Hennepin County Medical Center Maternal and Child Health, Epidemiology, School of Public Health, University of Minnesota. Prevention basics. Using research to inform programs and policy Conflict:

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child abuse prevention programmatic interventions

Child Abuse Prevention – Programmatic Interventions

Charles Oberg, MD, MPH

Hennepin County Medical Center

Maternal and Child Health, Epidemiology, School of Public Health,

University of Minnesota

prevention basics
Prevention basics
  • Using research to inform programs and policy
  • Conflict:
    • desire to protect children … BUT…
    • family is the desirable location for child rearing.
programmatic framework
Programmatic Framework
  • Audience of focus:
    • Universal population to…
    • Specific family
  • Stages of prevention
    • Primary: Universal population
    • Secondary: At-risk population
    • Tertiary: Abusive families
head start primary prevention
Head Start – Primary Prevention
  • Promote safety of children from a global perspective
  • 4 components:
    • Education
    • Health and nutrition
    • Parental involvement
    • Social service intervention
head start continued
Head Start (continued)
  • Activity objectives:
    • Reduce family stress
    • Decrease the likelihood of maltreatment
    • Promote “social capital” – support networks
home visitation secondary prevention
Home Visitation: Secondary Prevention
  • Service provision for selected at-risk persons
  • Home visiting: new parents are visited by a professional, paraprofessional and/or trained layperson
    • Support
    • Advice
    • Referrals
    • General encouragement
home visitation continued
Home Visitation (continued)
  • Documented effectiveness 20 years ago
    • Home visits reduced rate of child abuse cases for poor, unmarried adolescent mothers compared to moms without visits
  • 1997 15-year study
    • Nurse-visited, at-risk families had half the child abuse than those at-risk families without nurse visits
key ingredients in effective home visitation programs
Key ingredients in effective home visitation programs
  • Begin visits before or soon after birth
  • Extend visits over time
  • Form alliance between visitor and parents
  • Watch for early signs of abuse
  • Teach effective parenting skills
  • Focus on child
  • Provide specific and practical services
  • Involve father when appropriate
  • Adjust services to meet family needs
family centered services tertiary prevention
Family Centered Services:Tertiary Prevention
  • Focus on families with serious parenting problems
  • Attempts to keep the family together after abuse or neglect
  • Combine direct crisis and counseling assistance with case management strategy
family centered services tertiary prevention10
Family Centered Services:Tertiary Prevention
  • If the severity of the situation does not allow the preservation of the family…
    • Foster care
    • Kinship care
      • Less external support
      • Fewer services
      • Less contact with child protective services…

than foster care

summary
Summary
  • Successful programs
    • Are proactive
    • Reach across economic distinctions
    • Appreciate the complexity of factors
  • Future directions
    • Incorporate other areas of research (e.g., domestic violence)
    • Strength oriented approach (vs. deficit model)