Sharon G. Portwood

An evaluation of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program.

This study evaluated the effectiveness of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program, developed by the American Psychological Association in collaboration with the National Association for the Education of Young Children, as an economical primary prevention intervention for child maltreatment. Using an experimental design with random assignment to groups, program impact on participating parents’ knowledge, behavior, and attitudes compared to those of a comparison group of parents receiving standard community-based support services was examined. As hypothesized, the ACT Parents Raising Safe Kids program achieved positive results in several areas related to effective parenting, including a reduction in the use of harsh verbal and physical discipline and an increase in nurturing behavior. Positive results were observable both at the conclusion of the ACT program and at three-month follow-up. Results further indicated a positive impact on parent expectations and social support for those parents with the greatest need in these areas. Qualitative data collected through focus groups demonstrated that parents themselves perceived numerous benefits to the ACT program, including assistance in controlling their anger, learning and implementing better parenting and discipline strategies, and recognizing when their child’s behavior is developmentally appropriate. Overall, findings suggest that the ACT Parents Raising Safe Kids program is a promising primary prevention strategy that can be implemented across diverse community settings.

Child Maltreatment Prevention

Child maltreatment is a pervasive problem that affects families and communities in the United States and throughout the world. Most credit the “discovery” of child maltreatment to Henry Kempe, a physician from Colorado, who in 1962 published an article in the Journal of the American Medical Association on the “battered child syndrome” (Kempe, Silverman, Steele, Droegemueller, & Silver, 1962). Since the publication of Kempe’s seminal article, progress in the field has been rapid, mobilized by the efforts of many, including grassroots organizations, mental health professionals, university researchers, lawmakers, medical personnel, social service professionals, and criminal justice workers. These efforts have contributed significantly to furthering our understanding of child maltreatment and to the myriad ways that families and professionals can work together to prevent abuse and neglect. This chapter provides a brief overview of the problem of child maltreatment and describes successful research-based prevention strategies. The chapter also describes specific advocacy efforts and action steps and outcomes that should provide a critical component to alleviating the problem of child maltreatment.

Psychological Science and Innovative Strategies for Informing Health Care Redesign: A Policy Brief.

Recent health care legislation and shifting health care financing strategies are transforming health and behavioral health (a broad term referring to mental health, substance use, and health behavior) care in the United States. Advances in knowledge regarding effective treatment and services coupled with incentives for innovation in health and behavioral health care delivery systems make this a unique time for mobilizing our science to enhance the success of health and behavioral health care redesign. To optimize the potential of our current health care environment, a team was formed composed of leaders from the Societies of Clinical Child & Adolescent Psychology, Pediatric Psychology, and Child and Family Policy and Practice (Divisions 53, 54, and 37 of the American Psychological Association). This team was charged with reviewing the scientific and policy literature with a focus on five major issues: (a) improving access to care and reducing health disparities, (b) integrating behavioral health care within primary care, (c) preventive services, (d) enhancing quality and outcomes of care, and (e) training and workforce development. The products of that work are summarized here, including recommendations for future research, clinical, training, and policy directions. We conclude that the current emphasis on accountable care and evaluation of the outcomes of care offer numerous opportunities for psychologists to integrate science and practice for the benefit of our children, families, and nation. The dramatic changes that are occurring in psychological and behavioral health care services and payment systems also require evolution in our practice and training models.

Influencing Policymaking for Maltreated Children and Their Families

Public policy can be a powerful tool for children and their families. Accordingly, this article addresses how psychologists and other child-oriented researchers can leverage this tool to ensure that child and family issues, specifically issues related to child abuse and neglect, receive adequate attention. We encourage a bidirectional relationship between policymakers and experts in child maltreatment through which policymakers solicit and employ relevant expertise, and psychologists, in turn, provide useful information to policymakers. To facilitate such relationships, this article offers practical guidance to psychologists on understanding the policymaking process, gaining familiarity with relevant policy, communicating effectively with policymakers, and understanding the unique contributions that psychologists can make to the policy process.

Risk Factors of Smoking Among Health Care Professionals

Background: Health care professionals (HCPs) play a vital role at various levels of smoking cessation programs to reduce tobacco use in general populations. However, their smoking habits may limit their ability to intervene with their patients who smoke. Aims: To determine prevalence rates of current smoking and examine sociodemographic and work-related factors associated with current smoking among HCPs. Methods: A statewide survey was conducted in a representative sample of 4 groups of HCPs, physicians, nurses, respiratory therapists, and occupational therapists, with active licenses in Texas in 2003. Weighted prevalence estimates of current smoking rates were computed. Survey logistic regression analysis was used to investigate associations between individual characteristics and current smoking. Results: There were 3600 HCPs included in the analysis. The overall prevalence of current smoking was 9% with the highest prevalence (16%) recorded among respiratory therapists and the lowest prevalence (3%) recorded among physicians. In the multivariable logistic regression analysis non-Hispanic white HCPs were almost 4 times as likely to be current smokers (adjusted odds ratio= 3.95, 95% confidence interval = 1.24-12.59) and those working for 50 hours or more per week were twice as likely to be current smokers (adjusted odds ratio = 2.07, 95% CI = 1.20-3.57). Compared with physicians, all other HCP groups had significantly greater odds of currently smoking. HCPs who were female and resided or worked in rural settings had higher smoking rates in univariable analysis only (P < .05). Conclusions: Smoking is prevalent among certain HCP groups. Working long hours was identified as an important occupational factor associated with current smoking.

Pediatric Inpatient Nurses' Perceptions of Child Maltreatment

Purpose The purpose of this study was to explore the perceptions of child maltreatment among inpatient pediatric nurses. Design and Methods A cross‐sectional survey was used to obtain responses to an online survey designed to examine perceptions of child maltreatment from inpatient pediatric nurses. Results Many nurses surveyed (41.25%) indicated that they had not received adequate training or had never received training on child maltreatment identification and many (40%) also indicated they were not familiar with the applicable reporting laws. Conclusions Due to the serious immediate and long term effects of child maltreatment, it is imperative that pediatric inpatient nurses have adequate training on how to identify potential abuse and neglect cases, as well as legal reporting requirements, since they are in a unique position to identify potential cases of maltreatment. Practice Implications There is a continuing need for training on child maltreatment identification and reporting laws for inpatient pediatric nurses. HighlightsPediatric inpatient nurses are in a key position to identify potential child maltreatment cases.Many nurses felt they had not received adequate training on child maltreatment identification.Nearly half of nurses surveyed indicated they were not familiar with applicable reporting laws.Pediatric inpatient nurses need adequate training on identifying and reporting potential abuse and neglect.