The role of prevention services in the county context of child maltreatment

Highlights

• A series of 3 multi-level models are conducted.

• The role of county prevention spending in individual maltreatment is examined.

• County spending was associated with lower odds of individual level maltreatment.

• Social disorganizational theory was not supported at the county level.

Abstract

A growing body of literature has investigated the effects of living in certain neighborhoods on child maltreatment. Relatively few (5) studies to date have utilized methods that adequately account for clustering within neighborhoods. None of these studies accounted for the availability of local child maltreatment prevention services — the very programs that were put in place to address the problem of maltreatment. This study investigates the role of the availability of child maltreatment prevention programs in individual-level risk for maltreatment. A multi-level analysis was conducted using county-level information on child maltreatment prevention program spending, census information on county characteristics, and individual-level data on individual risks for maltreatment and maltreatment behaviors. Results show that controlling for individual- and county-level risks for maltreatment, the amount a county spends on maltreatment prevention programs is associated with lower odds of maltreatment at the individual level.

Introduction

In federal fiscal year 2011, there were 3.4 million official allegations of child abuse and neglect involving more than 6 million children in the United States; 676,569 (11%) were substantiated victims of child maltreatment (United States Department of Health & Human Services, 2012). The Fourth National Incidence Study of Child Abuse and Neglect (NIS-4), seeks to estimate maltreatment more broadly by including both cases that were reported and those that were not through interviews with professionals who have contact with children and families. According to NIS-4, more than 1.25 million children were abused or neglected over the period of 2005–2006 (Sedlak et al., 2010). Children who experience maltreatment are at a greater risk for developing a host of negative outcomes, including aggression, developmental delays, disturbed peer relationships, low self-esteem, psychiatric disorders, aggressive and antisocial behaviors, and difficulties interacting successfully with others (Downey and Walker, 1989, Hoffman-Plotkin and Twentyman, 1984, Kaplan et al., 1999, Putnam, 2003, Tong et al., 1987, Watts-English et al., 2006, White et al., 1988, Wolfe, 1999). Recent research has also indicates that maltreatment is associated with changes to biological stress systems and can have neurological consequences, including delays in cognitive, language, and academic skills (Edmiston et al., 2011, McCrory et al., 2011, Shonkoff and Phillips, 2000, Watts-English et al., 2006, Wilson et al., 2011). Children who are abused and neglected are also more likely than non-maltreated children to experience problems that persist into adulthood, including: alcohol and other drug abuse (Peters, 1988), depression (Mullen, Romans-Clarkson, Walton, & Herbison, 1988), and criminal activity (Rivera & Widom, 1990). Given the many problems, it is essential that researchers learn more about the risk and protective factors associated with the onset of maltreatment as well as the effectiveness of different primary prevention programs to prevent maltreatment from occurring. Researchers must take this information and make it readily available to policy makers and practitioners so that those who have the power to make changes, both in terms of funding and on the ground, have the very best information at their fingertips.

Numerous individual maltreatment prevention programs have been evaluated to understand their effectiveness in reducing maltreatment. Programs such as Nurse Family Partnership (Olds, 2006), Chicago Child Parent Centers (Reynolds & Robertson, 2003), and Triple P Positive Parenting Program (Prinz, Sanders, Shapiro, Whitaker, & Lutzker, 2009), have been found to successfully reduce maltreatment. These studies are essential in order to advance the field of maltreatment prevention. However, we don't yet know the extent to which current prevention efforts, regardless of their evidence base, are effective in reducing maltreatment. This study takes an ecological approach to evaluate the effectiveness of prevention programs by measuring aspects of the current prevention program service array and their association with official individual-level maltreatment investigations.