Community Health and Preventive Medicine Commons^™

Gender Differences In Sexual And Reproductive Health Protective And Risk Factors Of Batswana Adolescents: Implications For Parent And Adolescent Interventions, Christina J. Sun, Esther S. Seloilwe, Mabel Magowe, Kefalotse S. Dithole, Kim S. Miller, Janet S. St. Lawrence

OHSU-PSU School of Public Health Faculty Publications and Presentations

Adolescents in sub-Saharan Africa and in Botswana in particular continue to bear the brunt of the HIV epidemic. This analysis assessed gender differences among theory-based sexual and reproductive health protective and risk factors in a cross-sectional sample of 228 Batswana adolescents. Incongruence between preferred and actual sources of sexual information and several important gender differences in parent-adolescent relationships, psychosocial influences, and adolescent sexual behaviors were identified. Parents were the fourth most common source of information about sex; yet, over three-quarters of adolescents preferred to have parents teach them about sex. Boys reported more positive relationships with their parents and girls …

Hospital Variation In Costs – A Challenge To The Value Proposition, Aaron B. Caughey, Jonathan M. Snowden

OHSU-PSU School of Public Health Faculty Publications and Presentations

Mini Commentary on 2017-OG-19978R1: Hospital Variation in Cost of Childbirth and Contributing Factors: A Cross-Sectional Study. To view this article visit https://doi.org/10.1111/1471-0528.15007.

Prevalence, Age Profile, And Associated Risk Factors For Hymenolepis Nana Infection In A Large Population-Based Study In Northern Peru, Percy M. Vilchez Barreto, Ricardo Gamboa, Saul Santivañez, Seth E. O'Neal, Claudio Muro, Andrés G. Lescano, Luz M. Moyano, Guillermo Gonzálvez, Hector H. García

OHSU-PSU School of Public Health Faculty Publications and Presentations

Hymenolepis nana, the dwarf tapeworm, is a common intestinal infection of children worldwide. We evaluated infection and risk factor data that were previously collected from 14,761 children aged 2-15 years during a large-scale program in northern Peru. We found that 1,124 of 14,761 children (7.61%) had H. nana infection, a likely underestimate given that only a single stool sample was examined by microscopy for diagnosis. The strongest association with infection was lack of adequate water (adjusted prevalence ratio [aPR] 2.22, 95% confidence interval [CI] 1.82-2.48) and sanitation infrastructure in the house (aPR 1.94, 95% CI 1.64-2.29). One quarter of …

Planning And Designing The Improving Addiction Care Team (Impact) For Hospitalized Adults With Substance Use Disorder, Honora Englander, Melissa B. Weimer, Rachel Solotaroff, Christina Nicolaidis, Benjamin Chan, Christine M. Velez, Alison Noice, Tim Hartnett, Ed Blackburn, Pen Barnes, P. Todd Korthuis

School of Social Work Faculty Publications and Presentations

People with substance use disorders (SUD) have high rates of hospitalization and readmission, long lengths of stay, and skyrocketing healthcare costs. Yet, models for improving care are extremely limited. We performed a needs assessment and then convened academic and community partners, including a hospital, community SUD organizations, and Medicaid accountable care organizations, to design a care model for medically complex hospitalized patients with SUD. Needs assessment showed that 58% to 67% of participants who reported active substance use said they were interested in cutting back or quitting. Many reported interest in medication for addiction treatment (MAT). Participants had high rates …

C-Safe: A Computer-Delivered Sexual Health Promotion Program For Latinas, Charles H. Klein, Tamara Kuhn, Midori Altamirano, Carmela Lomonaco

Anthropology Faculty Publications and Presentations

This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days …

Brief Report: Medication Sharing Is Rare Among African Hiv-1 Serodiscordant Couples Enrolled In An Efficacy Trial Of Oral Pre-Exposure Prophylaxis (Prep) For Hiv-1 Prevention, Kerry A. Thomson, Jessica Haberer, Mark A. Marzinke, Andrew Mujugira, Craig Hendrix, Connie Celum, Patrick Ndase, Alan Ronald, David Bangsberg, Jared Baeten

OHSU-PSU School of Public Health Faculty Publications and Presentations

Sharing of pre-exposure prophylaxis (PrEP) medications is a concern for PrEP implementation. For HIV-1 serodiscordant couples, sharing may undermine the HIV-1 prevention benefit and also cause antiretroviral resistance if taken by HIV-1 infected partners. Within a PrEP efficacy trial among HIV-1 serodiscordant couples, we assessed the occurrence of PrEP sharing by self-report and plasma tenofovir concentrations in HIV-1 infected partners. PrEP sharing was self-reported at < 0.01% of visits, and 0% -1.6% of randomly selected and 0% of purposively selected specimens from HIV-1 infected participants had detectable tenofovir concentrations (median: 66.5 ng/mL, range: 1.3-292 ng/mL). PrEP sharing within HIV-1 serodiscordant couples was extremely rare.

Evaluating Knowledge Of Developmental Disabilities Among Wic Participants, Carolina Regalado Murillo, Katharine Zuckerman, Alison Chavez, Julie A. Reeder

Student Research Symposium

Background: Children in racial/ethnic minority and low-income families are more likely to experience low rates of early developmental disability (DD) diagnosis. Racial/ethnic and language differences in parent information about DDs could contribute to diagnostic delays, but little is known about differences in parent DD familiarity.

Objectives: To assess DD knowledge and information in a sample of low-income families.

Methods: We conducted a self-administered survey on 539 parents attending their child’s appointment at the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in six Oregon counties. Survey items assessed familiarity with early signs of DDs, self-reported knowledge about DDs, …

Mujeres Fuertes Y Corazones Saludables: Adaptation Of The Strongwomen—Healthy Hearts (Swhh) Program For Rural Latinas Using An Intervention Mapping Approach, Christie L. Jackson, Cynthia K. Perry, Jean Mccalmont, Emma Solanki, Rebecca Seguin, Judy P. Ward, Hannah-Dulya K. Menelas

Student Research Symposium

Objectives: To adapt Strong Women, Healthy Hearts (SWHH), an evidence-based physical activity and nutrition program to reflect the needs of rural Latinas.

Methods: Using a community-based participatory approach and an intervention mapping process, we partnered with a community advisory board of rural Latinas to identify and adapt a nutrition and physical activity program. A needs assessment and a logic model determined which program best aligned with community objectives and most fit for adaptation. SWHH was adapted; using feedback from the community advisory board to reflect the community’s culture, resources, and needs. We collaborated with one of developers of SWHH in …

Clinician-Parent Discussions About Influenza Vaccination Of Children And Their Association With Vaccine Acceptance, Annika M. Hofstetter, Jeffrey D. Robinson, Katherine Lepere, Morgan Cunningham, Nicole Etsekson, Douglas J. Opel

Communication Faculty Publications and Presentations

Objective: To examine how clinicians communicate with parents about influenza vaccination and the effect of these communication behaviors on parental vaccine decision-making.

Study Design: We performed a secondary analysis of data obtained from a cross-sectional observational study in which health supervision visits between pediatric clinicians and English-speaking parents of young children were videotaped. Eligible visits occurred during the 2011-2012 and 2013-2014 influenza seasons, included children ≥ 6 months, and contained an influenza vaccine discussion. A coding scheme of 10 communication behaviors was developed and applied to each visit. Associations between clinician communication behaviors and parental verbal vaccine acceptance …

Association Of Depressive Symptomology And Psychological Trauma With Diabetes Control Among Older American Indian Women: Does Social Support Matter?, R. Turner Goins, Carolyn Noonan, Kelly Gonzales, Blythe Winchester, Vickie L. Bradley

OHSU-PSU School of Public Health Faculty Publications and Presentations

Aims—Among older American Indian women with type 2 diabetes (T2DM), we examined the association between mental health and T2DM control and if social support modifies the association.

Methods—Survey data were linked to T2DM medical record information. Mental health measures were the Center for Epidemiologic Studies – Depression Scale and the National Anxiety Disorders Screening Day instrument. T2DM control was all HbA1c values taken post mental health measures.

Results—There was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support. There was a significant association …

Factors Associated With Sexual Dysfunction In Taiwanese Females With Rheumatoid Arthritis, Miao-Chiu Lin, Ming-Chi Lu, Hanoch Livneh, Ning-Sheng Lai, How-Ran Guo, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Patients with rheumatoid arthritis (RA) may experience sexual dysfunction because of symptoms or adverse effects from treatments. Data on female sexual dysfunction (FSD) in Asian females with RA issue are limited. This study investigated the prevalence and factors associated with FSD in Taiwanese patients with RA.

Methods: This cross-sectional study used a purposive sampling method to recruit 195 females with RA from a single hospital in southern Taiwan. Demographic and clinical characteristics were obtained by review of medical records and a structured questionnaire. The Chinese version of the Female Sexual Function Index and the Taiwanese Depression Questionnaire were …

North Douglas County Community Needs Health Assessment (Phase 2), Callie H. Lambarth, Diane Reid, Beth L. Green

Early Childhood

Beginning in August 2016, Phase 2 of the North Douglas County (NDC) Community Health Needs Assessment (CHNA) built on work completed in the Phase 1 planning process, and engaged the communities of Drain, Elkton, and Yoncalla, Oregon in the development and administration of a regional health services survey. The purpose of the survey was to learn from families with children ages 0-8 in the NDC region in order to:

• Identify service needs across a range of health service types, e.g., dental care, immunizations, prenatal care, well-child care, primary care, and mental health;
• Identify barriers to access;
• Prioritize the programs and …

Associations Between Prescribed Chinese Herbal Medicine And Risk Of Hepatocellular Carcinoma In Patients With Chronic Hepatitis B: A Nationwide Population-Based Cohort Study, Tzung-Yi Tsai, Hanoch Livneh, Tsung-Hsing Hung, I-Hsin Lin, Ming-Chi Lu, Chia-Chou Yeh

Counselor Education Faculty Publications and Presentations

Objective: Patients with chronic hepatitis B (CHB) are reported to exhibit higher risk of subsequent hepatocellular carcinoma (HCC). However, it remains unclear if Chinese herbal medicine (CHM), an important category of traditional Chinese medicine (TCM), may lower HCC risk in this population. So this study aimed to investigate the effects of CHM on HCC risk among patients with CHB.

Methods: This cohort study used the Taiwanese National Health Insurance Research Database to identify 21,020 newly diagnosed patients with CHB from 1998 to 2007. Among them, 8640 received CHM products after CHB onset (CHM users), and the remaining 12,380 patients were …

Real Talk: Developing A Computer-Delivered Sexual Health Program For Black Men Who Have Sex With Men, Charles H. Klein, Carmela Lomonaco

Anthropology Faculty Publications and Presentations

HIV disproportionately affects Black men who have sex with men (MSM), yet there are few evidence-based programs that respond to the diverse realities of Black MSM communities. This article examines the development of Real Talk, a new harm reduction-based, sexual health intervention for Black MSM. We first analyze the key themes from our formative research: (1) stigma, discrimination, and intersectionalities in the lives of Black MSM, (2) the importance of safe spaces and community provided by health promotion programs, and (3) moving beyond condoms in sexual health messaging. We then describe our agile design product development process and present an …

Immediate And Short-Term Effects Of Kinesio® Taping On Lower Trunk Range Of Motion In Division I Athletes, Hoshito Mizutani

Dissertations and Theses

Low back pain (LBP) is a common health problem that contributes to the high cost of health care. Improvement in trunk range of motion has been considered to be an important factor in ameliorating the symptoms of LBP. Kinesio® taping is a prominent therapeutic modality commonly used in the variety of populations for treating musculoskeletal conditions. However, previous research on the efficacy of Kinesio® taping for LBP is limited. The purpose of this study was to investigate the immediate and short-term effects of Kinesio® taping with the muscle inhibition technique on active trunk flexion range of motion. Twenty-five subjects with …

Civic Engagement Among Orphans And Non-Orphans In Five Low- And Middle-Income Countries, Christine L. Gray, Brian W. Pence, Lynne C. Messer, Jan Ostermann, Rachel A. Whetten, Nathan M. Thielman, Karen O'Donnell, Kathryn Whetten

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Communities and nations seeking to foster social responsibility in their youth are interested in understanding factors that predict and promote youth involvement in public activities. Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in resource-poor settings. Understanding whether and how OSC are engaged in civic activities is important for community and world leaders who need to provide care for OSC and ensure their involvement in sustainable development.

Methods: The Positive Outcomes for Orphans study (POFO) is a multi-country, longitudinal cohort study of OSC randomly sampled from institution-based care and from family-based care, and …

Is Housing Making People Sick?: An Overview Of Seven Studies That Raise Questions To Consider As We Incorporate Health Into Planning And Build New Housing To Address Shortages And Energy Efficiency, Merilee D. Karr

Metroscape

The article discusses the unintended consequences of some of the strategies for housing energy efficiency: they can lead to indoor air pollution that is making people sick. As we pursue ways to reduce the cost of housing, we must pursue innovation in building materials and techniques that might reduce the negative health consequences of sealing our homes from the elements.

Elimination Of Taenia Solium Transmission In Northern Peru, Hector H. Garcia, Armando E. Gonzalez, Victor C.W. Tsang, Seth E. O'Neal, Fernando Llanos‑Zavalaga, Guillermo Gonzalvez, Jaime Romero, Silvia Rodriguez, Luz M. Moyano, Viterbo Ayvar, Andre Diaz, Allen Hightower, Philip S. Craig, Marshall W. Lightowlers, Charles G. Gauci, Elli Leontsini, Robert H. Gilman

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Taeniasis and cysticercosis are major causes of seizures and epilepsy. Infection by the causative parasite Taenia solium requires transmission between humans and pigs. The disease is considered to be eradicable, but data on attempts at regional elimination are lacking. We conducted a three-phase control program in Tumbes, Peru, to determine whether regional elimination would be feasible.

Methods: We systematically tested and compared elimination strategies to show the feasibility of interrupting the transmission of T. solium infection in a region of highly endemic disease in Peru. In phase 1, we assessed the effectiveness and feasibility of six intervention …

Food-Related Practices And Beliefs Of Rural Us Elementary And Middle School Teachers, Nancy Findholt, Betty T. Izumi, Jackilen Shannon, Thuan Nguyen

Community Health Faculty Publications and Presentations

INTRODUCTION:

Childhood obesity disproportionately affects rural populations; therefore, promoting healthy eating among rural children is essential. Teachers are important role models for children and can influence children's eating behaviors through their own behaviors and beliefs about food. This study examined the food-related practices and beliefs of rural elementary and middle school teachers.

METHODS:

Data were used from the SNACZ study, a school- and community-based trial conducted in rural Oregon. Kindergarten through eighth-grade teachers (n=87), teaching students usually aged 5-14 years, from eight rural school districts completed a baseline survey in November 2012 concerning their classroom food practices, eating behaviors at …

North Douglas County Community Needs Health Assessment (Phase 1), Callie H. Lambarth, Diane Reid, Beth L. Green

Early Childhood

Beginning in February 2016, the North Douglas County (NDC) communities of Drain, Elkton, and Yoncalla, Oregon engaged in a Community Health Needs Assessment (CHNA) planning process, focusing on children ages birth-to-8 and their families. The purpose of this process was to explore, understand, and integrate linkages between early learning and young child and family health; identify health-related resources currently available and accessible to NDC families; and prioritize health areas of interest to be explored during the CHNA.

The North Douglas County CHNA builds on community partnerships already established in the region through initiatives that aim to coordinate and align early …

Dietary Fat Intake And Reproductive Hormone Concentrations And Ovulation In Regularly Menstruating Women, Sunni L. Mumford, Jorge E. Chavarro, Cuilin Zhang, Neil J. Perkins, Lindsey A. Sjaarda, Anna Z. Pollack, Karen C. Schliep, Kara A. Michels, Shvetha M. Zarek, Torie C. Plowden, Rose G. Radin, Lynne C. Messer, Robyn A. Frankel, Jean Wactawski-Wende

Community Health Faculty Publications and Presentations

Background: Emerging evidence suggests potential links between some dietary fatty acids and improved fertility, because specific fatty acids may affect prostaglandin synthesis and steroidogenesis.

Objective: The objective of this exploratory study was to evaluate associations between total and specific types of dietary fat intake and 1) hormone concentrations and 2) the risk of sporadic anovulation in a cohort of 259 regularly menstruating women in the BioCycle Study.

Design: Endogenous reproductive hormones were measured up to 8 times/cycle for up to 2 cycles, with visits scheduled with the use of fertility monitors. Dietary intake was assessed with up to …

Reasons For Missing Antiretroviral Therapy: Results From A Multi-Country Study In Tanzania, Uganda, And Zambia, Olivier Koole, Julie A. Denison, Joris Menten, Sharon Tsui, Fred Wabwire-Mangen, Gideon Kwesigabo, Modest Mulenga, Andrew F. Auld, Simon G. Agolory, Ya Diul Mukadi, Eric Van Praag, Kwasi Torpey, Seymour Williams, Jonathan Kaplan, Aaron Zee, David Bangsberg, Robert Colebunders

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives To identify the reasons patients miss taking their antiretroviral therapy (ART) and the proportion who miss their ART because of symptoms; and to explore the association between symptoms and incomplete adherence.

Methods Secondary analysis of data collected during a cross-sectional study that examined ART adherence among adults from 18 purposefully selected sites in Tanzania, Uganda, and Zambia. We interviewed 250 systematically selected patients per facility (≥18 years) on reasons for missing ART and symptoms they had experienced (using the HIV Symptom Index). We abstracted clinical data from the patients’ medical, pharmacy, and laboratory records. Incomplete adherence was defined as …

Social Norms About A Health Issue In Work Group Networks, Lauren B. Frank

Communication Faculty Publications and Presentations

The purpose of this study is to advance theorizing about how small groups understand health issues through the use of social network analysis. To achieve this goal, an adapted cognitive social structure examines group social norms around a specific health issue, H1N1 flu prevention. As predicted, individual’s attitudes, self-efficacy, and perceived social norms were each positively associated with behavioral intentions for at least one of the H1N1 health behaviors studied. Moreover, collective norms of the whole group were also associated with behavioral intentions, even after controlling for how individual group members perceive those norms. For members of work groups in …

Leader Behaviors, Group Cohesion, And Participation In A Walking Group Program, Betty T. Izumi, Amy J. Schulz, Graciela Mentz, Barbara A. Isreal, Sharon L. Sand, Angela G. Reyes, Bernadine Hoston, Dawn Richardson, Cindy Gamboa, Zachary Rowe, Goys Diaz

Community Health Faculty Publications and Presentations

Background—Fewer than half of all U.S. adults meet the 2008 Physical Activity Guidelines. Leader behaviors and group cohesion have been associated with increased participation or adherence in sports team and exercise class settings. Physical activity interventions in community settings that encompass these factors may enhance intervention adherence.

Purpose—To examine the impact of Community Health Promoter leader behaviors and group cohesion on participation in a walking group intervention among racially/ethnically diverse adults in low-to-moderate income communities in Detroit, Mich.

Design—Data for the current study were drawn from the Walk Your Heart to Health (WYHH) data set. WYHH was a multi-site cluster …

Sociocultural And Structural Factors Contributing To Delays In Treatment For Children With Severe Malaria: A Qualitative Study In Southwestern Uganda, Radhika Sundararajan, Juliet Mwanga-Amumpaire, Harriet Adrama, Jackline Tumuhairwe, Sheilla Mbabazi, Kenneth Mworozi, Ryan W. Carroll, David Bangsberg, Yap Boum Ii, Norma C. Ware

OHSU-PSU School of Public Health Faculty Publications and Presentations

Malaria is a leading cause of pediatric mortality, and Uganda has among the highest incidences in the world. Increased morbidity and mortality are associated with delays to care. This qualitative study sought to characterize barriers to prompt allopathic care for children hospitalized with severe malaria in the endemic region of southwestern Uganda. Minimally structured, qualitative interviews were conducted with guardians of children admitted to a regional hospital with severe malaria. Using an inductive and content analytic approach, transcripts were analyzed to identify and define categories that explain delayed care. These categories represented two broad themes: sociocultural and structural factors. Sociocultural …

Conceptualization Of Autism In The Latino Community And Its Relationship With Early Diagnosis, Katharine E. Zuckerman, Brianna Sinche, Martiza Cobian, Marlene Cervantes, Angie Mejia, Thomas Becker, Christina Nicolaidis

School of Social Work Faculty Publications and Presentations

Objective—Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non- Latino children. We aimed to qualitatively assess the understanding and conceptualization of ASD in the Latino community in order to understand potential community barriers to early diagnosis.

Method—We conducted 5 focus groups and 4 qualitative interviews with 30 parents of typicallydeveloping Latino children in Oregon. Participants were asked structured questions concerning video vignettes that follow a Latina mother from the time she begins to worry about her 3-year-old son's behaviors to the time he receives an …

Three-Year Change In The Wellbeing Of Orphaned And Separated Children In Institutional And Family-Based Care Settings In Five Low- And Middle-Income Countries, Kathryn Whetten, Jan Ostermann, Brian W. Pence, Rachel A. Whetten, Lynne C. Messer, Sumedha Ariely, Karen O'Donnell, Augustine L. Wasonga, Vanroth Vann, Dafrosa Itemba, Misganaw Eticha, Ira Madan, Nathan M. Thielman, Positive Outcomes For Orphans (Pofo) Research Team

Community Health Faculty Publications and Presentations

Background: With more than 2 million children living in group homes, or "institutions", worldwide, the extent to which institution-based caregiving negatively affects development and wellbeing is a central question for international policymakers.

Methods: A two-stage random sampling methodology identified community representative samples of 1,357 institutional dwelling orphaned and separated children (OSC) and 1,480 family-dwelling OSC aged 6–12 from 5 low and middle income countries. Data were collected from children and their primary caregivers. Survey-analytic techniques and linear mixed effects models describe child wellbeing collected at baseline and at 36 months, including physical and emotional health, growth, cognitive development and memory, …

Exposure To Fine Particulate Matter During Pregnancy And Risk Of Preterm Birth Among Women In New Jersey, Ohio, And Pennsylvania, 2000–2005, Kristen M. Rappazzo, Julie L. Daniels, Lynne C. Messer, Charles Poole, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Particulate matter < 2.5 micrometers in aerodynamic diameter (PM2.5) has been variably associated with preterm birth (PTB).

Objective: We classified preterm births into four categories (20–27, 28–31, 32–34, and 35–36 weeks completed gestation) and estimated risk differences (RD) for each category in association with a 1-µg/m3 increase in PM2.5 exposure during each week of gestation.

Methods: We assembled a cohort of singleton pregnancies that completed at least 20 weeks of gestation during 2000-2005 using live birth certificate data from three states (Pennsylvania, Ohio, and New Jersey) (n = 1,940,213; 8% PTB). We estimated mean PM2.5 exposures for each week of gestation from monitor-corrected Community Multi-Scale Air Quality modeling data. RDs were …

A Program Evaluation Of A Housing With Services Project For Low-Income Adults In Portland, Oregon, Jack A. Phillips, Paula C. Carder, Diana White

Student Research Symposium

Reducing hospital use and connecting individuals to local available services and supports are key features of the Affordable Care Act. Adult residents of public housing tend to experience worse health outcomes than other adults. Poor self-rated health and high rates of emergency department use and hospitalization among these residents have prompted efforts to improve health outcomes. Even among residents living independently, prior research indicates that health and social disparities can be effectively addressed through coordinated care and improved access to health and social services.

Cedar Sinai Park—a nonprofit residential care organization located in Portland, Oregon—will implement a demonstration project attempting …

The Effect Of Early Head Start On Child Welfare System Involvement: A First Look At Longitudinal Child Maltreatment Outcomes, Beth L. Green, Catherine Ayoub, Jessica Dym Bartlett, Adam Von Ende, Carrie Jeanne Furrer, Rachel Chazen-Cohen, Claire Vallotton, Joanne Klevens

Center for Improvement of Child and Family Services Publications

The high societal and personal costs of child maltreatment make identification of effective early prevention programs a high research priority. Early Head Start (EHS), a dual generational program serving low-income families with children prenatally through age three years, is one of the largest federally funded programs for infants and toddlers in the United States. A national randomized trial found EHS to be effective in improving parent and child outcomes, but its effectiveness in reducing child maltreatment was not assessed. The current study used administrative data from state child welfare agencies to examine the impact of EHS on documented abuse and …