title: A cluster analysis of detected and substantiated child maltreatment incidents in rural Colorado.
abstract: This paper reports the results of a cluster analysis of the incidents of detected and substantiated child maltreatment in 31 rural Colorado counties during the 5-year period (1986-1990). Mapping and statistical techniques employed revealed time-space clustering in the occurrence of child abuse and neglect in sparsely settled rural areas of the state. The study examined temporal-geographic patterns among all 830 confirmed incidents in the Colorado Child Abuse and Neglect Registry for counties of less than 10,000 population. These findings suggest that a first incident of abuse or neglect serves as a sentinel event, predicting a period of more frequent receipt and substantiation of maltreatment cases by child protection professionals in the county or community of occurrence. Clustering was apparent using 3-, 7-, 14-, 30-, and 60-day intervals of time; a scheme endorsed by the Centers for Disease Control for national study of the epidemicity of adolescent suicide. An agenda is proposed to review the appropriateness and adequacy of child protection policies and protocols in view of this phenomenon, and to pursue additional related research objectives.
authors.affiliation: Department of Family Medicine, University of Colorado Health Sciences Center, Denver 80220, USA.
authors.forename: G E
authors.initials: GE
authors.lastname: Fryer
authors.forename: T J
authors.initials: TJ
authors.lastname: Miyoshi
mesh_terms: D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D002669:Child Welfare / Q000706:statistics & numerical data*; D016000:Cluster Analysis; D003120:Colorado / Q000453:epidemiology; D006801:Humans; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012423:Rural Health / Q000706:statistics & numerical data*; D013029:Space-Time Clustering