title: Caregiver reports of serious injuries in children who remain at home after a child protective services investigation.
abstract: The study objectives were to examine serious injuries requiring medical attention among children who remain at home after a child welfare/child protective services (CPS) maltreatment investigation in the US and to determine whether child/caregiver characteristics and ongoing CPS involvement are related to injuries requiring medical attention. Using the National Survey of Child and Adolescent Well-being, we analyzed data on the subsample of children who remained at home (N = 3,440). A multivariate logistic regression model included child characteristics, chronic illness and disability in the child, level of CPS involvement, subsequent foster care placement, caregiver characteristics, and caregiver/family psychological variables. Injuries requiring medical attention were identified in 10.6% of the in-home population over a 15-month period, with no differences in rates by age. Children with a chronic medical condition (OR = 2.07; 95% CI, 1.20-3.58) and children with depressed caregivers (OR = 2.28; 95% CI, 1.45-3.58) were more likely to have an injury that required medical care. Older caregivers (>54 years) were less likely (OR = 0.15; 95% CI, 0.03-0.69) to have a child with an injury requiring care. Injuries were not related to further involvement with CPS after the initial maltreatment investigation. Children with chronic medical conditions who remained in their biological homes or whose caregivers were depressed were likely to experience an injury requiring medical attention. Older caregivers were less likely to report a child injury. Extending existing health policies for foster children to children who remain at home following referral to CPS may encourage more comprehensive injury prevention for this population.
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, CA 90089-0411, USA. juschnei@usc.edu
authors.forename: Janet U
authors.initials: JU
authors.lastname: Schneiderman
authors.forename: Laurel K
authors.initials: LK
authors.lastname: Leslie
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hurlburt
authors.forename: Jinjin
authors.initials: J
authors.lastname: Zhang
authors.forename: Sarah McCue
authors.initials: SM
authors.lastname: Horwitz
mesh_terms: D000061:Accidents, Home / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D005581:Foster Home Care; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D057566:Self Report; D012931:Social Environment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult