Wanda Hunter - Academia.edu (original) (raw)
Papers by Wanda Hunter
North Carolina Medical Journal
Pregnancy and early childhood are critical periods for attending to the needs of new parents and ... more Pregnancy and early childhood are critical periods for attending to the needs of new parents and promoting the health and development of their newborns. The earliest years of T "The earliest years of life are accompanied by the highest risk for physical abuse and neglect and almost all fatalities due to child maltreatment occur in the first three years of life.
Pediatrics, 2010
BACKGROUND: Although the history of recognition of child abuse in Europe and North America extend... more BACKGROUND: Although the history of recognition of child abuse in Europe and North America extends over 40 years, recognition and data are lacking in other parts of the world. Cultural differences in child-rearing complicate cross-cultural studies of abuse. OBJECTIVE: To ascertain rates of harsh and less-harsh parenting behavior in population-based samples. METHODS: We used parallel surveys of parental discipline of children in samples of mothers in Brazil, Chile, Egypt, India, Philippines, and the United States. Data were collected between 1998 and 2003. The instrument used was a modification of the Parent-Child Conflict Tactics Scale, along with a study-developed survey of demographic characteristics and other parent and child variables. Women (N = 14 239) from 19 communities in 6 countries were surveyed. We interviewed mothers aged 15 to 49 years (18–49 years in the United States) who had a child younger than 18 years in her home. Sample selection involved either random sampling ...
Child Maltreatment, 2005
Suicidal ideation was examined among 1,051 8-year-old children identified as maltreated or at ris... more Suicidal ideation was examined among 1,051 8-year-old children identified as maltreated or at risk for maltreatment. Of these children, 9.9% reported suicidal ideation. Many variables, including maltreatment, had bivariate associations with suicidal ideation. Severity of physical abuse, chronicity of maltreatment, and the presence of multiple types of maltreatment strongly predicted suicidal ideation. In multivariate analyses of the domains of proximity, only ethnic background remained significant among demographic variables, only witnessed violence and maltreatment remained significant among family or contextual variables, and only child psychological distress, substance use, and poor social problem solving remained significant among child variables. The effects of ethnicity, maltreatment, and witnessed violence on suicidal ideation were mediated by child functioning. There were few interactions between maltreatment and other factors to predict suicidal ideation. Children who are m...
LONGSCAN, Center for Child and Family Health, 3518 Westgate Dr., Suite 100, Durham, NC 27707; Tel... more LONGSCAN, Center for Child and Family Health, 3518 Westgate Dr., Suite 100, Durham, NC 27707; Tel: 919-962-1136; Fax: 919-966-7499; Web site: http://www.calib.com/nccanch/pubs /Resbrief. ... Prepared by the LONGSCAN, the Consortium for Longitudinal Studies in ...
Injury Control and Safety Promotion, 2004
The literature documenting the influence of socioeconomic status (SES) on health and injury does ... more The literature documenting the influence of socioeconomic status (SES) on health and injury does not provide a clear consensus on how to account for socioeconomic indicators in population and health outcome studies across countries. The World Studies of Abuse in the Family Environment (WorldSAFE) consortium conducted a series of population-based, multi-stage probability sampling cross-sectional surveys in selected communities in five countries from 1997 to 2003 that allows for the examination of the relationship of SES with current physical and psychological intimate partner violence (IPV). Women aged 15-49 years (n = 3975) from six urban low- and middle-income communities participating the the WorldSAFE consortium were interviewed. Using a standardized instrument, the following SES indicators were collected: dwelling ownership, land ownership, number of rooms in the house along with number of residents, toilet facilities, ownership of 13 specific individual/household items, current work status of the woman and her husband/partner, and years of formal schooling completed by the woman and her husband/partner. A family asset index was constructed using principal coordinate analysis. The outcome variables utilized in this manuscript were current (past 12 months) physical IPV, and current psychological IPV. Basic bivariate associations between the categorical predictors and outcome variables were followed by a multiple logistic regression analysis to investigate the effect of covariates on the study outcomes. The were considerable variability among the six sampled communities with respect to the relationship between socioeconomic indicators and current physical and psychological IPV. In general, the employment status of the woman was related to her experience of intimate partner violence, and her educational level and family's assets index were protective factors. When considered in multiple logistic regression models, the asset index was the only indicator that was consistently significant across communities. The derived asset index as an SES indicator was found to be associated with current psychological and physical IPV against women across the sampled six communities in four countries.
Psychiatry Interpersonal & Biological Processes
RESEARCH on parent perceptions of infant temperament and child maladjustment has evolved from an ... more RESEARCH on parent perceptions of infant temperament and child maladjustment has evolved from an initial interpretation of parent reports as objective, veridical descriptions of the child to an interpretation of parent reports as social perceptions that reflect both objective qualities of children and personality characteristics of parents (Bates 1983). Evidence that parents' descriptions reflect generalized behavior of their children is provided by modest correlations between parent and teacher reports of child behavior (Becker and Krug 1964; Glidewell et al. 1959; Rutter et al. 1970). Although limited agreement of parents and teachers in descriptions of child behavior might be interpreted as evidence of situational specificity of behavior (Mischel 1968), an alternative interpretation is that characteristics of parents influence their perceptions of child behavior. This longitudinal study tests hypotheses that maternal characteristics during pregnancy and infancy, prior to the development of stable child characteristics, predict mothers' reports of child psychopathology during the kindergarten year.
LONGSCAN is a consortium of five longitudinal studies of the antecedents and consequences of chil... more LONGSCAN is a consortium of five longitudinal studies of the antecedents and consequences of child abuse and neglect with common measurement and data collection procedures. The consortium came together and developed interview protocols for measuring etiologic and outcome variables related to child maltreatment in response to a call from the National Research Council for longitudinal research in child abuse and neglect. This manual, the second of two volumes, describes measures used by the LONGSCAN consortium at major interviews at Ages 6 and 8 and at annual contact interviews at Ages 5, 7, 9, 10, and 11. The first volume described measures used by the LONGSCAN consortium at the Age 4 interview, and at major interviews before Age 4 for the two studies who joined the consortium with children younger than 4. Each entry includes a description of the measure, its origin, administration and scoring information, norms and comparative data, descriptive statistics from the LONGSCAN samples, data on reliability and validity, and a copy of the instrument itself (as used in LONGSCAN), when permissible. The manual serves as an essential reference for users of LONGSCAN data, as well as for all researchers who seek useful measures related to child and family well-being. * the child, family, and community factors (e.g., chronic exposure to violence, parental substance abuse) that increase the harm caused by different forms of maltreatment;
Aggression and Violent Behavior
Rural and remote health
In recent years violence against women has emerged as an important social problem in India. It ha... more In recent years violence against women has emerged as an important social problem in India. It has attracted the attention of a wide spectrum of agencies, from healthcare providers to law enforcement authorities. This study attempted to determine the characteristics and the magnitude of physical and psychological violence against women in rural Maharashtra, central India. The study initially undertook focus group activities. This was followed by the formulation of the survey instrument in English, which focused on partner violence and child disciplinary practices. After pre-testing the instrument in 25 households, the actual study was conducted by trained interviewers in five randomly selected villages of rural Maharashtra. The study included 500 households (sample size = 500 women, eligible if they had at least one child less than 18 years of age). The results revealed that of the women interviewed, almost one-third (30.4%) had no formal education and the women's husbands were ...
PEDIATRICS, 2005
Parenting books are a commonly used source of information on how to keep children and adolescents... more Parenting books are a commonly used source of information on how to keep children and adolescents safe from injuries, the leading cause of death and disability for children aged 1 to 18 years. The content and the quality of the messages contained in these books have not been evaluated formally. The objective of this study was to determine the quantity and the quality of injury prevention messages contained in popular parenting books. Top-selling parenting books for 2 major booksellers were reviewed to determine the presence and the accuracy of injury prevention messages as compared with those recommended by the American Academy of Pediatrics (AAP) through The Injury Prevention Program (TIPP) for younger children, aged 0 to 12 years, and the American Medical Association (AMA) through its Parent Package for the safety of adolescents. Forty-six parenting books were reviewed, including 41 with messages related to younger children and 19 with messages related to adolescents. These books varied widely with regard to the number of injury prevention messages included. Although some books covered the great majority of TIPP messages for parents of young children, others included very few. In the case of books that address safety for adolescents, no book had more than half of the messages recommended by the AMA. Prevention of burns and motor vehicle injury were the most commonly addressed injury prevention topics in the books focused on younger children, whereas gun safety was the most prevalent injury prevention topic in books that focused on adolescents. Books that were authored by physicians addressed more of the recommended topics and messages than books that were written by authors from other professional backgrounds. The quality of messages was good, ie, consistent with the advice given by the AAP and the AMA. In only a few cases, the parenting books gave injury prevention advice that was inconsistent with recommendations. Overall, books on parenting adolescents are less likely to contain injury prevention messages than those that address younger children. However, the most frequent injury prevention messages for parents of adolescents describe strategies to prevent firearm injury, a leading cause of death for children in this age group. More emphasis should be placed on prevention of motor vehicle injuries, especially as relates to adolescents. Pediatricians and primary care physicians need to be aware of the strengths and weaknesses of parenting manuals in providing adequate guidance related to injury prevention.
PEDIATRICS, 2002
To investigate whether living in a 3-generation household (grandmother-mother-child) is associate... more To investigate whether living in a 3-generation household (grandmother-mother-child) is associated with fewer behavior problems and better cognitive development among preschool children of mothers who gave birth during adolescence and whether it protects children from the behavior and developmental problems associated with maltreatment and maternal depression. Cohort study. Participants included low-income families recruited from 4 sites: East, Northwest, Midwest, and South, who are part of LONGSCAN, a longitudinal study of children's health, development, and maltreatment. One hundred ninety-four mothers who were adolescents (less than age 19) at delivery. Data were gathered when children were 4 to 5 years of age. Twenty-six percent of the children lived in 3-generation households, 39% had a history of maltreatment, and 32% of the mothers had depression scores in the clinical range. Child behavioral problems were measured with the Child Behavior Checklist, completed by the mother, and child developmental status was assessed with the Battelle Developmental Inventory Screening Test, administered by research assistants. Multiple regression analyses revealed that children who had been reported for maltreatment and had mothers with depressive symptoms had more externalizing behavior problems, compared with children who experienced neither risk or only 1 risk. However, when residential status was considered, children with the greatest number of externalizing behavior problems were those who experienced both maltreatment and maternal depressive symptoms and lived in 3-generation households. Children who had been reported for maltreatment or had mothers with depressive symptoms were more likely to have internalizing problems, compared with children with neither risk. Residential status was not related to children's internalizing behavior problems or cognitive development. Living in a 3-generation household did not protect preschool children from the behavior problems associated with maltreatment and depression. In contrast, living in a 3-generation household was associated with more behavior problems among the highest risk group of children--those who had been maltreated and had mothers with symptoms of depression. Although 3-generation families may provide an important source of support and stability for adolescent mothers and their infants early in the parenting process, it may not be advisable to rely on 3-generation households as young mothers enter adulthood, particularly among those with a history of maltreatment or depression. Children with the fewest number of behavior problems were living with their mothers in their own household (often with the father), had not been maltreated, and had mothers with few symptoms of depression.
PEDIATRICS, 1998
Social capital describes the benefits that are derived from personal social relationships (within... more Social capital describes the benefits that are derived from personal social relationships (within families and communities) and social affiliations. This investigation examined the extent to which social capital is associated with positive developmental and behavioral outcomes in high-risk preschool children. A cross-sectional case-control analysis of young children "doing well" and "not doing well" at baseline in four coordinated longitudinal studies. A total of 667 2- to 5-year-old children (mean age, 4.4 years) and their maternal caregivers who are participating in the Longitudinal Studies of Child Abuse and Neglect Consortium. At recruitment, all children were characterized by unfavorable social or economic circumstances that contributed to the identification of the children as high risk. Social capital was defined as benefits that accrue from social relationships within communities and families. A social capital index was created by assigning one point to each of the following indicators: 1) two parents or parent-figures in the home; 2) social support of the maternal caregiver; 3) no more than two children in the family; 4) neighborhood support; and 5) regular church attendance. Outcomes were measured with the Child Behavior Checklist, a widely used measure of behavioral/emotional problems, and with the Battelle Developmental Inventory Screening Test, a standardized test that identifies developmental deficits. Children were classified as doing well if their scores on these instruments indicated neither behavioral nor developmental problems. Only 13% of the children were classified as doing well. The individual indicators that best discriminated between levels of child functioning were the most direct measures of social capital-church affiliation, perception of personal social support, and support within the neighborhood. The social capital index was strongly associated with child well-being, more so than any single indicator. The presence of any social capital indicator increased the odds of doing well by 29%; adding any two increased the odds of doing well by 66%. Our findings suggest that social capital may have an impact on children's well-being as early as the preschool years. In these years it seems to be the parents' social capital that confers benefits on their offspring, just as children benefit from their parents' financial and human capital. Social capital may be most crucial for families who have fewer financial and educational resources. Our findings suggest that those interested in the healthy development of children, particularly children most at risk for poor developmental outcomes, must search for new and creative ways of supporting interpersonal relationships and strengthening the communities in which families carry out the daily activities of their lives.
Journal of Public Health Management and Practice, 2005
To conduct a formative and pilot impact evaluation of the State Technical Assessment Team (STAT) ... more To conduct a formative and pilot impact evaluation of the State Technical Assessment Team (STAT) program, a visitation-based (visitatie) peer assessment program designed to enhance the organizational capacity of state health department injury prevention programs. The formative evaluation was based on observational, record review, and key informant interview data collected during the implementation of the first 7 STAT visits. Pilot impact data were derived from semi-structured interviews with state injury prevention personnel one year after the visit. Formative evaluation identified 6 significant implementation problems in the first visits that were addressed by the program planners, resulting in improvements to the STAT assessment protocol. Impact evaluation revealed that after one year, the 7 state injury prevention programs had acted on 81% of the recommendations received during their STAT visits. All programs reported gains in visibility and credibility within the state health department and increased collaboration and cooperation with other units and agencies. Other significant program advancements were also reported. Specific program standards and review procedures are important to the success of peer assessment programs such as STAT. Early impact evaluation suggests that peer assessment protocols using the visitatie model can lead to gains in organizational capacity.
The Journal of Pediatrics, 1988
... Desmond K. Runyan, MD, DrPH, Mark D. Everson, PhD, Gail A. Edelsohn, MD, MSPH, Wanda M. Hunte... more ... Desmond K. Runyan, MD, DrPH, Mark D. Everson, PhD, Gail A. Edelsohn, MD, MSPH, Wanda M. Hunter, MPH, and Martha L. Coulter ... An arbitrary standard of improvement by one standard deviation was chosen because the standard devia-tions in each scale were large and ...
Journal of Pediatric Psychology, 2000
To determine the type and severity of discipline practices in rural India and to identify risk an... more To determine the type and severity of discipline practices in rural India and to identify risk and protective factors related to these practices. Five hundred mothers, ages 18-50, participated in face-to-face interviews as part of a cross-sectional, population-based survey. One of the mother's children was randomly selected as the referent child. The interview focused primarily on discipline practices and spousal violence. Sociodemographic characteristics, neighbor support, residential stability, and husband's drinking behavior were also assessed. Nearly half of the mothers reported using severe verbal discipline and 42% reported using severe physical discipline. While common, severe discipline practices occurred less frequently than moderate practices and had different risk factors, notably low maternal education and spousal violence. Results suggest that increased formal education for rural women in India may have the added benefit of reducing family violence, including spouse and child abuse.
Journal of Interpersonal Violence, 2000
Page 1. Journal of Interpersonal Violence http://jiv.sagepub.com/ Methodological and Ethical Chal... more Page 1. Journal of Interpersonal Violence http://jiv.sagepub.com/ Methodological and Ethical Challenges Associated With Child Self-Report of Maltreatment : Solutions Implemented by the LongSCAN Consortium ELIZABETH ...
North Carolina Medical Journal
Pregnancy and early childhood are critical periods for attending to the needs of new parents and ... more Pregnancy and early childhood are critical periods for attending to the needs of new parents and promoting the health and development of their newborns. The earliest years of T "The earliest years of life are accompanied by the highest risk for physical abuse and neglect and almost all fatalities due to child maltreatment occur in the first three years of life.
Pediatrics, 2010
BACKGROUND: Although the history of recognition of child abuse in Europe and North America extend... more BACKGROUND: Although the history of recognition of child abuse in Europe and North America extends over 40 years, recognition and data are lacking in other parts of the world. Cultural differences in child-rearing complicate cross-cultural studies of abuse. OBJECTIVE: To ascertain rates of harsh and less-harsh parenting behavior in population-based samples. METHODS: We used parallel surveys of parental discipline of children in samples of mothers in Brazil, Chile, Egypt, India, Philippines, and the United States. Data were collected between 1998 and 2003. The instrument used was a modification of the Parent-Child Conflict Tactics Scale, along with a study-developed survey of demographic characteristics and other parent and child variables. Women (N = 14 239) from 19 communities in 6 countries were surveyed. We interviewed mothers aged 15 to 49 years (18–49 years in the United States) who had a child younger than 18 years in her home. Sample selection involved either random sampling ...
Child Maltreatment, 2005
Suicidal ideation was examined among 1,051 8-year-old children identified as maltreated or at ris... more Suicidal ideation was examined among 1,051 8-year-old children identified as maltreated or at risk for maltreatment. Of these children, 9.9% reported suicidal ideation. Many variables, including maltreatment, had bivariate associations with suicidal ideation. Severity of physical abuse, chronicity of maltreatment, and the presence of multiple types of maltreatment strongly predicted suicidal ideation. In multivariate analyses of the domains of proximity, only ethnic background remained significant among demographic variables, only witnessed violence and maltreatment remained significant among family or contextual variables, and only child psychological distress, substance use, and poor social problem solving remained significant among child variables. The effects of ethnicity, maltreatment, and witnessed violence on suicidal ideation were mediated by child functioning. There were few interactions between maltreatment and other factors to predict suicidal ideation. Children who are m...
LONGSCAN, Center for Child and Family Health, 3518 Westgate Dr., Suite 100, Durham, NC 27707; Tel... more LONGSCAN, Center for Child and Family Health, 3518 Westgate Dr., Suite 100, Durham, NC 27707; Tel: 919-962-1136; Fax: 919-966-7499; Web site: http://www.calib.com/nccanch/pubs /Resbrief. ... Prepared by the LONGSCAN, the Consortium for Longitudinal Studies in ...
Injury Control and Safety Promotion, 2004
The literature documenting the influence of socioeconomic status (SES) on health and injury does ... more The literature documenting the influence of socioeconomic status (SES) on health and injury does not provide a clear consensus on how to account for socioeconomic indicators in population and health outcome studies across countries. The World Studies of Abuse in the Family Environment (WorldSAFE) consortium conducted a series of population-based, multi-stage probability sampling cross-sectional surveys in selected communities in five countries from 1997 to 2003 that allows for the examination of the relationship of SES with current physical and psychological intimate partner violence (IPV). Women aged 15-49 years (n = 3975) from six urban low- and middle-income communities participating the the WorldSAFE consortium were interviewed. Using a standardized instrument, the following SES indicators were collected: dwelling ownership, land ownership, number of rooms in the house along with number of residents, toilet facilities, ownership of 13 specific individual/household items, current work status of the woman and her husband/partner, and years of formal schooling completed by the woman and her husband/partner. A family asset index was constructed using principal coordinate analysis. The outcome variables utilized in this manuscript were current (past 12 months) physical IPV, and current psychological IPV. Basic bivariate associations between the categorical predictors and outcome variables were followed by a multiple logistic regression analysis to investigate the effect of covariates on the study outcomes. The were considerable variability among the six sampled communities with respect to the relationship between socioeconomic indicators and current physical and psychological IPV. In general, the employment status of the woman was related to her experience of intimate partner violence, and her educational level and family's assets index were protective factors. When considered in multiple logistic regression models, the asset index was the only indicator that was consistently significant across communities. The derived asset index as an SES indicator was found to be associated with current psychological and physical IPV against women across the sampled six communities in four countries.
Psychiatry Interpersonal & Biological Processes
RESEARCH on parent perceptions of infant temperament and child maladjustment has evolved from an ... more RESEARCH on parent perceptions of infant temperament and child maladjustment has evolved from an initial interpretation of parent reports as objective, veridical descriptions of the child to an interpretation of parent reports as social perceptions that reflect both objective qualities of children and personality characteristics of parents (Bates 1983). Evidence that parents' descriptions reflect generalized behavior of their children is provided by modest correlations between parent and teacher reports of child behavior (Becker and Krug 1964; Glidewell et al. 1959; Rutter et al. 1970). Although limited agreement of parents and teachers in descriptions of child behavior might be interpreted as evidence of situational specificity of behavior (Mischel 1968), an alternative interpretation is that characteristics of parents influence their perceptions of child behavior. This longitudinal study tests hypotheses that maternal characteristics during pregnancy and infancy, prior to the development of stable child characteristics, predict mothers' reports of child psychopathology during the kindergarten year.
LONGSCAN is a consortium of five longitudinal studies of the antecedents and consequences of chil... more LONGSCAN is a consortium of five longitudinal studies of the antecedents and consequences of child abuse and neglect with common measurement and data collection procedures. The consortium came together and developed interview protocols for measuring etiologic and outcome variables related to child maltreatment in response to a call from the National Research Council for longitudinal research in child abuse and neglect. This manual, the second of two volumes, describes measures used by the LONGSCAN consortium at major interviews at Ages 6 and 8 and at annual contact interviews at Ages 5, 7, 9, 10, and 11. The first volume described measures used by the LONGSCAN consortium at the Age 4 interview, and at major interviews before Age 4 for the two studies who joined the consortium with children younger than 4. Each entry includes a description of the measure, its origin, administration and scoring information, norms and comparative data, descriptive statistics from the LONGSCAN samples, data on reliability and validity, and a copy of the instrument itself (as used in LONGSCAN), when permissible. The manual serves as an essential reference for users of LONGSCAN data, as well as for all researchers who seek useful measures related to child and family well-being. * the child, family, and community factors (e.g., chronic exposure to violence, parental substance abuse) that increase the harm caused by different forms of maltreatment;
Aggression and Violent Behavior
Rural and remote health
In recent years violence against women has emerged as an important social problem in India. It ha... more In recent years violence against women has emerged as an important social problem in India. It has attracted the attention of a wide spectrum of agencies, from healthcare providers to law enforcement authorities. This study attempted to determine the characteristics and the magnitude of physical and psychological violence against women in rural Maharashtra, central India. The study initially undertook focus group activities. This was followed by the formulation of the survey instrument in English, which focused on partner violence and child disciplinary practices. After pre-testing the instrument in 25 households, the actual study was conducted by trained interviewers in five randomly selected villages of rural Maharashtra. The study included 500 households (sample size = 500 women, eligible if they had at least one child less than 18 years of age). The results revealed that of the women interviewed, almost one-third (30.4%) had no formal education and the women's husbands were ...
PEDIATRICS, 2005
Parenting books are a commonly used source of information on how to keep children and adolescents... more Parenting books are a commonly used source of information on how to keep children and adolescents safe from injuries, the leading cause of death and disability for children aged 1 to 18 years. The content and the quality of the messages contained in these books have not been evaluated formally. The objective of this study was to determine the quantity and the quality of injury prevention messages contained in popular parenting books. Top-selling parenting books for 2 major booksellers were reviewed to determine the presence and the accuracy of injury prevention messages as compared with those recommended by the American Academy of Pediatrics (AAP) through The Injury Prevention Program (TIPP) for younger children, aged 0 to 12 years, and the American Medical Association (AMA) through its Parent Package for the safety of adolescents. Forty-six parenting books were reviewed, including 41 with messages related to younger children and 19 with messages related to adolescents. These books varied widely with regard to the number of injury prevention messages included. Although some books covered the great majority of TIPP messages for parents of young children, others included very few. In the case of books that address safety for adolescents, no book had more than half of the messages recommended by the AMA. Prevention of burns and motor vehicle injury were the most commonly addressed injury prevention topics in the books focused on younger children, whereas gun safety was the most prevalent injury prevention topic in books that focused on adolescents. Books that were authored by physicians addressed more of the recommended topics and messages than books that were written by authors from other professional backgrounds. The quality of messages was good, ie, consistent with the advice given by the AAP and the AMA. In only a few cases, the parenting books gave injury prevention advice that was inconsistent with recommendations. Overall, books on parenting adolescents are less likely to contain injury prevention messages than those that address younger children. However, the most frequent injury prevention messages for parents of adolescents describe strategies to prevent firearm injury, a leading cause of death for children in this age group. More emphasis should be placed on prevention of motor vehicle injuries, especially as relates to adolescents. Pediatricians and primary care physicians need to be aware of the strengths and weaknesses of parenting manuals in providing adequate guidance related to injury prevention.
PEDIATRICS, 2002
To investigate whether living in a 3-generation household (grandmother-mother-child) is associate... more To investigate whether living in a 3-generation household (grandmother-mother-child) is associated with fewer behavior problems and better cognitive development among preschool children of mothers who gave birth during adolescence and whether it protects children from the behavior and developmental problems associated with maltreatment and maternal depression. Cohort study. Participants included low-income families recruited from 4 sites: East, Northwest, Midwest, and South, who are part of LONGSCAN, a longitudinal study of children's health, development, and maltreatment. One hundred ninety-four mothers who were adolescents (less than age 19) at delivery. Data were gathered when children were 4 to 5 years of age. Twenty-six percent of the children lived in 3-generation households, 39% had a history of maltreatment, and 32% of the mothers had depression scores in the clinical range. Child behavioral problems were measured with the Child Behavior Checklist, completed by the mother, and child developmental status was assessed with the Battelle Developmental Inventory Screening Test, administered by research assistants. Multiple regression analyses revealed that children who had been reported for maltreatment and had mothers with depressive symptoms had more externalizing behavior problems, compared with children who experienced neither risk or only 1 risk. However, when residential status was considered, children with the greatest number of externalizing behavior problems were those who experienced both maltreatment and maternal depressive symptoms and lived in 3-generation households. Children who had been reported for maltreatment or had mothers with depressive symptoms were more likely to have internalizing problems, compared with children with neither risk. Residential status was not related to children's internalizing behavior problems or cognitive development. Living in a 3-generation household did not protect preschool children from the behavior problems associated with maltreatment and depression. In contrast, living in a 3-generation household was associated with more behavior problems among the highest risk group of children--those who had been maltreated and had mothers with symptoms of depression. Although 3-generation families may provide an important source of support and stability for adolescent mothers and their infants early in the parenting process, it may not be advisable to rely on 3-generation households as young mothers enter adulthood, particularly among those with a history of maltreatment or depression. Children with the fewest number of behavior problems were living with their mothers in their own household (often with the father), had not been maltreated, and had mothers with few symptoms of depression.
PEDIATRICS, 1998
Social capital describes the benefits that are derived from personal social relationships (within... more Social capital describes the benefits that are derived from personal social relationships (within families and communities) and social affiliations. This investigation examined the extent to which social capital is associated with positive developmental and behavioral outcomes in high-risk preschool children. A cross-sectional case-control analysis of young children "doing well" and "not doing well" at baseline in four coordinated longitudinal studies. A total of 667 2- to 5-year-old children (mean age, 4.4 years) and their maternal caregivers who are participating in the Longitudinal Studies of Child Abuse and Neglect Consortium. At recruitment, all children were characterized by unfavorable social or economic circumstances that contributed to the identification of the children as high risk. Social capital was defined as benefits that accrue from social relationships within communities and families. A social capital index was created by assigning one point to each of the following indicators: 1) two parents or parent-figures in the home; 2) social support of the maternal caregiver; 3) no more than two children in the family; 4) neighborhood support; and 5) regular church attendance. Outcomes were measured with the Child Behavior Checklist, a widely used measure of behavioral/emotional problems, and with the Battelle Developmental Inventory Screening Test, a standardized test that identifies developmental deficits. Children were classified as doing well if their scores on these instruments indicated neither behavioral nor developmental problems. Only 13% of the children were classified as doing well. The individual indicators that best discriminated between levels of child functioning were the most direct measures of social capital-church affiliation, perception of personal social support, and support within the neighborhood. The social capital index was strongly associated with child well-being, more so than any single indicator. The presence of any social capital indicator increased the odds of doing well by 29%; adding any two increased the odds of doing well by 66%. Our findings suggest that social capital may have an impact on children's well-being as early as the preschool years. In these years it seems to be the parents' social capital that confers benefits on their offspring, just as children benefit from their parents' financial and human capital. Social capital may be most crucial for families who have fewer financial and educational resources. Our findings suggest that those interested in the healthy development of children, particularly children most at risk for poor developmental outcomes, must search for new and creative ways of supporting interpersonal relationships and strengthening the communities in which families carry out the daily activities of their lives.
Journal of Public Health Management and Practice, 2005
To conduct a formative and pilot impact evaluation of the State Technical Assessment Team (STAT) ... more To conduct a formative and pilot impact evaluation of the State Technical Assessment Team (STAT) program, a visitation-based (visitatie) peer assessment program designed to enhance the organizational capacity of state health department injury prevention programs. The formative evaluation was based on observational, record review, and key informant interview data collected during the implementation of the first 7 STAT visits. Pilot impact data were derived from semi-structured interviews with state injury prevention personnel one year after the visit. Formative evaluation identified 6 significant implementation problems in the first visits that were addressed by the program planners, resulting in improvements to the STAT assessment protocol. Impact evaluation revealed that after one year, the 7 state injury prevention programs had acted on 81% of the recommendations received during their STAT visits. All programs reported gains in visibility and credibility within the state health department and increased collaboration and cooperation with other units and agencies. Other significant program advancements were also reported. Specific program standards and review procedures are important to the success of peer assessment programs such as STAT. Early impact evaluation suggests that peer assessment protocols using the visitatie model can lead to gains in organizational capacity.
The Journal of Pediatrics, 1988
... Desmond K. Runyan, MD, DrPH, Mark D. Everson, PhD, Gail A. Edelsohn, MD, MSPH, Wanda M. Hunte... more ... Desmond K. Runyan, MD, DrPH, Mark D. Everson, PhD, Gail A. Edelsohn, MD, MSPH, Wanda M. Hunter, MPH, and Martha L. Coulter ... An arbitrary standard of improvement by one standard deviation was chosen because the standard devia-tions in each scale were large and ...
Journal of Pediatric Psychology, 2000
To determine the type and severity of discipline practices in rural India and to identify risk an... more To determine the type and severity of discipline practices in rural India and to identify risk and protective factors related to these practices. Five hundred mothers, ages 18-50, participated in face-to-face interviews as part of a cross-sectional, population-based survey. One of the mother's children was randomly selected as the referent child. The interview focused primarily on discipline practices and spousal violence. Sociodemographic characteristics, neighbor support, residential stability, and husband's drinking behavior were also assessed. Nearly half of the mothers reported using severe verbal discipline and 42% reported using severe physical discipline. While common, severe discipline practices occurred less frequently than moderate practices and had different risk factors, notably low maternal education and spousal violence. Results suggest that increased formal education for rural women in India may have the added benefit of reducing family violence, including spouse and child abuse.
Journal of Interpersonal Violence, 2000
Page 1. Journal of Interpersonal Violence http://jiv.sagepub.com/ Methodological and Ethical Chal... more Page 1. Journal of Interpersonal Violence http://jiv.sagepub.com/ Methodological and Ethical Challenges Associated With Child Self-Report of Maltreatment : Solutions Implemented by the LongSCAN Consortium ELIZABETH ...