With the transition to the International Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification (ICD-10-CM), additional research is needed to understand which ...diagnostic codes for intimate partner violence (IPV) are being used. The current study examined characteristics of IPV visits and frequency of diagnostic codes to identify IPV in all emergency department (ED) and inpatient hospital visits for adults in California from 2016–2018, after ICD-10-CM implementation. Five ICD-10-CM codes outlined in the Uniform Data System Reporting Instructions were used to identify IPV. Fewer than 0.1% of visits (17,347 ED visits and 1,430 hospitalizations) included documentation of IPV. Visits with documented IPV were more common among patients who were younger, female, Black, primarily English-speaking, and publicly insured compared to visits with no documented IPV. There were fairly consistent patterns over time in the specific ICD-10-CM codes used for IPV between 2016 and 2018. Physical and sexual abuse were the most common codes for types of abuse. Among the 15 EDs and 15 hospitals in California with the highest volume of IPV visits, there was variability in the use of ICD-10-CM codes for IPV visits. Accurate documentation of IPV in administrative data may improve patient care and increase understanding of the burden and effects of IPV on individuals and communities.
While general U.S. rates of adolescent pregnancy and childbirth have declined over the past four decades, the rate among adolescents in foster care has not reflected this same drop. Decades of ...research has indicated negative outcomes for both parenting adolescents and their children compared to their non-parenting peers, however, less is understood about the risks, outcomes and needs specific to adolescents who give birth while in foster care. This comprehensive literature review adds to the knowledge of pregnant and parenting mothers in foster care and their children by identifying and summarizing all relevant studies published between 2011 and 2017. Findings indicate that youth in care have high rates of pregnancy and childbirth, experience multiple risks and negative outcomes, and are in need of various supportive services. Implications for research, practice and policy (need to reduce unintended pregnancy and improve circumstances, identifying successful interventions, expanding knowledge of these youth and their children, and developing two-generation interventions) were also explored.
. Existing literature has documented a strong relationship between parental mental illness and child maltreatment, but little is known about the prevalence of mental illness among childbearing women. ...In the present study, linked administrative records were used to identify the prevalence of maternal mental health (MH) disorders documented at birth and determine the associated likelihood of maltreatment reports during infancy.
. Vital records for California's 2006 birth cohort were linked to hospital discharge and Child Protective Services (CPS) records. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) billing codes from the mother's delivery hospitalization were used to determine diagnosed maternal MH disorders for 551,232 infants born in 2006, and reports of alleged maltreatment were documented from CPS records. Vital birth records were used to control for sociodemographic factors. Finally, the associated risk of reported maltreatment during the first year of life was examined using generalized linear models.
. Among infants in this statewide birth cohort, 2.8% were born to a mother with a documented MH disorder, of which 41.3% had documented maternal substance abuse issues versus less than 0.5% of infants born to mothers without a diagnosed MH disorder. Further, 34.6% of infants born to mothers with a MH disorder were reported to CPS within one year, and a majority of those reports were made within the first month of life (77.2%). In contrast, among children born to mothers without a MH disorder, 4.4% were reported to CPS during infancy. After controlling for sociodemographic factors, the rate of CPS reports during infancy for infants born to mothers with a MH disorder but no substance use disorder was 2.6 times that of infants born to mothers without a MH disorder (95% CI = 2.47, 2.73). Among infants born to mothers with MH and substance use disorders, the rate of CPS reports during infancy was 5.69 times that of infants born to mothers without a MH disorder (95% CI = 5.51, 5.87).
. Administrative records provide a method for identifying infants born to mothers with MH disorders, enabling researchers to track rates over time and generate population-level data to inform policy development and improve service delivery.
CONTEXT
Research has documented elevated rates of early childbirth among adolescents who have spent time in foster care, and a better understanding is needed of the characteristics of vulnerable ...individuals and the circumstances of their time in care.
METHODS
California birth records for 1999–2010 were probabilistically linked to state child welfare service records spanning the same date range to identify females aged 12–19 who had spent time in foster care and had had a first birth before age 20. Latent class analysis was used to identify subgroups based on age at most recent entry into care, length of this stay and three indicators of placement instability. The probability of a first birth being related to class membership was assessed as a distal outcome, and differences across classes were assessed using chi‐square tests.
RESULTS
Four distinct classes of foster youth were identified: Later Entry/High Instability (20% of individuals), Later Entry/Low Instability (43%), Earlier Entry/High Instability (12%) and Earlier Entry/Low Instability (25%). The probability of a first childbirth ranged from 31% (class 1) to 15% (class 4); classes 2 and 3 experienced moderate risk (23% and 24%, respectively). Two groups were further characterized by high rates of reentry into care, with 56% of class 1 and 41% of class 3 individuals experiencing more than one episode in care.
CONCLUSIONS
Identifiable subgroups of female foster youth are at heightened risk of early childbirth and may benefit from early intervention, enhanced support and access to reliable, ongoing sexual and reproductive health care.
Abstract Purpose This analysis examined California county birth rate variations among girls in foster care. The objective was to generate data to assess potential intervention points tied to federal ...legislation extending foster care beyond age 18 years. Methods Child protection records for all adolescent girls in foster care at age 17 years between 2003 and 2007 (N = 20,222) were linked to vital birth records through 2011. The cumulative percentage of girls who had given birth by age 21 years was calculated by county and race/ethnicity. Results One in three (35.2%) adolescent girls in foster care had given birth at least once before age 21 years. Although significant birth rate variations emerged, even at the low end of the county range, more than one in four girls had given birth by age 21 years. Conclusions Child welfare systems are now charged with coordinating transitional services for foster youth beyond age 18 years. Extended foster care provides new opportunities for pregnancy prevention work and targeted parenting support.
This study identified children born to mothers in foster care and documented Child Protective Service (CPS) involvement among children.
Probabilistically linked birth and CPS records from California ...(2009–2012) were used to identify all mothers in foster care on or after conception. Children were followed prospectively using linked records to identify CPS involvement occurring during the first three years of life. Differences between reported and unreported children were examined using χ2 tests. The Latent Class Analysis (LCA) identified classes of children born to mothers in care who were at increased risk of CPS involvement. Model fit was assessed using the Bayesian Information Criterion, entropy, and likelihood ratio tests. For each of the classes, the relationship to the distal outcome (i.e., a maltreatment report by age three), was examined.
Findings indicate that 53% of children born to mothers in care were reported. The proportion of children reported to CPS for maltreatment declined over time, from 63% of children born to mothers in foster care in 2009, to 46% in 2012. The LCA documented three distinct classes of mother-child dyads with varying risk of report. More than one third of children in Class 1 and nearly 70% of children in Class 3 were reported.
This study was the first to develop multi-dimensional class profiles of two-generation CPS involvement among mother-child dyads. This study documents that mothers’ experiences in care and mental health conditions vary widely, underscoring the importance of providing services that fit the needs of dyads.
Children’s Data Network Foust, Regan; Hoonhout, Jonathan; Eastman, Andrea ...
International journal of population data science,
01/2021, Letnik:
6, Številka:
3
Journal Article
Recenzirano
Odprti dostop
The Children's Data Network (CDN) is a data and research collaborative focused on the linkage and analysis of administrative records. In partnership with public agencies, philanthropic funders, ...affiliated researchers, and community stakeholders, we seek to generate knowledge and advance evidence-rich policies that improve the health, safety, and well-being of the children of California. Given our experience negotiating access to and working with existing administrative data (and importantly, data stewards), the CDN has demonstrated its ability to perform cost-effective and rigorous record linkage, answer time-sensitive policy- and program-related questions, and build the public sector's capacity to do the same. Owing to steadfast and generous infrastructure and project support, close collaboration with public partners, and strategic analyses and engagements, the CDN has promoted a person-level and longitudinal understanding of children and families in California and in so doing, informed policy and program development nationwide. We sincerely hope that our experience—and lessons learned—can advance and inform work in other fields and jurisdictions.
•Both samples had first contact with both systems at the same ages.•Females who had experienced CSE had more justice system contact.•Between 69% and 76% of both samples experienced dual system ...contact.
Commercial sexual exploitation (CSE) is related to both child welfare (CW) and juvenile justice (JJ) system involvement, yet research of CSE largely examines single system involvement. Using a sample of justice involved females with histories in out-of-home care, this study explores dual system contact for females with CSE experiences (n = 225) compared to a matched sample of females without a history of CSE (n = 237). Differences between the samples’ system experiences were compared using chi-square analyses or t-tests of group mean differences. Nearly all females had a history of at least one maltreatment allegation and between 69% and 76% of the samples were classified as dual system females as measured by the justice-involved youth also having a substantiated case of maltreatment. The CSE sample, compared to the no-CSE sample, had significantly more contact with the juvenile justice system including more arrests, petitions filed, bench warrants, and entrances to detention. Findings highlight the extent of dual system involvement among justice involved females with histories of CSE and out-of-home care, and the need for cross-systems collaboration to improve youth outcomes.
Children born to mothers in foster care have increased numbers of reports of alleged abuse or neglect in comparison to children born to mothers who are not in care. The present investigation ...leveraged unstructured, case narrative fields in child welfare records to enhance knowledge about Child Protective Services (CPS) involvement among children born to mothers in care. A content analysis was conducted to assess reasons described for CPS involvement among children who were (1) born to mothers who were in foster care on or after the estimated date of conception and (2) reported to CPS during the first 3 years of life. The present investigation builds upon a prior Latent Class Analysis that identified classes of children born to mothers in care who were at varying risk of CPS involvement. Thirteen mother-child dyads from each of the three distinct classes identified in the prior study were selected for a detailed examination of mother and child case records (N = 39). Findings show class membership varied based on the mother's earlier experiences in care and reasons for the children's maltreatment report. A lack of placement stability for the mother can have long term consequences for the mother with cascading effects for the children. Study findings illustrate the importance of linking parents to services that meet their unique needs and those of their children. Findings add depth to the understanding of factors associated with the maltreatment of children born to mothers in foster care and demonstrate the importance of two-generation strategies.
•Identified reasons for Child Protective Services involvement among children born to mothers in foster care•Highlighted common experiences and stark contrasts among classes of mother-child dyads•Described barriers to service provision and supported the utility of analyzing child welfare case narrative records•Demonstrated the importance of developing two-generation strategies to address needs of both the mother and child
Most child protective services (CPS) investigations involve allegations of neglect. Broad and vague definitions have led to concerns that CPS-investigated neglect is driven by poverty-based material ...hardship. In a representative sample of 295 neglect investigations in California in 2017, structured data and narrative text fields were used to characterize the types of neglect and concurrent parental risk factors investigated by CPS and to assess the rate and nature of investigated physical neglect, defined as inadequate food, housing, or hygiene. The most common types of neglect were inadequate supervision (44%) and failure to protect (29%), followed by physical neglect (14%). Common risk factors identified in neglect investigations were parental substance use (41%), domestic violence (21%), mental illness (18%), and co-reported physical or sexual abuse (29%). Nearly all investigations of physical neglect (99%) included concerns related to substance use, domestic violence, mental illness, co-reported abuse or an additional neglect allegation (i.e., abandonment). Given concerns identified in neglect investigations, economic supports are likely insufficient without an array of behavioral-health supports.
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