Trauma exposure is common; however, considerably higher rates are reported in some vulnerable groups including adults and children involved in child welfare systems. In this context, early screening ...and service linkage may ameliorate its negative impact on the physical and mental well-being of adults and children alike. Using data from two Ohio-based child welfare interventions targeting co-occurring maltreatment and substance use (Ohio START
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and EPIC2), the purpose of this brief report was to first describe the rate of trauma exposure among participating adults (Adverse Childhood Experiences or ACEs, N = 402), children 0–5 years (CTAC, N = 271) and youth 6–18 years (CTAC, N = 177), and second to benchmark observed rates against reported rates in other child welfare or similar populations across the United States. Results show that adults were exposed to 4.2 ACEs on average, a 24% increase over previous child welfare estimates. While mean CTAC scores were not significantly different among young children ages 0–5, older children reported on average 5.6 exposures which is 27% higher than previously reported estimates. Our findings highlight the difference in risk profiles between families involved child welfare due primarily to substance misuse and those without substance misuse concerns, or where substance misuse was not the primary cause of entry. We discuss implications for service provision and time-sensitive child welfare requirements.
In 2020, the continuing murder of Black Americans by police officers received widespread media attention and sparked global outrage. Public health responses to these events focused on discrimination ...by police and structural racism in broader society. However, police violence is but one of many forms of racialized violence propagated by structural racism and anti-Black racism in particular. We aim to expand the current public health dialogue by describing how structural racism and structural violence are deeply interrelated; embedded in institutions, systems, and processes; and threaten health, safety, and well-being across the life course for racialized minority groups. Structural racism and structural violence are threats to health equity and anti-racist public health work.
Limited evidence suggests that how much a parent drinks in a particular venue, such as a bar, restaurant, or a friend’s home, is associated with use of corporal punishment. However, these ...relationships could differ depending on their drinking companions (e.g., spouse or friends). In this study, weighted zero-inflated Poisson models were used to examine whether the relationships between venue-specific drinking frequency, heavier drinking, and corporal punishment are moderated by drinking companions in a mixed-mode sample of parents (n = 1,599). The relationships between drinking frequency, heavier drinking, and corporal punishment varied by drinking companions, with some combinations being protective and others conferring risk. While most alcohol screening tools focus on individual alcohol use, more nuanced assessment examining where and with whom parents are drinking could be helpful in understanding risk of physical discipline.
Hopefulness is associated with better health and may be integral for stress adaptation and resilience. Limited research has prospectively examined whether hopefulness protects against physiological ...dysregulation or does so similarly for U.S. whites, blacks and Hispanics. We examined the association between baseline hopefulness and future allostatic load using data from the Health and Retirement Study (n = 8,486) and assessed differences in this association by race/ethnicity and experiences of discrimination. Four items measured hopefulness and allostatic load was a count of seven biomarkers for which a respondent's measured value was considered high-risk for disease. A dichotomous variable assessed whether respondents experienced at least one major act of discrimination in their lifetime. We used Poisson regression to examine the association between hopefulness and allostatic load and included a multiplicative interaction term to test racial/ethnic differences in this association. Subsequent analyses were stratified by race/ethnicity and tested the interaction between hopefulness and discrimination within each racial/ethnic group. Hopefulness was associated with lower allostatic load scores, but its effects varied significantly by race/ethnicity. Race-stratified analyses suggested that hopefulness was protective among whites and not associated with allostatic load among Hispanics irrespective of experiencing discrimination. Hopefulness was associated with lower allostatic load among blacks reporting discrimination but associated with higher allostatic load among those who did not. Findings suggest that hopefulness plays differing roles for older whites, blacks and Hispanics and, for blacks, its protective effects on physiological dysregulation are intricately tied to their experiences of discrimination.
•Our findings show general support for the expansion of the National START model to serve eligible families with children of all ages.•Fidelity to timely access to services did not differ between ...families with older children and those with young children 0–5.•Successful completion of the Ohio START model did not differ between the two groups.•No regional or cohort effects on timely access to services nor for successful completion of the model.•Increasing availability of the START model to families with children of all ages may have wider reaching impacts on youth’s own substance misuse.
The Sobriety Treatment and Recovery Teams (START) model is an evidence-supported intervention for families with at least one child under age 6 involved in the child welfare system due to substance misuse. The hallmark of the START model is early identification and linkage to addiction treatment services. To address the dual problem of heightened need for addiction treatment services and limited treatment availability in the wake of the opioid epidemic, Ohio’s adaptation extended the model to serve all eligible families regardless of the age of children in the household.
To investigate the delivery of the START model for parents and caregivers of older youth (age 6–18) only as compared to the population for which it was originally intended.
We used data from 40 counties and with parents as the unit of analysis (N = 714). We used multilevel models to estimate the relationship between the age of children in the home and 1) meeting fidelity for timely access to treatment services and 2) successful completion of the model.
There was no statistically significant difference in the likelihood of meeting fidelity requirement for timely access to treatment services, nor in successful completion for families with older children as compared to those with at least one child aged 0–5.
These results lend support to the use of the START model for all eligible families, regardless of the children’s ages. Future studies can examine more nuanced relationships to include the role of specific substances, child placement, and the role of family peer mentors.
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