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The Cochrane Database of Systematic... Jul 2022Many nations require child-serving professionals to report known or suspected cases of significant child abuse and neglect to statutory child protection or safeguarding... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Many nations require child-serving professionals to report known or suspected cases of significant child abuse and neglect to statutory child protection or safeguarding authorities. Considered globally, there are millions of professionals who fulfil these roles, and many more who will do so in future. Ensuring they are trained in reporting child abuse and neglect is a key priority for nations and organisations if efforts to address violence against children are to succeed.
OBJECTIVES
To assess the effectiveness of training aimed at improving reporting of child abuse and neglect by professionals and to investigate possible components of effective training interventions.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, 18 other databases, and one trials register up to 4 June 2021. We also handsearched reference lists, selected journals, and websites, and circulated a request for studies to researchers via an email discussion list.
SELECTION CRITERIA
All randomised controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies examining the effects of training interventions for qualified professionals (e.g. teachers, childcare professionals, doctors, nurses, and mental health professionals) to improve reporting of child abuse and neglect, compared with no training, waitlist control, or alternative training (not related to child abuse and neglect).
DATA COLLECTION AND ANALYSIS
We used methodological procedures described in the Cochrane Handbook for Systematic Reviews of Interventions. We synthesised training effects in meta-analysis where possible and summarised findings for primary outcomes (number of reported cases of child abuse and neglect, quality of reported cases, adverse events) and secondary outcomes (knowledge, skills, and attitudes towards the reporting duty). We used the GRADE approach to rate the certainty of the evidence.
MAIN RESULTS
We included 11 trials (1484 participants), using data from 9 of the 11 trials in quantitative synthesis. Trials took place in high-income countries, including the USA, Canada, and the Netherlands, with qualified professionals. In 8 of the 11 trials, interventions were delivered in face-to-face workshops or seminars, and in 3 trials interventions were delivered as self-paced e-learning modules. Interventions were developed by experts and delivered by specialist facilitators, content area experts, or interdisciplinary teams. Only 3 of the 11 included studies were conducted in the past 10 years. Primary outcomes Three studies measured the number of cases of child abuse and neglect via participants' self-report of actual cases reported, three months after training. The results of one study (42 participants) favoured the intervention over waitlist, but the evidence is very uncertain (standardised mean difference (SMD) 0.81, 95% confidence interval (CI) 0.18 to 1.43; very low-certainty evidence). Three studies measured the number of cases of child abuse and neglect via participants' responses to hypothetical case vignettes immediately after training. A meta-analysis of two studies (87 participants) favoured training over no training or waitlist for training, but the evidence is very uncertain (SMD 1.81, 95% CI 1.30 to 2.32; very low-certainty evidence). We identified no studies that measured the number of cases of child abuse and neglect via official records of reports made to child protection authorities, or adverse effects of training. Secondary outcomes Four studies measured professionals' knowledge of reporting duty, processes, and procedures postintervention. The results of one study (744 participants) may favour the intervention over waitlist for training (SMD 1.06, 95% CI 0.90 to 1.21; low-certainty evidence). Four studies measured professionals' knowledge of core concepts in all forms of child abuse and neglect postintervention. A meta-analysis of two studies (154 participants) favoured training over no training, but the evidence is very uncertain (SMD 0.68, 95% CI 0.35 to 1.01; very low-certainty evidence). Three studies measured professionals' knowledge of core concepts in child sexual abuse postintervention. A meta-analysis of these three studies (238 participants) favoured training over no training or waitlist for training, but the evidence is very uncertain (SMD 1.44, 95% CI 0.43 to 2.45; very low-certainty evidence). One study (25 participants) measured professionals' skill in distinguishing reportable and non-reportable cases postintervention. The results favoured the intervention over no training, but the evidence is very uncertain (SMD 0.94, 95% CI 0.11 to 1.77; very low-certainty evidence). Two studies measured professionals' attitudes towards the duty to report child abuse and neglect postintervention. The results of one study (741 participants) favoured the intervention over waitlist, but the evidence is very uncertain (SMD 0.61, 95% CI 0.47 to 0.76; very low-certainty evidence).
AUTHORS' CONCLUSIONS
The studies included in this review suggest there may be evidence of improvements in training outcomes for professionals exposed to training compared with those who are not exposed. However, the evidence is very uncertain. We rated the certainty of evidence as low to very low, downgrading due to study design and reporting limitations. Our findings rest on a small number of largely older studies, confined to single professional groups. Whether similar effects would be seen for a wider range of professionals remains unknown. Considering the many professional groups with reporting duties, we strongly recommend further research to assess the effectiveness of training interventions, with a wider range of child-serving professionals. There is a need for larger trials that use appropriate methods for group allocation, and statistical methods to account for the delivery of training to professionals in workplace groups.
Topics: Child; Child Abuse; Family; Health Personnel; Humans; Mandatory Reporting; Systematic Reviews as Topic
PubMed: 35788913
DOI: 10.1002/14651858.CD011775.pub2 -
Atencion Primaria Apr 2019
Topics: Aggression; Bullying; Humans; Mandatory Reporting; Power, Psychological; Schools; Spain
PubMed: 30709641
DOI: 10.1016/j.aprim.2018.05.015 -
Australian Journal of General Practice Dec 2023
Topics: Humans; Mandatory Reporting; Students, Medical; Delivery of Health Care
PubMed: 38049128
DOI: 10.31128/AJGP-07-23-6892 -
Journal of Midwifery & Women's Health May 2016Intimate partner violence (IPV) is a serious concern for women that is associated with significant adverse health effects. Routine screening for IPV is recommended, but... (Review)
Review
Intimate partner violence (IPV) is a serious concern for women that is associated with significant adverse health effects. Routine screening for IPV is recommended, but there are many barriers to screening that have been identified by providers, including discomfort, lack of training, and not knowing how to respond to a positive screen. This article reviews IPV screening and appropriate techniques for responding to a positive screen. IPV screening best practices include using a systematic protocol, developing a screening script, using a validated screening tool, and considerations for privacy and mandatory reporting. Responding to a positive screen should include acknowledging the experience, asking if the woman desires help, offering support and referrals, encouraging safety planning, and completing additional assessments to determine level of danger and to identify any comorbidities. Using these techniques along with therapeutic communication may increase IPV identification and create an environment in which women feel empowered to get help.
Topics: Female; Humans; Mandatory Reporting; Mass Screening; Spouse Abuse; United States
PubMed: 26990666
DOI: 10.1111/jmwh.12443 -
Soins; La Revue de Reference Infirmiere May 2018
Topics: Civil Rights; Female; Humans; Interpersonal Relations; Male; Mandatory Reporting; Occupational Exposure; Sex Offenses; Sexual Harassment; Social Justice; Women's Rights
PubMed: 29773246
DOI: 10.1016/j.soin.2018.03.016 -
BMC Public Health Aug 2018Within Canadian provinces over the past half-century, legislation has been enacted to increase child protection organization (CPO) involvement in situations of child... (Review)
Review
BACKGROUND
Within Canadian provinces over the past half-century, legislation has been enacted to increase child protection organization (CPO) involvement in situations of child maltreatment (CM). This study had two objectives: 1) to document enactment dates of legislation for mandatory reporting of CM; 2) to examine reported CPO involvement among people reporting a CM history in relation to the timing of these legislative changes.
METHODS
The history of mandatory reporting of CM was compiled using secondary sources and doctrinal legal review of provincial legislation. The 2012 Canadian Community Health Survey - Mental Health (CCHS-MH) with n = 18,561 was analyzed using birth cohorts to assess associations between the timing of legislation enactment and contact with CPO.
RESULTS
All Canadian provinces currently have mandatory reporting of physical and sexual abuse; 8 out of 10 provinces have mandatory reporting for children's exposure to intimate partner violence. Increases in reporting CM to CPOs paralleled these laws' enactment, particularly for severe and frequent CM.
CONCLUSIONS
These findings show that mandatory reporting laws increase reporting contact with CPO, particularly for severe and frequent CM. Whether they have had the intended effect of improving children's lives remains an important, unanswered question.
Topics: Canada; Child; Child Abuse; Child Protective Services; Humans; Mandatory Reporting
PubMed: 30115126
DOI: 10.1186/s12889-018-5864-0 -
Journal of Addiction Medicine 2019In many states, health care providers are legally required to report pregnant women who use substances, or infants affected by prenatal substance use, to child welfare...
OBJECTIVE
In many states, health care providers are legally required to report pregnant women who use substances, or infants affected by prenatal substance use, to child welfare authorities. The objective of this study was to characterize obstetric and pediatric providers' perceptions of and experiences with policies requiring mandatory reporting of prenatal substance use to child welfare authorities.
METHODS
We conducted a qualitative interview study among 20 obstetric and pediatric providers to elicit participants' perspectives about and experience with current policy requiring mandatory reporting of prenatal substance use. Two investigators used an iterative content analysis approach to code interview transcripts and identify themes.
RESULTS
Study participants included obstetrician/gynecologists (N = 7), midwives (N = 5), and pediatricians (N = 8). Providers noted that implementation of the policy was often targeted and that targeted screening can be biased. Most providers reported that they incorporated information about mandatory reporting policies into patient counseling about substance use. They described not knowing what happens to patients after mandatory reporting and concerns regarding unintended consequences. Providers indicated that changes are needed to improve outcomes for patients and their families and suggested increased research into best practices, more funding for social services, and eliminating the policy altogether.
CONCLUSIONS
Health care providers expressed concern about the targeted screening process used to identify women with substance use whose children are reported to child welfare authorities. Most providers believed that mandatory reporting processes could be modified in ways that would support the health of women and children.
Topics: Female; Health Personnel; Health Policy; Humans; Infant; Interviews as Topic; Mandatory Reporting; Maternal Exposure; Obstetrics; Pediatrics; Practice Patterns, Physicians'; Pregnancy; Qualitative Research; Substance Abuse Detection; Substance-Related Disorders
PubMed: 30550393
DOI: 10.1097/ADM.0000000000000489 -
Journal of the American Pharmacists... 2020To examine and describe the reporting requirements for pharmacists related to interpersonal violence and abuse in the United States.
OBJECTIVE
To examine and describe the reporting requirements for pharmacists related to interpersonal violence and abuse in the United States.
METHODS
A comprehensive search of state laws related to mandatory reporting of intimate partner violence and domestic violence (IPV), child abuse, and elder abuse was conducted. Identified statutes were reviewed to determine if pharmacists were mandatory reporters for each type of violence.
RESULTS
Pharmacists are specifically identified as mandatory reporters of intimate partner violence in 10 states, of child abuse in 11, and of elder abuse in 20. They may also have reporting requirements in more states as statutes sometimes identify health care providers as mandatory reporters, but do not specify which types of providers. Additionally, many states require reporting of child and elder abuse by anyone who is aware of or suspects abuse. IPV statutes mainly require reporting when treating wounds from gunshots, stabbings, and burns.
CONCLUSIONS
Pharmacists are accessible health care providers who should be aware of reporting requirements for their practice location and setting. They have mandatory reporting requirements in much of the United States, especially for child and elder abuse. They should seek specific guidance about their reporting requirements and reporting methods, as well as identify educational and local referral resources for victims they may encounter in practice.
Topics: Aged; Child; Child Abuse; Domestic Violence; Elder Abuse; Humans; Mandatory Reporting; Pharmacists; United States
PubMed: 32778517
DOI: 10.1016/j.japh.2020.07.014 -
BMJ Open Oct 2017To systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated reporters' (MRs) experiences with reporting.
DESIGN
As no studies assessing the effectiveness of mandatory reporting were retrieved from our systematic search, we conducted a meta-synthesis of retrieved qualitative research. Searches in Medline (Ovid), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, Education Resources Information Center, Criminal Justice Abstracts and Cochrane Library yielded over 6000 citations, which were deduplicated and then screened by two independent reviewers. English-language, primary qualitative studies that investigated MRs' experiences with reporting of child maltreatment were included. Critical appraisal involved a modified checklist from the Critical Appraisal Skills Programme and qualitative meta-synthesis was used to combine results from the primary studies.
SETTING
All healthcare and social-service settings implicated by mandatory reporting laws were included. Included studies crossed nine high-income countries (USA, Australia, Sweden, Taiwan, Canada, Norway, Finland, Israel and Cyprus) and three middle-income countries (South Africa, Brazil and El Salvador).
PARTICIPANTS
The studies represent the views of 1088 MRs.
OUTCOMES
Factors that influence MRs' decision to report and MRs' views towards and experiences with mandatory reporting of child maltreatment.
RESULTS
Forty-four articles reporting 42 studies were included. Findings indicate that MRs struggle to identify and respond to less overt forms of child maltreatment. While some articles (14%) described positive experiences MRs had with the reporting process, negative experiences were reported in 73% of articles and included accounts of harm to therapeutic relationships and child death following removal from their family of origin.
CONCLUSIONS
The findings of this meta-synthesis suggest that there are many potentially harmful experiences associated with mandatory reporting and that research on the effectiveness of this process is urgently needed.
Topics: Child; Child Abuse; Developed Countries; Developing Countries; Humans; Mandatory Reporting; Qualitative Research
PubMed: 29042370
DOI: 10.1136/bmjopen-2016-013942 -
Rhode Island Medical Journal (2013) Apr 2022The opioid epidemic has renewed debate about how to structure laws, agency policies and hospital protocols for mandatory reporting of illicit substances during...
The opioid epidemic has renewed debate about how to structure laws, agency policies and hospital protocols for mandatory reporting of illicit substances during pregnancy. This paper analyzes the ethics of Rhode Island's approach to mandatory reporting - in particular, reporting of positive maternal and newborn drug tests at time of delivery. Given that state intervention is generally perceived by pregnant people as punitive and threatening to their family, we consider how four elements often used to justify punitive action by the state - retribution, deterrence, rehabilitation, and incapacitation (societal protection) - apply to Rhode Island's policy and approach to prenatal substance use. In addition, the paper considers the equity implications of Rhode Island's approach. It concludes that, given the potential for the policy to do more harm than good, investment of resources would be better spent on clinical and community services that support substance using parents and their newborns.
Topics: Female; Humans; Infant, Newborn; Mandatory Reporting; Parents; Policy; Pregnancy; Substance Abuse Detection; Substance-Related Disorders
PubMed: 35349617
DOI: No ID Found