Transcript Document

PARENTING NEEDS
OF
W O M E N S E E K I N G I N T I M AT E P A RT N E R V I O L E N C E S E R V I C E S
Raquel Vargas-Whale MD 1,2 , Kristine A. Campbell MD, MSc 1,2 , & Lenora M. Olson PhD, MA 1
U n i ve r s ity o f U t a h ,
1 D e p ar t me nt
BACKGROUND
The study reflects collaborative work with a longstanding
community partner to identify needs of women and children
seeking services to end intimate partner violence (IPV).
 Physical and behavioral healthcare needs of children identified
by mothers trying to end IPV are not well understood
OBJECTIVES
To support efforts to meet the needs of children with exposure to
IPV, we deployed a self administered survey. This survey described
maternal perceptions of parenting stress & child physical &
behavioral health at the time of seeking services for intimate
partner violence
 43 mothers, average age 33 years
 Current analysis does not account for maternal clusters
-children within family may share health and behavior problems
Community
n-18
Minority race
19%
20%
17%
Hispanic ethnicity
60%
60%
61%
Did not complete high school
50%
44%
35%
Married or partnered
26%
24%
28%
Living with IPV over 1 year
73%
64%
88%
Depressive symptoms (PHQ-2)
55%
60%
41%
Low self-perception of social status (MacArthur Ladder)
67%
76%
53%
Child Experiences
Visits with mother’s
abusive partner
Shelter
n=57
Community
n-35
28%
23%
36%
47%
Witnessed parent
arrest related to IPV
28%
 Inclusion Criteria: English or Spanish speaking mothers
presenting to IPV walk-in center (COMMUNITY) or living in an
IPV shelter (SHELTER) with children between 3-11 years
History of CPS
involvement
34%
History of out-of-home
placement
3%
59%
32%
41%
4%
Parenting Stress
Measures
*
 Parenting stress: Parenting Stress Index-Short Form
53%
CONCLUSIONS
 Children of mothers actively seeking services to end IPV have
significantly more behavior problems of clinical importance, as
well as healthcare needs, than the population at large
 These children are being parented by mothers who reports
clinically significant levels of parenting stress as compared to
general population
All
n=92
Shelter
n=57
Community
n-35
Need for medical
appointment
45%
49%
38%
Need for behavioral
health appointment
60%
58%
63%
Usual source of
pediatric care
87%
26%
Currently uninsured
19%
3%
IPV discussed with
pediatric provider
28%
21%
Special
Healthcare
Needs
24%
13%
 Work with IPV service organizations to identify & refer children
for needed health services
23%
36%
Behavior Prob.
*
56%
 The authors have documented that they have no financial
relationships or conflicts of interest to disclose
*
Screener
25%
24%
26%
20%
Popula on
 Funding source K23 HD059850 & R e s e a r c h resource support
through 1ULTR001067
15%
All
Shelter
Community
 The investigators thank the YWCA Utah and the Family Justice
Center and the women who participated in this this project for
their time and willingness to share their experiences.
DISCLOSURES
 Child physical health: Children with Special Health Care Needs
 Comparison between TOTAL SAMPLE and POPULATION norms
ACKNOWLEDGEMENTS
56%
43%
15%
NEXT STEPS
88%
49%
 Child behavioral health: Strength and Difficulties Questionnaire
 Community agencies providing IPV services to women should
provide resources to address child health needs & parenting
challenges at times of family crisis
 Analysis of covariates to identify contribution to outcome
measures
86%
56%
 Maternal distress may be generate over-reporting of child
problems
- but maternal perceptions are critical to parent-child interactions
Child Health Care
All
n=92
 Location: Urban community center working with women, men,
and children who have experienced family violence
 Comparison between COMMUNITY and SHELTER sample
- does not account for changes over time among children in shelter
 92 children, average age 7 years
Shelter
n=25
54%
Analysis
 Small, community-based cross-sectional survey
All
n=43
 Timeline: Fall 2013
OUTCOMES
L I M I TAT I O N S
Maternal Demographics
Witnessed police
response to IPV
 Survey: Validated instruments & researcher-developed
questions
f o r S a f e a n d H e a l t hy Fa m i l i es
Survey Respondents
METHODS
 Design: Cross-sectional study design using self administered
survey
2 C e nt er
R E S U LT S
 Women and children living with IPV suffer impaired mental &
physical health
 This may negatively impact parenting & parent/child wellbeing,
placing children at risk for subsequent maltreatment
o f Pe d i at r i c s,
Popula on
All
Shelter
Community
Popula on
All
Shelter
Community
* difference between normative population and study sample all p<0.05; difference between shelter and community samples all p>0.05