Funded Injury Control Research Centers (ICRCs)

Abstract

The Scientific Advisory Team (SAT) is lead by the center PI and includes a large body of scientists that meet yearly to review center progress, provide guidance around new projects, and ensure communication with other university centers, departments, institutes and schools. Select scientists within this group serve on two smaller teams that provide ongoing support throughout the year. These smaller working teams are the Research Methods Support Team (RMST) and the Academic/Communication/Dissemination Team (ACDT). The RMST includes scientists from several disciplines and offer expertise in research design, statistics, economics, cultural and organizational issues in implementation. The ACDT includes experts in health/prevention communication, media communication and dissemination to policy makers. In addition the core is informed by a national Research Advisory Board consisting of experts from a range of disciplines and organizations that provide a national view and meet (by teleconference and/or in-person) every other year. The Administrative Core supports two additional mechanisms designed to enhance both current and future research efforts. These include the topical research groups and the developmental research grants (seed projects). Topical research groups are lead by members of the SAT and include CM, IPV, SV, and SA. These groups will have a brown bag lunch meeting at least once a year that is open to all scientists and/or agency members with interests in this topic to share current ideas and build collaboration to support new work. Seed projects assist researchers in developing ideas for larger studies. The BCVIP begins with two identified projects as a part of this proposal (described below) and offers another opportunity to apply in year 3 for implementation in year 4 of the center. Principal investigators and their project managers are responsible for each study’s research operations and accountable for achieving research aims according to project timelines. The center directors work closely with each study to assure its needs for technical and scientific expertise, and that resources and support are well understood, anticipated and addressed. The administrative coordinator of BCVIP provides (1) scheduling for SAT.RMST and ACDT meetings; (2) scheduling support for topical research groups during the year so that researchers across Washington University, St Louis University School of Public Health and University of Missouri at St Louis Criminology department have an opportunity to share completed findings as well as discuss and build cross disciplinary teams for new studies; (3) tracking for the completion of human subjects applications for projects; (4) supervision of center RAs working on BCVIP activities; and (5) general administrative support for budget and center report generation.

Large Project: Violence Prevention of Adolescent Girls with Poor Maltreatment

Despite the strong empirical evidence that girls with histories of maltreatment are at greater risk than other adolescents of engaging in youth violence and interpersonal violence as adults, there are no reports of violence prevention programs tailored for female adolescents in foster care. The proposed study will adapt the CBITS program for use with girls in foster care who have experienced previous maltreatment, and evaluate its impact in preventing future youth violence and intimate partner violence. The study will utilize a randomized clinical trial that evaluates the effectiveness of a 10-session Cognitive-Behavioral Therapy for Foster Care (CBTFC) for adolescent girls compared with a usual care group. The CBT-FC experimental condition will include elements of trauma-focused cognitive behavioral therapy such as stress inoculation skills, thought stopping, social problem solving, relationship between thoughts, feelings, and behaviors, creating and processing the trauma, and relapse prevention. The specific aims of the proposed study are to 1. To adapt the CBITS program for female foster care youths (CBT-FC) that targets mental health problems as they relate to youth violence, sexual and drug risk behaviors, and future intimate partner violence. 2. Utilizing a randomized controlled design, implement the CBT-FC prevention program with 150 adolescent girls in foster care compared with 150 girls who received usual care. 3. Conduct a process evaluation that will monitor treatment integrity through ratings of session content delivered, participants’ attendance, program relevance and satisfaction, and tracking comparison and experimental group adolescents to reduce study attrition. 4. Conduct an outcome evaluation to compare the effectiveness of both conditions on primary outcomes such as trauma symptoms (PTSD, depression, internalizing and externalizing behaviors), problem-solving skills, and violence-related behaviors, intentions, beliefs, self-efficacy, and prevention knowledge. This study will advance knowledge of both trauma treatment and violence prevention by adapting an evidence based approach for the unique needs of adolescent girls with histories of maltreatment. The real-world utility of this study is enhanced by the fact that the intervention will be refined and delivered through collaborative efforts with the Children’s Advocacy Services of Greater St. Louis, an organization that currently conducts assessments and delivers services to adolescents for the Children’s Division. Thus, there is potential for the intervention to be adopted and disseminated among providers of treatment for youths in foster care.

Small Project: Can Child Savings Accounts Prevent Maltreatment by Promoting Safe, Stable, Nurturing Relationships?

Despite a wealth of literature showing a strong relationship between economic resources and child maltreatment, no existing intervention research has examined whether or not an economic approach could be helpful in the prevention of maltreatment. This project will study whether an asset-building approach is effective in reducing promoting a safe, stable and nurturing relationship that reduces risk of child maltreatment. This small exploratory study augments data from a funded experiment of child development accounts in Oklahoma (SEED for Oklahoma Kids, or SEED OK). SEED K deposited $1,000 into an Oklahoma College savings plan accounts (SEED OK account) for every infant in the treatment group and will provide matching funds to savings made by income-eligible parents. It is hypothesized hat asset-building intervention through child development accounts (SEED OK accounts) impacts parenting ehaviors and attitudes leading to improved likelihood of a safe, stable and nurturing relationship between the child and parent. This project will add questions for the second wave of data collection following the initial provision of accounts to see if the treatment group varies significantly in maltreatment risk from the control group. The sample of the SEED OK experiment was randomly selected from birth records provided by the Oklahoma State Department of Health (OSDH). SEED OK oversampled racial/ethnic minority groups to guarantee enough power for separate analyses of these groups. SEED OK randomly assigned the sample into treatment (N=1,360) and control (N=1,347) groups after the completion of baseline survey. Sample size is estimated to be sufficient to detect intervention effects if they exist. In addition to being able to measure both poverty and assets, this study will measure key aspects of CDC’s safe, stable nurturing environments: (1) elements of insuring safety (efficacy, social support, stress, maternal depression, no removal from home into foster care, and harsh parenting); (2) stability (of caretaker and residence); and (3) nurturing (attachment, maternal depression, parenting efficacy & practices, cognitive home environment, social support).

Small Project: Veterans, Trauma, and Battering Behavior: Developing a proactive Community Response to Violence Prevention

Domestic violence rates among combat veterans with posttraumatic stress disorder (PTSD) are higher than the general population, with PTSD symptoms being associated with increased levels psychological aggression and physical assaults. Male veterans with PTSD are 2 to 3 times more likely to than veterans without PTSD to engage in intimate partner violence and more likely to be involved with the legal system. Wars in Afghanistan and Iraq have increased the risk of PTSD and intimate partner violence. This has potentially long-term consequences for immediate victims and their families, and poses new challenges in developing proactive evidence-based community responses to violence prevention. The goal of this study is to develop and pilot a method—community based system dynamics—for designing community prevention strategies to emerging public health issues with a specific focus on addressing the increased risk of IPV and its effects on families. This project builds off earlier group model building efforts through the Missouri Mental Health Transformation Project; ongoing collaborations with faculty jointly appointed to Washington University and the Department of Veterans Affairs (VA), and violence prevention community agencies (RAVEN), and previous empirical and simulation research on intimate partner violence, community responses to violence, and implementation of evidence based practice in community based organizations. The specific aims of the research are to: (1) Develop a set of group model building “scripts” or protocols for working with community stakeholders (veterans administration, community based providers, administrators from department of mental health, veterans, victim advocates, etc.) to define and model the problem using system dynamics; (2) Conduct group model building sessions to develop a system dynamics simulation model with stakeholders on how to respond to the increasing risk of IPV associated with veterans with PTSD; (3) Identify and evaluate a community violence prevention strategy using system dynamics simulation modeling to be tested in a subsequent research application. This study adds to the science of implementation literature in adapting and tailoring prevention strategies to fit organizational culture and target population characteristics. Systems dynamics modeling is a relatively new approach to solving social problems and research like this has high public health significance in the are of program planning and policy. Of course, outcomes of the strategy chosen is the true test of the approach and thus a future research application will be submitted to implement and test the product of this study.

Small Project: Adapting the “Safe N Sound” Injury Prevention Program for primary Prevention of Abuse and Neglected young Families

While much is now known about the risk factors for child maltreatment, the harmful sequelae of child abuse, and, to a lesser extent, evidence-based treatment services, there have been fewer scientific contributions to guide the development of interventions aimed at community-based prevention. The goal of this proposal is to build upon a tailored injury prevention program (Safe ‘n Sound) and deliver highly relevant protective information to parents of young children to target the risk factors for abuse and neglect. Safe ‘n Sound is a computer-based program developed by our team that delivers tailored information to parents of children ages 0-4 about the specific injury prevention practices they can adopt in order to make their home and car safer for their child. Research has found that Safe ‘n Sound is an efficacious and effective means of delivering injury prevention messages to parents of young children and is easily adopted by clinic practices, but such an approach has never been used to prevent child maltreatment. Specifically, this project aims to: 1. Extend the scope of Safe ‘n Sound io address child abuse and neglect and related unintentional injury risk areas by developing and delivering culturally appropriate, health literate positive parenting messages to parents and pediatricians, specifically tailored to individual risk factors. 2. Implement the enhanced program in a community setting and examine factors related to adoption, use, sustainability and impact.

Small Project: Violence Surveillance Database Pilot

Child maltreatment, Sexual Violence, Suicide, administrative data, policy (I). Abstract Evidence Based Practice and Evidence Based Policy (termed EBP/P in this proposal) require that practitioners and policy makers have access to the best available evidence as part of their decision cycle. Indeed the lag between research findings and policy needs is one of the problems in effectively influencing policy. In the world of policy (including violence prevention), agencies/organizations that provide services often have to respond to policy concerns without the benefit of time to do controlled research. Having current violence surveillance and service use data available for agencies to access easily would help bridge the gap between evidence and policy as well as assist with evaluation. While many agencies relevant to prevention of CM, IPV, SV and SA maintain electronic databases these are typically not linked. This proposal outlines a demonstration project which will be designed in cooperation with public agency (state and local level) practitioner and policy makers, private social service personnel and academics with substantive knowledge in violence (Drake, Hovmand), data security (Gill), and data management (Drake). The primary purpose of this pilot is to develop this web-based application as a “proof of concept” demonstration, evaluate its utility, and refine the technical design requirements. This pilot will then provide the basis for seeking subsequent funding from state agencies, foundations, and federal agencies for larger scale development and testing. AIM 1: To develop a secure, multi-agency datacube pilot to provide access to current information on prevalence of detected CM, SV, and SA, their overlap, and related individual and services characteristics. AIM 2: To conduct alpha testing of the cube with one public and one private agency to assess feasibility, utility and validity of results, and identify any concerns with the use of this approach.