Appendix G
Summary of Evaluation Studies on Training of Health Care Professionals on Child Abuse and Neglect



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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Appendix G Summary of Evaluation Studies on Training of Health Care Professionals on Child Abuse and Neglect

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Child Abuse and Neglect   Nature of Training Provided Expected Outcomes and Measure Target Population (study citation) Intervention Group Comparison Group (if applicable) Study Design Major Outcomes Measure Medical students, residents, fellows, and attending physicians in pediatrics (Palusci & McHugh, 1995) Type: Mixed Length: 9-15 hrs.in a clinical rotation Clinical aids: None Other rotation comparison Two-group, nonequivalent group Knowledge of child sexual abuse Self-report (30 items) Residents in pediatrics (Dubowitz & Black, 1991) Type: Mixed Length: Six 90-min. sessions Clinical aids: None None Two-group, comparison group Knowledge, attitudes, and skills of child abuse Self-report (31 items) Perceived competency to manage child abuse cases Self-report (1 item) Residents in pediatrics (Sugarman et al., 1997) Type: Mixed Length: 8 hrs. Clinical aids: None Number of participants:22   One group Knowledge of child sexual abuse Self-report (33 items)

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Timing Sample Size and Attrition from Measurement Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up Baseline Posttest (months) Follow-ups (months) Intervention Comparison Within-Group Change Relative Group Difference Comment Yes Immediately after training   Enrolled = 15 Post = 15 (100%) Pre = 15 Pre = 15 (80%) Ipost > Ipre* Post = 12 Ipost > Cpost* The study also included a reference group who received no training and was administered the pretest. It consisted of 127 students, residents, and physicians who attended report and continuity clinic conferences. All groups did not significantly differ at the pretest. Yes 1 3-4 Eligible = 31 Pre = 31 Post = 31 (100%) Eligible = 19 Pre = 19 Post = 19 (100%) Ipost1 > Ipre* Ipost > Cpost* IFU > CFU The pretest scores of the two groups did not significantly differ. Ipost > Cpost* IFU > CFU* Yes Immediately after training   Eligible = Pre = 22 Post = 22 (100%) Not reported Ipost1 > Ipre*  

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Child Abuse and Neglect   Nature of Training Provided Expected Outcomes and Measure Target Population (study citation) Intervention Group Comparison Group (if applicable) Study Design Major Outcomes Measure Physicians, nurses, and caseworkers (Hibbard et al., 1987) Type: Mixed Length: 1 day Clinical aids: Anatomically correct dolls; handbook of potential interventions   One group Knowledge of child abuse Self-report Physicians, nursepractitioners, family practice and public health nurses, social w rkers, and secondary health educators (Sullivan & Clancy,1990) Type: Mixed Length: 1 day Clinical aids: None One group Number of sexual abuse indicators recalled Self-report Number of physical indicators of child abuse recalled Self-report Number of psychological indicators of child abuse recalled Self-report Number of behavioral indicators of child abuse recalled Self-report Number of specific actions to take in interviews Self-report

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Timing Sample Size and Attrition from Measurement Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up Baseline Posttest (months) Follow-ups (months) Intervention Comparison Within-Group Change Relative Group Difference Comment Yes 0.5 6 Eligible = 51 Pre = 38 (75%) Post = 35 (69%) FU =21 (41%)   Medical staff: Ipost1 >Ipre* IFU >Ipre* Social workers: Ipost1 >Ipre* IFU>Ipre*   Increased use of anatomically dolls was noted at the 6-month follow-up, but no data were reported. Yes Immediately after training 3, 6 Eligible = 350 Posttest only: Assigned = 85 Post = 82 (97%) Pre- and posttest: Assigned = 96 Post = 65 (68%) Pre- and FU: Assigned = 88 Post = 65 (74%) Pre- and FU2: Assigned = 81 Post = 41 (81%) Ipost1 >Ipre* IFU>Ipre* IFU2 <Ipost Groups were randomized to one of the four testing conditions. Because the design (anonymity of subjects)did not permit pairing pretest, posttest, and follow-up scores, the results on within-group change should be interpreted with caution. Results indicated no pretest effect on the immediate posttest. Significant differences on all but sexual abuse indicators are for all posttests and follow-up combined. Ipost1 >Ipre* Ipost1 >Ipre* Ipost1 >Ipre Ipost1 >Ipre*

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Child Abuse and Neglect   Nature of Training Provided Expected Outcomes and Measure Target Population (study citation) Intervention Group Comparison Group (if applicable) Study Design Major Outcomes Measure Child protective service workers, including social workers (Cheung et al., 1991) Type: Mixed Length: 6 hrs. Clinical aids: None   One group Ability to complete initial case planning Vignette (ratings) Ability to formulate goals Vignette (ratings) Ability to set objectives for family Vignette (ratings) Ability to develop a contract with family Vignette (ratings) Child protective service workers, including social workers (Leung &Cheung, 1998) Type: Mixed Length: 3 mo. training program Clinical aids: None One group Perceived information and experience to:   Identify abuse Self-report (1 item) Identify risk Self-report (1 item) Recognize indicators Self-report (1 item) Attitudes (e.g., value of family preservation and cultural differences) Self-report (9-item subscale)

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Timing Sample Size and Attrition from Measurement Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up Baseline Posttest (months) Follow-ups (months) Intervention Comparison Within-Group Change Relative Group Difference Comment Yes Immediately after training   Eligible = 18 Pre = 18 Post = 18   Ipost1 > Ipre   Ipost1 > Ipre* Ipost1 > Ipre Ipost1 > Ipre* Yes Immediately after training   Eligible = 413 Pre = 188 Post = 188 (100%)   The questionnaire on perceived knowledge and experience included 16 items, all of which showed statistically significant improvement. Sample sizes for the performance evaluation varied, given that most of the workers were not yet eligible for their second-   Ipost1 > Ipre*   Ipost1 > Ipre* Ipost1 > Ipre* Yes Immediately after training   Eligible = 23 Pre = 20 Post = 20 (100%)   Ipost1 > Ipre*  

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Child Abuse and Neglect   Nature of Training Provided Expected Outcomes and Measure Target Population (study citation) Intervention Group Comparison Group (if applicable) Study Design Major Outcomes Measure   Type: Mixed Length: 3 mo. training program Clinical aids: None Not specified but some training as random sample of current caseworkers Two-group, comparison group Performance on job, including use of interviewing techniques, determining presence of child abuse or neglect, implementation of case management plans, and sufficient case documentation Supervisor evaluation forms

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Timing Sample Size and Attrition from Measurement Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up Baseline Posttest (months) Follow-ups (months) Intervention Comparison Within-Group Change Relative Group Difference Comment No 6-9 12, 24 Eligible = 413 Post = 66 FU = 140 FU2 = 18 Eligible = ? Post = 39 FU = 50 FU2 = 46 IFU > Ipost* IFU2 > IFU* Ipost =Cpost year evaluation.

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