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OCR for page 317
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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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence
This page in the original is blank.
Representative terms from entire chapter:
abuse recalled
