Index

A

Abandonment, 70

Abuse Assessment Screen, 94

Abused Women Coalition, 256

Academy of Certified Social Workers, 56

Accreditation Council for Graduate Medical Education (ACGME), 36, 194

Accreditation requirements, 8, 9, 54-55, 81, 84-85, 131, 132, 149, 150, 194-196

Accreditation Review Commission on Education of the Physician Assistant (ARC-PA), 196

Administration for Children and Families, 4, 75, 156

Administration on Children, Youth, and Families, 75

Adolescent health program, 115, 117

Adult protective service workers, 104

Advocacy for Women and Kids in Emergencies (AWAKE), 236, 258

Advocacy groups, 9, 64-67, 150

Agency for Healthcare Research and Quality, 4, 68, 75, 77, 135, 156

Alabama, 206-207, 218-219, 250

Alabama Coalition Against Domestic Violence, 250

Alaska, 57, 66, 70, 71, 73, 127, 206-207, 218-219, 232, 234-235, 250

Alaska Family Violence Prevention Project (AFVPP), 66, 127, 234-235, 250

Allina Health System, 260

Alzheimer’s Association, 104, 247

Alzheimer’s disease centers program, 5, 152

American Academy of Family Physicians (AAFP), 198

American Academy of Pediatrics (AAP), 10, 27, 37, 60, 82, 117, 120, 156-157, 198, 235, 238, 239

American Academy of Physician Assistants (AAPA), 38, 60, 198-199

American Association of Colleges of Nursing (AACN), 10, 39, 40, 61, 110, 114-115, 156, 199

American Association of Orthopedic Nursing, 61

American Board of Examiners in Clinical Social Work, 64

American Board of Obstetrics and Gynecology, 55

American Board of Pediatrics, 37, 55, 56, 117-118

American College of Emergency Physicians (ACEP), 37, 200

American College of Nurse Midwives (ACNM), 10, 27, 39, 61, 65, 82, 114, 157, 204, 250



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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Index A Abandonment, 70 Abuse Assessment Screen, 94 Abused Women Coalition, 256 Academy of Certified Social Workers, 56 Accreditation Council for Graduate Medical Education (ACGME), 36, 194 Accreditation requirements, 8, 9, 54-55, 81, 84-85, 131, 132, 149, 150, 194-196 Accreditation Review Commission on Education of the Physician Assistant (ARC-PA), 196 Administration for Children and Families, 4, 75, 156 Administration on Children, Youth, and Families, 75 Adolescent health program, 115, 117 Adult protective service workers, 104 Advocacy for Women and Kids in Emergencies (AWAKE), 236, 258 Advocacy groups, 9, 64-67, 150 Agency for Healthcare Research and Quality, 4, 68, 75, 77, 135, 156 Alabama, 206-207, 218-219, 250 Alabama Coalition Against Domestic Violence, 250 Alaska, 57, 66, 70, 71, 73, 127, 206-207, 218-219, 232, 234-235, 250 Alaska Family Violence Prevention Project (AFVPP), 66, 127, 234-235, 250 Allina Health System, 260 Alzheimer’s Association, 104, 247 Alzheimer’s disease centers program, 5, 152 American Academy of Family Physicians (AAFP), 198 American Academy of Pediatrics (AAP), 10, 27, 37, 60, 82, 117, 120, 156-157, 198, 235, 238, 239 American Academy of Physician Assistants (AAPA), 38, 60, 198-199 American Association of Colleges of Nursing (AACN), 10, 39, 40, 61, 110, 114-115, 156, 199 American Association of Orthopedic Nursing, 61 American Board of Examiners in Clinical Social Work, 64 American Board of Obstetrics and Gynecology, 55 American Board of Pediatrics, 37, 55, 56, 117-118 American College of Emergency Physicians (ACEP), 37, 200 American College of Nurse Midwives (ACNM), 10, 27, 39, 61, 65, 82, 114, 157, 204, 250

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence American College of Obstetricians and Gynecologists (ACOG), 10, 27, 60, 62-63, 82, 156-157, 251 American College of Physicians, 10, 156, 252 American College of Surgeons (ACS), 200 American Dental Association (ADA), 10, 60, 156, 194, 200-201 American Medical Association (AMA), 10, 27, 47, 60, 156, 198, 200, 201 American Medical Women’s Association (AMWA), 201, 252 American Nurses Association (ANA), 39, 47, 60-61, 201 American Osteopathic Healthcare Association (AOHA), 194 American Psychological Association (APA), 10, 27, 40, 41, 42, 50, 60, 61, 64, 72 n.8, 81, 156, 195, 202, 236 American Society of Internal Medicine (ASIM), 252 Arizona, 206-207, 218-219, 242 Arkansas, 206-207, 218-219, 252 Association of American Medical Colleges (AAMC), 10, 50, 156 Association of Physician Assistant Programs, 38 Association of Professors of Gynecology and Obstetrics (APGO), 252 Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN), 39, 61 B Barriers to training barriers to practice and, 45 cognitive biases, 124-132, 139, 149 competency requirements as, 8, 9, 54-56, 81, 84-85, 149, 150 curriculum priority conflicts, 48-50 institutional culture and norms, 8, 9, 50-54, 81 intrinsic, 46-54 leadership issues, 53-54 measuring and addressing, 128, 130 perceptions of need, 8, 9, 46-48, 81 personal issues, 9, 59-60, 149, 150 privacy issues, 51-53 professional factors, 8, 9, 56-59, 149, 150 research base on, 45 resource constraints, 74-81, 83, 127 response of health care system to victims, 66, 142 third-party reimbursement policies and, 67-68 time constraints, 9, 57, 127 Battered child syndrome, 22, 24 Battered woman syndrome, 22 Battered women’s shelters, 64 Behavioral change in health professionals case studies, 132-134 concepts affecting, 108 in continuing medical education, 125-134, 148 systems approaches, 127-134, 139-140, 148-149 Benjamin Rose Institute, 247 Blue Shield of California, 67 Boston Medical Center, 258 Boston University, 76 Brown University, 236 Bureau of Health Professions, 40, 75 n.11 C California, 57, 70, 71, 73, 120, 206-207, 218-219, 226-227, 230, 237, 253 California Medical Training Center, 253 Cancer, 14, 28, 78 Carnegie Mellon University, 76 Center for Child Protection, 237 Center on Child Abuse and Neglect, 77, 237 Centers for Disease Control and Prevention, 4, 6, 15, 19, 25, 34, 75, 77, 78-79, 85 n.1, 135, 154, 156, 251 Centre for Evidence-Based Medicine, 135 Certification, 8, 9, 55, 56, 61, 149, 150 Charge to Committee, 1-2, 15 Child abuse and neglect cases reported, 14 categories, 24-25 certification requirements, 55 definitional issues, 22, 24-25 common elements, 24 core competencies, 115, 117-118 costs of health care, 29 current educational initiatives, 36, 37, 38, 39, 40-42, 43, 60, 64, 81, 84, 234-246, 265 deaths, 28, 29

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence evaluation of training initiatives, 9, 85, 86 nn.2,4, 87, 88-90, 92-93, 95-97, 98, 106 exposure to intimate partner violence, 25, 28-29, 42 funding for training, 77-78, 79 health effects of, 28-30 health professionals’ responsibilities, 14, 27 incidence of, 14, 24-25 licensure requirements, 55 mandatory education laws, 73, 150-151, 198, 230 mandatory reporting laws, 27, 52, 68, 69, 71, 118, 150-151, 206-217 outcomes of training, 9, 28, 92-93, 95, 99- 100, 317-325 parental authority issue, 51 perceptions of training adequacy, 87 research base, 3 and risk of becoming abusers, 29 shaken baby syndrome, 28 standardization of terminology, 34 as subspecialty, 117-118 Child Abuse and Neglect Working Group, 34 Child Abuse Prevention and Treatment Act of 1974, 64, 77, 79 Child Advocacy Center, 239 Child protective services workers, 99, 322-325 Child Witness to Violence Project, 258 Children’s Bureau, 34, 75 Children’s Hospital and Health Center (San Diego), 237 Children’s Hospital Medical Center (Cincinnati), 239 Children’s Hospital of Boston, 236, 258 Children’s Hospital of Philadelphia, 238 Children’s Memorial Hospital (Chicago), 239 Children’s Mercy Hospital (Kansas City), 243 Clinical Social Work Federation, 64 Cochrane Collaboration, 134-135, 136 Cognitive biases cognitive heuristics and, 124-125 continuing medical education and, 125-127 debiasing, 8, 125, 139, 148, 149 systems change models and, 127-132, 139-140, 148-149 College of St. Catherine, 253 Colorado, 41, 70, 206-207, 226-227, 254 Commission on Accreditation of Allied Health Education Programs (CAAHEP), 196 Commission on Collegiate Nursing Education Accreditation (CCNE), 195 Commonwealth v. McAfee, 51 Community health center staff, 102, 103, 254, 262, 288-289, 294-295, 312-313 Computer Retrieval of Information on Scientific Projects (CRISP), 77 Connecticut, 70, 206-207, 218-219, 254 Connecticut Primary Care Association, 254 Continuing medical education behavioral change models, 125-134, 148 cognitive biases and, 125-127 current programs, 37, 40, 41, 42, 43, 49, 198, 234-235, 238, 239, 242-244, 252, 253, 256, 257, 259-263, 267 effective teaching strategies, 89, 148 evidence-based practice in, 135 formal, 126-127 impacts of, 74, 126-127 perceptions of adequacy of, 49-50 policy statements of professional organizations on, 198 and screening for abuse, 57-58 Cook County Hospital, 256 Core competencies. See also Curriculum;Knowledge acquisition;Training and education achievement through training, 122-134 advanced, 111-112, 115, 117, 139 as barriers to training, 54-56, 81, 84-85 basic, 7, 111, 115, 116-117, 138-139, 147 child abuse and neglect, 115, 117-118 common elements, 113-114, 147 conclusions of Committee, 7, 138-139 cultural, 42, 119-122 defined, 7, 109, 147 domains, 113-114, 118, 147 elder maltreatment, 112, 115 evaluation of, 109, 113, 148 evidence base, 108-109, 112-118 forensic services, 111-112, 118-119, 132, 242 importance of, 109 integrated delivery networks, 111 interpersonal, 114 leadership, 111, 139 levels differentiated, 109-111 Oklahoma Principles, 110 and outcomes of training, 113 performance indicators, 116-117 role assignments for providing care, 111-112, 139, 327-329

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Costs of health care, 3, 29, 31-32, 33, 67-68, 145 Council on Social Work Education (CSWE), 10, 27, 42-43, 156, 196 Cultural considerations, 42, 119-122 Curriculum. See also Core competencies defined, 19 evidence-based practice in, 135, 136 existing programs on family violence, 61, 233-268 integrated content, 126-127 perceptions of adequacy, 6, 44 priority conflicts, 48-50 D Definitional issues family violence, 4, 17-18, 21-27, 33-34, 145-146 and prevalence/incidence estimates, 21-22, 145-146 professional responsibility, 4, 18, 19, 27-33 responses of health professionals to family violence, 19 standardization initiatives, 33-34 training and education, 18-19 Delaware, 70, 206-207, 218-219 Dental Coalition to Combat Child Abuse and Neglect, 38-39 Dentists and dental hygienists accreditation, 55 beliefs about family violence, 47-48 reporting of abuse, 71 training programs, 38-39, 49-50, 73, 89, 136, 194, 198, 237, 240, 247, 260, 261 Detection of family violence, 19 District of Columbia, 70, 206-207, 218-219, 268 Domestic violence. See Intimate partner violence Duke Medical Center, 239 E Education. See Evaluation of training efforts; Training and education Education and research centers, 5-6, 152-156 Education Development Center, 142 Elder maltreatment categories, 26 common elements, 24 core competencies, 112, 115 current educational initiatives, 36, 37, 38, 39-40, 42, 43, 84, 104, 146, 247-249 definitional issues, 26-27 evaluation of training initiatives, 85-86, 87, 106 funding for training, 76, 77, 78, 79 health effects of, 32-33 health professionals’ responsibilities, 27 incidence/prevalence of, 26-27, 34 institutional, 36 licensure requirements, 55 mandatory education laws, 73, 231 mandatory reporting laws, 27, 68, 70-71, 218-225 outcomes of training on, 104-105 professionals’ perceptions of adequacy of training, 49-50 screening problems, 32 self-neglect, 23, 27 standardization of terminology, 34 survey of, 34 survival rates, 27, 32 utilization of health care services, 32 Emergency departments certification requirements, 56 outcomes of training, 100 n.10, 101, 102, 103, 104-105, 278-287, 292-293, 296-297 training programs, 64, 89, 234-235, 253, 263, 304-307 utilization of services, 13, 30, 31, 32 Emergency medical technicians, 86 n.4, 278-279 Emergency Nurses Association (ENA), 39, 61, 202 ERIC, 85 Evaluation of training efforts. See also Outcomes of training barriers to, 84-85, 106 characteristics assessed, 88, 92-97 for child abuse and neglect, 9, 85, 86 nn.2,4, 87, 88-90, 92-93, 95-97, 98, 106, 151 conclusions of Committee, 6-7, 107, 146-147 core competencies, 109, 113 critical questions, 74, 91 current initiatives, 65 design issues, 6-7, 86-87 n.4, 90-91, 96-97, 98, 106, 107, 136, 146-147 for elder maltreatment, 85-86, 87, 106

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence follow-up component, 90, 95, 97 funding for, 3, 4, 85, 151-152, 159-160 infrastructure support for, 81 internal validity, 90-91 methodologies, 11, 90-92, 100, 103-104, 106 outcome measures, 7, 86, 90, 91, 92, 93-99, 146-147 population relevant to, 86 quality of evidence, 6-7, 105-107 quantitative comparisons, 92 n.8 quasi-experimental design, 7, 91, 96-97, 106, 107, 136, 146, 159 randomized field experiments, 90-91, 96, 98, 100, 102, 103, 105, 106, 107, 147, 159 recommendations, 11, 143, 158-160 scope of Committee review, 19 search for studies, 85-87 time series and cohort studies, 91, 98 types of interventions, 57-58, 88-90 Evidence-based practice, 8, 134-137, 140, 149 F Family Peace Project, 268 Family violence data deficiencies, 2-3, 4, 33, 41 n.2, 145, 146 definitional issues, 4, 17-18, 21-27, 33-34 evidentiary requirements, 22, 146 funding for training, 77, 79 health effects of, 1, 13-14, 28-33, 145 health professionals’ roles, 2, 4, 27-33 magnitude of problem, 1, 2-3, 4, 13, 21-22, 33, 109, 145, 146 prevention, 245 research needs, 3-4, 33 symptoms of, 48 types of, 17-18 underreporting of, 13-14 Family Violence Prevention and Services Act, 79 Family Violence Prevention Fund, 64, 66, 68, 82, 85 n.1, 254 Family Violence Task Force, 236, 258 Financial exploitation, 23, 27, 70 Florida, 38, 71, 73, 206-207, 218-219, 232, 248, 252, 255, 261 Florida International University, 255 Florida State University, 255 Food and Drug Administration, 77 Forensic services, 111-112, 118-119, 132, 242, 243, 246, 253 Fulgham v. State, 51 Funding issues, 3, 4-5, 74-80, 81, 83, 85, 142, 151-152, 159-160 G Gender violence. See Intimate partner violence George Washington University, 268 Georgia, 206-207, 218-219 Geriatric Education Center Program, 40, 153 Geriatricians, 112 Gorman v. State, 51 Group Health Cooperative of Puget Sound, 67, 138, 148, 157, 255 H Harborview Injury Prevention and Research Center, 255 Harvard Youth Violence Prevention Center, 152-153 Hawaii, 120, 208-209, 218-219, 240, 247 Hawaii Dental Hygienists’ Association, 240, 247 Health care providers, 67-68, 236, 248, 250, 252-254, 255, 258, 259, 260 Health Education Alliance (San Jose), 253 Health effects of family violence, 3-4, 13-14, 28-33, 145 Health insurance organizations, 9, 67, 150 Health professional organizations. See also individual organizations influence on training, 8, 9, 36, 37, 65, 82, 142, 149, 150 policies and guidelines on training, 27, 60-64, 197-204 recommended roles, 10, 156-157 Health professionals. See also Training and education adequacy of training, 49, 50 beliefs about family violence, 8, 9, 47-49, 52, 59, 81, 149, 150 certification of, 56 clinical responsibility, 27 core competencies, 111, 114, 234-235 definitional issues, 4, 18, 19, 27-33 educational materials for, 60, 252

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence groups most likely to encounter victims, 2, 18, 89 legal responsibilities, 27 licensure requirements, 55 marginalization of, 53 outcomes of training, 99, 288-291, 306-307, 318-321 perceptions of training adequacy, 6, 14, 44, 47, 49-50, 57, 61, 64, 81, 87 personal experience with violence, 59, 81, 150 reporting of abuse, 14, 82-83 responses to family violence, 19, 56-60, 142 role assignments for providing care, 111-112, 139, 327-329 testimony in court, 118-119 time constraints, 57 vicarious traumatization, 59-60, 150 Health Professions Education Partnerships Act of 1998, 15 Health Research Services Administration, 61 Health Resources and Services Administration, 4, 74, 77, 115, 153, 156, 255 HealthPartners Family Violence Prevention Program, 260 Healthplan Employer Data and Information Set (HEDIS), 8, 131, 132, 134, 137-138, 140, 148, 149 Healthy People 2000 objectives, 79, 80 Hemenway, David, 152-153 Home visitors, 104-105, 234-235 Hospital Crisis Intervention Project, 256 Hospitalizations of abuse victims, 30-32 Human resources, for education and training, 80-81 I Idaho, 71, 208-209, 220-221 Illinois, 208-209, 220-221, 239, 256 Indiana, 208-209, 220-221, 256 Indiana University School of Medicine, 256 Institute for Family Violence Studies, 255 Institute of Medicine, 3, 17, 105, 127, 143, 146, 151 Institutional culture and norms, 50-54, 81 Integrated Health Services, 248 Intimate partner violence categories, 25 certification requirements, 55 children’s exposure to, 25, 28-29, 42 clinical outcomes, 103-104 common elements, 24 core competencies, 110, 120 current educational initiatives, 36, 37, 38, 42, 43, 47, 84, 127, 250-268 deaths, 30 definitional issues, 25-26, 34 economic costs, 31-32 evaluation of training initiatives, 85, 86 n.2, 87, 88-90, 92, 93, 94-97, 98, 106-107 female victims, 25-26, 30 funding for training, 78, 79 guidelines of health professional organizations on, 60-61 health effects, 30-32 incidence/prevalence of, 25, 30-31 male victims, 25-26, 30 mandatory education laws, 73, 232 mandatory reporting laws, 68, 69-70, 71, 72, 226-227 outcomes of training on, 100-104 perceptions of health professionals about, 47, 51-53, 57, 66 referral of victims, 57 research base, 49 response of health care system to, 66, 68 screening for, 57-58, 59, 89, 101-103 special populations, 26, 30, 60 standardization of terminology, 34 and utilization of health care services, 30-31 victims of, 25, 67 Intimate partners, defined, 23 Iowa, 73, 208-209, 220-221, 230, 231 J John A. Hartford Institute for Geriatric Nursing Practice, 40 Johns Hopkins University, 76 Joint Commission on Accreditation of Healthcare Organizations (JCAHO), 202 K Kaiser Permanente of Northern California, 67, 132, 148, 157 Kansas, 70, 208-209, 220-221 Kemp Children’s Center, 244 Kentucky, 73, 208-209, 220-221, 226-227, 232, 256-257

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Knowledge acquisition andragogy principles, 123-124 behavioral models, 8, 122-123, 125-126, 128-130, 132-134, 148 cognitive heuristics, 124-125 debiasing and, 8, 125 evidence-based practice and, 136-137 Koop, C. Everett, 46-47 L Law Enforcement Child Abuse Project of Philadelphia, 239 Leadership issues, 111, 139 Liaison Commission on Medical Education (LCME), 194 Licensure, 8, 9, 40, 55, 149, 150 Louisiana, 208-209, 220-221, 240 Louisiana State University, 240-241, 257 M Maine, 208-209, 220-221 Maltreatment, definitions of, 22 Mandatory education laws child abuse curriculum, 73, 198, 230 elder maltreatment, 73, 231 health professionals affected by, 73 impacts, 73-74, 83, 149, 150-151 intimate partner violence, 73, 232 requirements, 37, 73, 106 state standards, 229-232 Mandatory reporting laws child abuse and neglect, 27, 52, 68, 69, 71, 118, 150-151, 206-217 for data collection purposes, 70-71 elder maltreatment, 27, 68, 70-71, 118, 218-225 exemptions from, 70, 71 health professionals responsible for, 27, 69, 70, 71 impacts of, 71-72, 82-83 intimate partner violence, 68, 69-70, 71, 72, 118, 226-227 limits on, 69 requirements, 69-71, 106 research base on, 9, 72 standards, by state, 70, 205-227 and training of health professionals, 8, 9, 68-69, 72, 73, 82-83, 118, 149, 150-151 victims’ concerns about, 9, 72, 82-83, 150 March of Dimes, 257 Maryland, 208-209, 220-221, 257 Maryland Alliance Against Family Violence, 257 Maryland State Medical Society, 257 Massachusetts, 38-39, 210-211, 220-221, 241, 258-259 Massachusetts Medical Society, 259 Massachusetts Society for the Prevention of Cruelty to Children, 241 Maternal and Child Health Bureau, 115, 117 Maternal and child health providers, 250, 310-311 Mayerson Center for Safe and Healthy Children, 239 McMaster University, 126, 128 MEDCEU, 259 Medical Directions, Inc., 267 Medical Education Collaborative, 266 Medical Education Foundation, 252 Medical Legal Advisory Board on Child Abuse, 239 Medical schools accreditation requirements, 194 evidence-based practice in, 135 professionals’ perceptions of adequacy of training, 49-50 Medical students outcomes of training, 99, 100, 101, 270-275, 298-299, 318-319 training programs for, 35-36, 194, 234, 236, 237, 252, 259, 265, 268 Medical University of South Carolina, 76 MEDLINE, 85 Medulogic, 260 Mental health services referral of victims for, 57 training initiatives, 40-42, 49-50, 132, 195, 236, 237, 258, 262 utilization, 31 Michigan, 210-211, 220-221 Minnesota, 70, 210-211, 222-223, 260-261 Mississippi, 210-211, 222-223 Missouri, 70, 210-211, 222-223 Montana, 210-211, 222-223 Mortality rates, 28, 29, 30, 32

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence N National Association for Children of Alcoholics, 109-110 National Association of Orthopedic Nurses (NAON), 27, 203 National Association of Pediatric Nurse Associates & Practitioners, Inc. (NAPNAP), 195 National Association of Social Workers (NASW), 60, 64, 203 National Association of State Units on Aging, 78 National Black Nurses’ Association, 61 National Board of Medical Examiners, 55 National Campaign Against Family Violence, 201 National Center for Injury Prevention and Control (NCIPC), 154 National Center on Child Abuse and Neglect (NCCAN), 64, 77, 106 National Center on Elder Abuse, 78 National Centers of Excellence in Women’s Health, 256 National Clearinghouse on Child Abuse and Neglect (NCCAN), 34 National Committee for Quality Assurance (NCQA), 137 National Consortium on Violence Research, 75 National Council on Boards of Nursing, 55 National Institute for Child Health and Human Development, 34 National Institute of Justice (NIJ), 4, 76, 156 National Institute of Mental Health (NIMH), 3, 75, 76, 143 National Institute on Aging (NIA), 34, 76, 77, 152 National Institute on Nursing Research, 76 National Institutes of Health (NIH), 4, 34, 76-77, 80, 142, 156 National League for Nursing Accrediting Commission (NLNAC), 195 National Library of Medicine, 135 National Nursing Summit on Violence Against Women, 61 National Research Council (NRC), 18-19, 78, 105, 146, 151 Committee on National Statistics, 34 Committee on the Assessment of Family Violence Interventions, 3, 17, 127, 143 National Science Foundation (NSF), 76 National Violence Against Women Prevention Research Center, 78-79 National Violence Against Women Survey, 25-26 Nebraska, 71, 210-211, 222-223 Neglect, 23, 24-25, 27 Network for Continuing Medical Education, 261 Nevada, 70, 210-211, 222-223 New Hampshire, 70 n.7, 210-211, 222-223 New Jersey, 70, 210-211 New Mexico, 120, 212-213, 222-223 New York State, 70, 73, 212-213, 230, 248 North Carolina, 70, 212-213, 222-223 North Dakota, 70, 212-213 Northern Illinois University, 76 Nova Southeastern University, 38, 241, 248, 261 Nurse midwives, 40, 56, 250, 257, 288-289 Nurse practitioners, 56, 195, 320-321 Nurses. See also professional organizations accreditation, 55 beliefs about family violence, 47-48, 59 core competencies, 111-112, 114-115, 117, 327-329 outcomes of training, 103, 278-279, 294-295, 308-309, 320-321 public health, 103, 294-295, 312-313, 320-321 sexual assault examiners, 111-112 training programs, 39-40, 49-50, 52-53, 64, 73, 76, 135, 136, 195, 199, 237, 253, 256, 257, 259, 260, 262, 267 victimization experiences, 59 Nursing Network on Violence Against Women International, 65 O Office of Assistant Secretary for Health, 77 Office of Community Services, 75 Office of Justice Programs, 4, 156 Office of Minority Health, 255 Office on Child Abuse and Neglect (OCAN), 64, 77 Office on Women’s Health, 61 Ohio, 212-213, 222-223, 242, 247, 261 Ohio State Medical Association, 261 Ohio State University, 242 Oklahoma, 212-213, 222-223, 237 Oklahoma Principles, 110

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Older Americans Act, 78, 79 Oregon, 38, 71, 212-213, 224-225, 261 Oregon Health Sciences University, 261 Osteoporosis, 32 Outcomes of training. See also Patient outcomes assessment instruments, 93-95 on child abuse, 28, 92-93, 95, 99-100, 317-325 clinical intervention practices, 9, 92-93, 94, 97, 98, 99, 103-104, 107, 292-297, 324-325 core competencies and, 113 domains, 86, 92-93 on elder abuse, 104-105 on intimate partner violence, 92, 94, 95, 100-104, 270-315 knowledge, attitudes, and beliefs, 7, 92-93, 94, 97, 98, 99-100, 101, 105, 106, 107, 270-291, 318-323 quality of care, 92, 103, 104, 137 research base on, 105-107, 141, 147 screening, identification, and detection, 92-93, 94-95, 97, 98, 101-103, 104, 105, 107, 298-315, 322-323, 324-325 supportive environment and, 10, 107, 147 systems approach and, 132 timing of measurements, 95-96 P Pacific Business Group on Health, 67 Parkland Hospital (Dallas), 263 Patient outcomes. See also Health effects of family violence;Outcomes of training child abuse victims, 28 evidence-based practice and, 8, 136-137, 140, 148 Pediatric intensive care, 29-30 Pennsylvania, 41, 70, 127, 212-213, 238, 239, 262 Pennsylvania Coalition Against Domestic Violence, 127 Perinatal hospital staff, 282-285, 296-297, 308-309 Perpetrators, 23, 42, 71, 150 Phelps, Tony, 152 Philadelphia Child Fatality Review Team, 239 Philadelphia Family Violence Working Group, 262 Physical abuse, 22, 23, 24, 26, 27, 28, 245 Physician assistants accreditation requirements, 55, 196 policy statements of professional organizations, 198-199 training programs, 38, 89, 241, 248, 253, 261 Physicians. See also Continuing medical education; Medical students; Residency training programs Physicians for a Violence-Free Society, 65, 262 Physicians for Social Responsibility, 262 Policy statements of professional organizations, 198 Post-traumatic stress syndrome, 30, 59-60 Pregnancy, unintended, 30 Pregnant women, as victims of abuse, 26, 30, 60, 103, 251, 257 Prenatal health clinic staff, 296-297, 314-315 Presidential Task Force on Violence and the Family, 40, 50, 61, 64 Prevent Abuse and Neglect Through Dental Awareness (PANDA), 38 Prevent Child Abuse America, 29 Primary care team members, 101, 102, 255, 290-291, 296-297, 314-315 Privacy of family matters, 51-53 Professional organizations. See Health professional organizations Professional Resource Press, 262 Program Against Sexual Violence, 261 Protective order statutes, 51 PSYCHInfo database, 85 Psychological/emotional abuse, 22-24, 28 Psychologists. See also Mental health services accreditation, 55 beliefs about family violence, 47-48 core competencies, 117 training programs, 40-42, 49-50, 195, 234-235, 236, 237, 258, 262 vicarious traumatization, 60 Public Health Services Act, 75 Public health staff training, 103, 135, 136, 237, 294-295, 312-313, 320-321 R Recommendations developing, testing, and evaluating training programs, 10-11, 157-158 education and research centers, 5-6, 152-156 evaluation methodologies, 158-160

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence health professional organizations’ roles, 10, 156-157 of prior studies, 143-144, 152 Referral of family violence victims, 19 Reporting of abuse. See also Mandatory reporting laws by dentists, 71 immunity for, 69 mandatory education laws and, 73 voluntary, 69 Reproductive health care providers, 237, 250, 252 Research on family violence. See also Evaluation of training efforts adequacy of, 3, 9, 16, 45, 49, 108-109, 112-118, 141-142 funding, 4-5, 75, 142 mandatory reporting laws, 72 recommended, 5, 152, 154 response to prior recommendations, 2-3, 143-144 survey methods and populations, 22 victim partnerships in, 66, 67 Residency Review Committees (RRC), 36, 117, 194 Residency training programs accreditation requirements, 194 child abuse and neglect, 36-37, 234, 236, 237, 238, 239, 240-241, 242, 245, 246 core competencies, 117 elder maltreatment, 36, 37 intimate partner violence, 36, 37, 251, 255, 256 outcomes of, 99, 101, 102, 104, 105, 136, 274-277, 280-281, 292-293, 298-303, 318-319 perceptions of adequacy of training, 49-50 policy statement of professional organizations, 198 Rhode Island, 70, 212-213, 224-227, 236 Robert Wood Johnson Foundation, 142 S Sacred Heart Medical Center (Spokane), 268 Same-sex relationships, violence in, 26, 42 Screening for family violence assessment/diagnostic tools, 88, 89-90, 94-95, 102, 103 defined, 19 disciplinary policies, 103 for elder maltreatment, 32 for intimate partner violence, 57-58, 59, 89, 101-103 as outcome measure of training, 92-93, 94-95, 97, 98, 101-103, 298-315, 322-323, 324-325 personal experiences of professionals and, 59 professional organizations’ recommendations, 60-61, 64 rates, 54, 103 reimbursement policies, 67-68 training and, 46 n.1, 57-58, 88 Select Media, 263 Self-neglect, 23, 27 Sexual abuse certification requirements, 56 of children, 24, 28, 29, 40, 42, 64, 237, 242, 245 costs of health care, 29 defined, 23 health effects of, 28, 30 of intimate partners, 26, 31, 36 licensure requirements, 55 training and education on, 36, 237, 242, 245 Sexual assault, 36, 53, 64, 67, 111-112 Shaken baby syndrome, 28 Social Security Act, 78, 79 Social workers accreditation, 55 beliefs about family violence, 47-48, 52-53 certification, 56 core competencies, 112, 117 outcomes of training, 320-325 referrals to, 57 training programs, 42-43, 49-50, 64, 73, 136, 196, 237, 244, 245, 253, 255, 257, 260, 262, 263, 264, 265, 266, 267-268 Society for Academic Emergency Medicine (SAEM), 263 Society for Adolescent Medicine, 117 Society of Teachers of Family Medicine, 120 Sociological Abstracts, 85 South Carolina, 214-215, 224-225 South Dakota, 70, 214-215 Spousal abuse. See Intimate partner violence St. Joseph’s Hospital (Phoenix), 242 State University of New York, 243 State v. Jones, 52 State Victim Compensation and Assistance Fund, 77

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Substance abuse, 14, 29, 30 Substance Abuse and Mental Health Administration, 77 Suicide/suicidal behavior, 29, 30 Survey methods, 86 n.3 Syracuse University Health Center, 243 Systems change models, 127-132, 139-140, 148, 148-149 T Tallahassee Memorial Regional Medical Center, 255 Team for Children at Risk, 243 Tennessee, 214-215, 224-225 Terra Nova Films (ELDER), 248 Texas, 214-215, 224-225, 263 Training and education. See also Barriers to training;Continuing medical education; Evaluation of training efforts; Knowledge acquisition;Medical schools; Residency training programs academic detailing, 128-129, 130 accreditation requirements and, 8, 9, 54-55, 81, 84-85, 131, 132, 149, 150, 194-196 adequacy of, 1, 14, 44, 47, 49-50, 87, 146 adult education principles, 8, 123-124, 139 advocacy groups and, 64, 66, 80, 82, 134, 149, 150 amount of, 35-36 assessment/diagnostic tools, 88 behavioral change models, 7-8, 107, 125-126, 139-140, 148 booster sessions, 133 capacity building strategies, 141-145, 152-156 case-based methods, 67 certification requirements and, 8, 9, 56, 61, 81, 149, 150 collaborative programs, 108, 110, 127, 129, 130, 144-144, 237 conclusions of Committee, 6, 43-44 content, see Core competencies current initiatives, 35-44, 233-268 definitional issues, 18-19 effectiveness of, 84 environmental enabling factors, 129-132, 133 evidence-based practice and, 8, 133-134, 135-136, 137, 148, 149 formal, 86 funding issues, 4-5, 74-80, 81, 83, 151-152 health care providers/payers and, 67-68, 80, 82 HEDIS and, 8, 131, 132, 134, 137-138, 140, 148, 149 human resources, 66-67, 80-81 incentives for participation, 58-59, 129, 132 interactive meetings, 129, 130, 148 intervention planning models, 128-129 learning organizations and, 133 licensure requirements and, 8, 9, 55, 81, 149, 150 mandatory education laws and, 8, 9, 73-74, 83, 149, 150-151 mandatory reporting laws and, 8, 9, 68-72, 73, 82-83, 149, 150-151 materials, 41-42, 60, 81, 253, 254 organizational environment, 129, 131-132, 133 outcome measurement and reporting and, 8, 134, 140, 148 perceptions of adequacy, 87 political considerations, 79-80 practice environment, 129-132 precede/proceed model, 128-133 predisposing factors, 128, 130, 132, 133 professional organizations’ influence on, 47, 60-64, 65, 82 recognition of need for, 46-48 recommendations, 10-11, 154-155, 157-158 reflective practice, 133 reinforcing factors, 131, 132-133, 148 responsibility for developing, testing, and evaluating, 10-11, 157-158 scope of Committee assessment, 15-17, 19 teaching strategies, 6, 7-8, 19, 36, 37, 39 n.1, 44, 67, 88, 89, 126, 127-132, 139-140, 146, 148, 234-268 time allocated for, 6, 35-36, 37, 39, 40, 44, 49-50, 73, 88, 146 victim participation in, 66-67, 80, 82 U University of Arkansas for Medical Sciences, 252 California at Davis, 243 California at Los Angeles, 101 Chicago Pritzker School of Medicine, 256 Cincinnati, 239 Colorado Hospital, 244

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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence Connecticut Health Center Domestic Violence Training Project, 254 Iowa, 263 Kentucky, 264 Maryland Medical System, 244 Massachusetts Medical School, 259 Michigan, 244-245, 264-265 Minnesota, 261, 265 New Hampshire, 76 North Carolina at Chapel Hill, 245 Oklahoma Health Sciences Center, 77, 237 Pittsburgh, 245, 265-266 St. Thomas, 253 Texas at Austin, 246, 266 Toronto, 126, 128 Virginia, 132, 148, 157 Washington, 255 Unwarranted control, defined, 23 U.S. Advisory Board on Child Abuse and Neglect (ABCAN), 3, 141-142, 143 U.S. Department of Health and Human Services (DHHS), 3, 4, 5, 29, 34, 61, 74-75, 78, 79, 120, 143, 152, 153, 156 U.S. Department of Housing and Urban Development (HUD), 76 U.S. Department of Justice (DOJ), 4, 29, 78, 156 U.S. General Accounting Office (GAO), 6, 156 U.S. Healthcare, 266 U.S. Public Health Service, 61 Utah, 214-215, 224-225 Utilization of health care services child abuse victims, 13, 29-30 data adequacy, 3, 33, 145 by elder abuse victims, 13, 32 for intimate partner violence, 13, 30-31 mandatory reporting laws and, 71 V Vanderbilt University, 246 Vantage Professional Education, 267 Vermont, 214-215, 224-225 Victim Assistance and Law Enforcement Fund, 77 Victims. See also Health effects of family violence; Patient outcomes advocacy by, 9, 66-67, 150 concerns about mandatory reporting laws, 9, 72, 82-83, 150 defined, 23 disclosure of abuse, 59 noncompliance with medical advice, 58, 59 research partnerships with, 66, 67 response of health care system to, 66, 142 training involvement, 66-67, 150 Victims of Crime Act, 79 Violence against women. See Intimate partner violence Violence Against Women Act (VAWA), 78, 79 Violence Intervention Prevention (VIP) Center, 263 Violent Crime Control and Law Enforcement Act, 78 Virginia, 214-215, 224-225 Virtual Lecture Hall, 267 W Washburn University, 267-269 Washington, DC. See District of Columbia Washington Business Group on Health, 67 Washington State, 214-215, 224-225, 268 West Virginia, 214-215, 224-225 Western Schools, Inc., 246 Wisconsin, 70, 216-217, 248, 249, 268 Wisconsin Coalition Against Domestic Violence, 248, 249 W.K. Kellogg Foundation Fellowships in Health Policy Research, 142 WomanKind program, 85 n.1 Women childhood victimization, 29 costs of health care, 29 intimate partner violence, 14, 30, 72, 60-61, 62-63, 64 untreated victims, 14 Work Group on the Prevention of Violence During Pregnancy, 251 Working Group on Implications for Education and Training of Child Abuse and Neglect, 41, 50, 81, 236 World Psychiatric Association, 27 Wyoming, 70, 216-217, 224-225 Y Young adults, 26