. "4 Forces Influencing Health Professionals' Education." Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press, 2002.
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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence
violence research by NIH or NIH-supported scientists revealed no entries for “family violence,” “spouse abuse,” “domestic violence,” or “child abuse.” The only family violence entry was for “elder abuse,” accompanied by a link to the National Institute on Aging. The Computer Retrieval of Information on Scientific Projects (CRISP) database revealed 93 projects including the phrase “child abuse,” 63 including “spouse abuse” (38 for “domestic violence”), and 4 for “elder abuse” currently (1999-2000) funded by several federal agencies (the National Institutes of Health, the Substance Abuse and Mental Health Administration, the Health Resources and Services Administration, the Food and Drug Administration, the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the Office of Assistant Secretary of Health). Some projects are listed twice (due to multiyear funding across the reporting year) and some projects only mention, rather than focus on, family violence. In other cases, currently funded projects are not included in the database. Funding amounts for these projects are not disclosed.
The allocation of federal funds for child abuse and neglect has been primarily in response to federal legislation, the Child Abuse Prevention and Treatment Act of 1974 (CAPTA—P.L. 93-247), which was reauthorized in 1996. As mentioned earlier, CAPTA established the National Center on Child Abuse and Neglect (NCCAN), defined child abuse and neglect, and supported other demonstration programs and projects to prevent, identify, and treat child abuse and neglect. In addition to allocating funds directly, CAPTA authorizes aid to states for child abuse and neglect programs. The program authorizes funds through 2001 and $99.3 million has been requested for 2001. These funds finance four broad programs, none of which explicitly include training: child abuse state grants, child abuse discretionary grants, community-based family resource and support grants, and an adoption opportunities program. The discretionary grants may include training. NCCAN did do a one-time funding of multidisciplinary training programs, a few of which remain (e.g., the Center on Child Abuse and Neglect, University of Oklahoma Health Sciences Center). NCCAN was reorganized as the Office of Child Abuse and Neglect (OCAN) in 1996 with 80 percent fewer staff. Among other activities, OCAN published the “Child Abuse and Neglect State Statutes Series” (NCCAN, 1997) to provide some information for health care providers about reporting mandates for child abuse and neglect. OCAN does not actively disseminate the information to health care providers or evaluate the impact of the information provided. State Victim Compensation and Assistance and Victim Assistance and Law Enforcement funds, allocated through the U.S. Department of Justice, have sometimes been used for the continued training of professionals in evaluating criminal forms of maltreatment, but the focus is not on health professionals.
Funding for health professional training for child abuse and neglect appears to be decreasing in proportion to the growth of the problem (Theodore and Runyan, 1999). For example, between 1980 and 1986, while the reported inci-