Public health approaches to family maltreatment prevention: Resetting family psychology's sights from the home to the community

Department of Psychology, Stony Brook University, NY 11794-2500, USA.
Journal of Family Psychology (Impact Factor: 1.89). 09/2008; 22(4):518-28. DOI: 10.1037/0893-3200.22.3.518
Source: PubMed


The authors review recent trends within the family maltreatment research field toward a public health approach, discuss the rationale for community-level interventions for family maltreatment, and sketch the history and development of community-level prevention approaches. Next, to illustrate the both the logistic and the scientific challenges of such work, the authors discuss the development and testing of an empirically guided, research-community partnership for the prevention of family maltreatment, the United States Air Force's NORTH STAR initiative (New Orientation to Reduce Threats to Health From Secretive Problems That Affect Readiness). Finally, recommendations are made for effective and disseminable family maltreatment prevention interventions.

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    • "The need for community involvement is stressed for all members of society to be aware of what to look for in detecting maltreatment. The more individuals are educated and active, the better the chances that children will be identified and helped (Slep & Heyman, 2008). "
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    • "An analysis of the prevalence of family conflict identified considerable variation across 30 communities varying in socio-economic status. This variation supports the requirement for community-based interventions (Slep and Heyman 2008). The findings from the multilevel regression analyses demonstrate that community variation in family conflict was only partly explained by location and socio-demographic factors entered into the models. "
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    ABSTRACT: Children's reports of high family conflict consistently predict poor outcomes. The study identified criteria for high family conflict based on prospective prediction of increased risk for childhood depression. These criteria were subsequently used to establish the prevalence of high family conflict in Australian communities and to identify community correlates suitable for targeting prevention programs. Study 1 utilised a longitudinal design. Grade 6 and 8 students completed a family conflict scale (from the widely used Communities That Care survey) in 2003 and depression symptomotology were evaluated at a 1-year follow-up (International Youth Development Study, N = 1,798). Receiver-operating characteristic analysis yielded a cut-off point on a family conflict score with depression symptomatology as a criterion variable. A cut-off score of 2.5 or more (on a scale of 1 to 4) correctly identified 69 % with depression symptomology, with a specificity of 77.2 % and sensitivity at 44.3 %. Study 2 used data from an Australian national survey of Grade 6 and 8 children (Healthy Neighbourhoods Study, N = 8,256). Prevalence estimates were calculated, and multivariate logistic regression with multi-level modelling was used to establish factors associated with community variation in family conflict levels. Thirty-three percent of Australian children in 2006 were exposed to levels of family conflict that are likely to increase their future risk for depression. Significant community correlates for elevated family conflict included Indigenous Australian identification, socioeconomic disadvantage, urban and state location, maternal absence and paternal unemployment. The analysis provides indicators for targeting family-level mental health promotion programs.
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