Disruption paper winners

TRAINING & EDUCATION

WINNERS: Lisa Schelbe, Ph.D., MSW; Donna L. Wilson, Ph.D., LPC; Wade Fickler; Nina Williams-Mbengue; and J. Bart Klika, Ph.D., MSW 

Bridging the Gaps between Research, Policy, and Practice in the field of Child Maltreatment through Cross-Sector Training and Innovation

The disconnects between research, policy, and practice are widely recognized. These three sectors are frequently siloed, and all of them have unique and systemic impediments to collaboration. At the same time, harnessing their individual strengths in a collective manner could solve the challenging social problem of child maltreatment. State policies greatly influence the provision of child welfare services and child maltreatment prevention efforts, and programs and services typically are administrated at least in part at the state level. As such, improving cross-sector collaboration at the state level is paramount. To build effective and lasting collaborations, teams of researchers, policymakers, and practitioners must be trained to understand each other’s strengths and barriers to collaboration. The vision of this initiative is to train policymakers how to use data to make decisions related to child maltreatment prevention; train researchers how to develop and present their research so that it is useful to policymakers and practitioners; train practitioners how to implement practices that align with current research and policy; and develop a framework that jurisdictions across the nation can use to better align research, policy, and practice to prevent child maltreatment. Applying the principles of Design Thinking within a cross-sector training and collaboration has the potential to disrupt and radically change how these sectors work together to end child maltreatment. 

CLINICAL

WINNER:  Babcock, Patricia

What if Child Maltreatment was Childhood Leukemia?: Lessons from the Halls of the Hospital

This paper aims to examine the aspects of childhood acute lymphoblastic leukemia (ALL) prevention, research, training, and clinical treatment that can be applied to child welfare. Since the 1960s, childhood cancer researchers have been able to reach a 98% remission rate and 90% five-year survival rate with limited research, training, and treatment dollars. In contrast, child welfare fatalities and maltreatment incidences have continued to increase. Although childhood leukemia is not readily associated with child welfare and child maltreatment, there are approaches, protocol and lessons from the cancer arena that can and will disrupt the status quo of how we address child welfare. This paper focuses on utilizing childhood cancer research and treatment as the catalyst for disrupting or re-creating a child welfare system that is preventative in nature and better equipped to treat the multitude of family and community issues that contribute to maltreatment. 

PREVENTION

WINNERS:  Risser, Heather; Svevo-Cianci, Kimberly; Karim, Elba Jung; Morford, Alexandra

Achieving Comprehensive Prevention of Child Abuse & Neglect

The U.S. has a comprehensive array of child abuse and neglect (CAN) prevention resources, has allocated funding to provide these resources, and professionals are committed to preventing CAN. Yet, the current paradigm to prevent CAN is inadequate for three reasons. First, access to CAN prevention resources is not ubiquitous. Second, stigma prevents parents from seeking support and accessing services. Third, the average individual does not have a clear role in preventing CAN in their everyday lives. We need to shift the paradigm so that everyone feels entitled to advocate for CAN prevention and everyone knows how to engage in CAN prevention. We will use the handwashing paradigm as an example. Handwashing protocols are ubiquitous across all settings. Clear instructions for handwashing are posted in most restrooms, regardless of the setting. Every person believes they are entitled to have access to clean water and soap in every restroom, to request that others wash hands, and know how to model the behavior. Our aim is to create a shared mindset where people feel entitled to resources to build and maintain a web of healthy social relationships, displacing the current paradigm in which parents fear child welfare involvement and the stigma associated with asking for support; and non-parents question their role in preventing CAN. To achieve ubiquitous access and promote feelings/beliefs of entitlement to CAN prevention we propose one option for implementation by leveraging existing infrastructure, increasing system collaboration and engaging experts in a population-based public health campaign to inoculate society against CAN. 

RESEARCH

WINNERS:  Bullinger, Lindsey; Feely, Megan; Raissian, Kerri; Schneider, William

Heed Neglect, Disrupt Child Maltreatment: A Call to Action for Researchers

Given that child neglect remains the most common type of child maltreatment and neglect is present in 80% of the child fatalities attributed to maltreatment, the disruption of child maltreatment must prioritize neglect prevention. Moreover, a new approach of focusing on macro-level factors, such as economies, labor markets, and governmental affairs should be investigated. These macro factors play a key, yet underexplored, role in family circumstances, and they strongly influence parents’ ability to consistently provide safe and sufficient environments for their children. Existing research, policies, and programs have successfully improved the health and safety of children in many areas including reducing physical and sexual abuse and reducing child deaths from disease and car accidents. Yet, these strategies have not been implemented in the area of child neglect, partially because the research community does not fully understand the causes of neglect. To inform new directions for child protection, we propose shifting the focus of research away from individual and family-level factors of indicated populations. Instead, we suggest focusing on macro-level factors that, while receiving far less attention from researchers, show initial promise for understanding the causal pathways of neglect and identifying policies for universal prevention. Additionally, financial support is needed for this vein of research and to encourage the research, policy and practice partnerships that are essential for implementing effective solutions.

TRAINING & EDUCATION

Cindy W. Christian, MD; Anthony A. Latini; Kara R. Finck, J.D.; Cynthia Connolly, Ph.D., R.N., FAAN; Sara Jaffee, Ph.D.; Johanna Greeson, Ph.D., M.S.S., M.L.S.P.; Antonio Garcia, M.S.W., Ph.D.; Stacey L. Carlough, M.S.Ed.; Caroline L. Watts, Ed.D.

TEAR DOWN THOSE WALLS: The Future of Graduate Education in Child and Family Advocacy

The future of graduate education in child welfare requires specialized advanced degrees that are defined by interprofessional training and education. Disrupting the current silos in graduate education will result in a workforce able to integrate knowledge across disciplines with the ultimate goals of ending child abuse and neglect and improving outcomes for families. Although there are numerous challenges to implementing interprofessional education (IPE) in this context, research and existing programs highlight the potential for comprehensive reform of current practice and education. The authors describe a university-community partnership model for a master’s degree program in child and family advocacy that exemplifies the opportunities and value of IPE. In so doing, they articulate an approach for addressing historical barriers from academia and professional disciplines to disrupt traditional structures and move towards a 21st century model of workforce development that best serves the needs of vulnerable, high-risk families. 

TRAINING & EDUCATION

Tricia Gardner, JD; Susan Schmidt, PhD; Beverly Funderburk, PhD; Erin Taylor, PhD

Building Strong Children Together: Charting a New Course in Professional Education

Our current educational system places the onus on individual professions to create largescale change within the field of child maltreatment. Historically, each profession has expended significant time and resources to personally create and traverse their own pathway in addressing the prevention and treatment of child abuse and neglect. The siloed structure of our current educational system inherently limits our collective vision and impact toward a safer future for children. Our greatest failing has been the lack of multidisciplinary training for everyone interested in working on behalf of abused and neglected children. Our vision for breaking down educational silos begins at the undergraduate level and continues throughout the graduate and post-graduate process through the establishment of a multidisciplinary educational arena. We must create new opportunities for individuals to learn and grow as professionals. Our paper will focus on the creation of EndCAN Academy to train our nation’s future leaders in working together to end child maltreatment in our lifetime.

CLINICAL

Cline, Craig

The application of a social justice theory to the well-being of substance-exposed infants

In utero exposure to drugs and alcohol threatens the well-being of infants. Federal law has established child well being as one of the three main goals of the child welfare system, and recent changes to federal law require state child welfare programs to assess the needs of substance-exposed infants and plan for their safe care. CPS workers are often the first point of contact these infants have with the public child welfare system; yet, CPS workers have no framework for assessing the well-being of substance-exposed infants. In this paper, the author applies the Theory of Justice as Well-being to substance-exposed infants as a way to assess the deficits to well-being these infants experience. Furthermore, Justice as Well-being is applied to substance-exposed infants and their families to serve as a conceptual framework for an interprofessional approach to planning for the treatment and safe care needs of this highly vulnerable child welfare population.

PREVENTION

Roygardner, Debangshu; Palusci, Vince; Hughes, Kelli

Advancing Prevention Zones: Implementing Community-Based Strategies to Prevent Child Maltreatment and Promote Healthy Families

If we were to create a broadly defined system to protect children, it would be necessary to begin our work with families, using professionals from multiple disciplines and members of the community, as early as the prenatal period. Families raise children within communities, and that is where child maltreatment prevention begins. While reporting, investigations and services would all still exist, they would be placed into a model nested within a community that meets basic human needs. Addressing food insecurity, inadequate housing, and problematic child care at the community-level would address all forms of child maltreatment through early identification, treatment, and prevention. Imagine a world where children were conceived, born, and grew up in communities with dedicated professionals and supports that promoted family strengths and individual resiliency as well as identified early manifestations of risk for future maltreatment. Within our lifetime, we can instill the expectation among professionals that child maltreatment occurs across social strata, race, and ethnicity, and that prevention is the norm rather than the exception. While it has been more than 25 years since the U.S. Advisory Board heralded community-based Prevention Zones, we believe the time is right again to propose this “disruptive” concept of strengthening community resources, placing investigation and investigators within a community context, and fully integrating home-visitation programs, primary medical care systems and parental support into a community-based prevention network.

RESEARCH

Christ, Sharon L.; Schwab Reese, Laura M.

Shedding the Constraints of Formal Systems in Research on Child Maltreatment through High Quality Measurement and Broad Population Surveys

Effective prevention and intervention of child maltreatment requires that we understand what exposures harm children in the natural environments in which they live and develop. Determining which exposures cause harm requires appropriately defining and measuring the exposures as well as determining the relevant developmental outcomes used as indicators of harm. Research establishing these harms should not depend on definitions used by the formal regulatory systems responsible for child welfare, i.e., Child Protective Services (CPS) and the associated legal infrastructure. In addition, child maltreatment research requires engagement with populations outside of formal child welfare regulatory systems and across social, cultural, political, or institutional boundaries. In this paper, we appeal for more “systems-free” research with the goal of new discoveries in both defining and recognizing childhood maltreatment and the varied social pathways of prevention. We specifically propose rigorous measurement and modeling approaches, diverse samples, and rich data collection to meet these goals. These methods would provide new insights into multifaceted approaches to prevention and intervention, many of which may not involve existing child welfare systems. Though the proposed methods are ambitious and may be costly, the resulting improvements to prevention and intervention efforts could substantially reduce the mental and physical health, social, and economic costs of child maltreatment.