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APPENDIX G 317 Appendix G Summary of Evaluation Studies on Training of Health Care Professionals on Child Abuse and Neglect 317
318 APPENDIX G Child Abuse and Neglect Expected Nature of Training Provided Outcomes and Measure Timing Target Comparison Post- Population Intervention Group Study Major Base- test (study citation) Group (if applicable) Design Outcomes Measure line (mon Medical Type: Mixed Other Two-group, Knowledge of Self-report Yes Imm students, Length: 9-15 rotation nonequivalent child sexual abuse (30 items) ately residents, hrs. in a comparison group traini fellows, and clinical rotation attending Clinical aids: physicians in None pediatrics (Palusci & McHugh, 1995) Residents in Type: Mixed None Two-group, Knowledge, Self-report Yes 1 pediatrics Length: Six comparison attitudes, and (31 items) (Dubowitz & 90-min. group skills of child abuse Black, 1991) sessions Clinical aids: Perceived Self-report None competency to (1 item) manage child abuse cases Residents in Type: Mixed One group Knowledge of Self-report Yes Imm pediatrics Length: 8 hrs. child sexual abuse (33 items) ately (Sugarman Clinical aids: traini et al., 1997) None Number of participants: 22
APPENDIX G 319 Results I = Intervention Group easure Sample Size and C = Comparison Group Attrition from Pre = Baseline or Pretest Timing Measurement Post = Posttest FU = Follow-up Post- Follow- Within- Relative Base- test ups Group Group Measure line (months) (months) Intervention Comparison Change Difference Comment Self-report Yes Immedi- Enrolled = 15 Pre = 15 Ipost > Ipre* Ipost > Cpost* The study also (30 items) ately after Pre = 15 Post = 12 included a training Post = 15 (80%) reference group (100%) who received no training and was adminis- tered the pretest. It consisted of 127 students, residents, and physicians who attended report and continuity clinic confer- ences. All groups did not significantly differ at the pretest. Self-report Yes 1 3-4 Eligible = 31 Eligible = 19 Ipost1 > Ipre* Ipost > Cpost* The pretest (31 items) Pre = 31 Pre = 19 IFU > CFU scores of the e Post = 31 Post = 19 two groups did (100%) (100%) not signifi- Self-report Ipost > Cpost* cantly differ. (1 item) IFU > CFU* Self-report Yes Immedi- Eligible = Ipost1 > Ipre* (33 items) ately after Not reported training Pre = 22 Post = 22 (100%) continued on next page
320 APPENDIX G Child Abuse and Neglect Expected Nature of Training Provided Outcomes and Measure Timing Target Comparison Post- Population Intervention Group Study Major Base- test (study citation) Group (if applicable) Design Outcomes Measure line (mon Physicians, Type: Mixed One group Knowledge of Self-report Yes 0.5 nurses, and Length: 1 day child abuse caseworkers Clinical aids: (Hibbard Anatomically et al., 1987) correct dolls; handbook of potential interventions Physicians, Type: Mixed One group Number of sexual Self-report Yes Imm nurse- Length: 1 day abuse indicators ately practitioners, Clinical aids: recalled traini family practice None and public health nurses, social workers, and secondary health educators (Sullivan & Clancy, 1990) Number of Self-report physical indicators of child abuse recalled Number of Self-report psychological indicators of child abuse recalled Number of Self-report behavioral indicators of child abuse recalled Number of specific Self-report actions to take in interviews
APPENDIX G 321 Results I = Intervention Group easure Sample Size and C = Comparison Group Attrition from Pre = Baseline or Pretest Timing Measurement Post = Posttest FU = Follow-up Post- Follow- Within- Relative Base- test ups Group Group Measure line (months) (months) Intervention Comparison Change Difference Comment Self-report Yes 0.5 6 Eligible = 51 Medical Increased use Pre = 38 (75%) staff: of anatomically Post = 35 (69%) Ipost1 > Ipre* dolls was noted FU = 21 (41%) IFU > Ipre* at the 6-month Social follow-up, but workers: no data were Ipost1 > Ipre* reported. IFU > Ipre* Self-report Yes Immedi- 3, 6 Eligible = 350 Ipost1 > Ipre* Groups were ately after Posttest only: IFU > Ipre* randomized to training Assigned = 85 IFU2 < Ipost one of the four Post = 82 (97%) testing Pre- and conditions. posttest: Because the Assigned = 96 design Post = 65 (68%) (anonymity of Pre- and FU: subjects) did not Assigned = 88 permit pairing Post = 65 (74%) pretest, posttest, Self-report Pre- and FU2: Ipost1 > Ipre* and follow-up Assigned = 81 scores, the Post = 41 (81%) results on within-group change should Self-report Ipost1 > Ipre* be interpreted with caution. Results indicated no pretest effect Self-report Ipost1 > Ipre on the immedi- ate posttest. Significant differences on all but sexual c Self-report Ipost1 > Ipre* abuse indicators are for all posttests and follow-up combined. continued on next page
322 APPENDIX G Child Abuse and Neglect Expected Nature of Training Provided Outcomes and Measure Timing Target Comparison Post- Population Intervention Group Study Major Base- test (study citation) Group (if applicable) Design Outcomes Measure line (mon Child protective Type: Mixed One group Ability to Vignette Yes Imm service workers, Length: 6 hrs. complete initial (ratings) ately including social Clinical aids: case planning traini workers (Cheung None et al., 1991) Ability to Vignette formulate goals (ratings) Ability to set Vignette objectives for (ratings) family Ability to develop Vignette a contract with (ratings) family Child protective Type: Mixed One group Perceived Yes Imm service workers, Length: 3 mo. information and ately including social training experience to: traini workers (Leung program & Cheung, 1998) Clinical aids: Identify abuse Self-report None (1 item) Identify risk Self-report (1 item) Recognize Self-report indicators (1 item) Attitudes (e.g., Self-report Yes Imm value of family (9-item ately preservation and subscale) traini cultural differences)
APPENDIX G 323 Results I = Intervention Group easure Sample Size and C = Comparison Group Attrition from Pre = Baseline or Pretest Timing Measurement Post = Posttest FU = Follow-up Post- Follow- Within- Relative Base- test ups Group Group Measure line (months) (months) Intervention Comparison Change Difference Comment Vignette Yes Immedi- Eligible = 18 Ipost1 > Ipre (ratings) ately after Pre = 18 training Post = 18 Vignette Ipost1 > Ipre* (ratings) Vignette Ipost1 > Ipre (ratings) Vignette Ipost1 > Ipre* (ratings) Yes Immedi- Eligible = 413 The question- ately after Pre = 188 naire on training Post = 188 perceived (100%) knowledge and Self-report Ipost1 > Ipre* experience (1 item) included 16 items, all of Self-report Ipost1 > Ipre* which showed (1 item) statistically significant Self-report Ipost1 > Ipre* improvement. (1 item) Sample sizes for the performance Self-report Yes Immedi- Eligible = 23 Ipost1 > Ipre* evaluation (9-item ately after Pre = 20 varied, given subscale) training Post = 20 that most of the (100%) workers were not yet eligible for their second- continued on next page
324 APPENDIX G Child Abuse and Neglect Expected Nature of Training Provided Outcomes and Measure Timing Target Comparison Post- Population Intervention Group Study Major Base- test (study citation) Group (if applicable) Design Outcomes Measure line (mon Type: Mixed Not specified Two-group, Performance on Supervisor No 6-9 Length: 3 mo. but some comparison job, including use evaluation forms training training as group of interviewing program random sample techniques, Clinical aids: of current determining None caseworkers presence of child abuse or neglect, implementation of case management plans, and sufficient case documentation
APPENDIX G 325 Results I = Intervention Group easure Sample Size and C = Comparison Group Attrition from Pre = Baseline or Pretest Timing Measurement Post = Posttest FU = Follow-up Post- Follow- Within- Relative Base- test ups Group Group Measure line (months) (months) Intervention Comparison Change Difference Comment Supervisor No 6-9 12, Eligible = 413 Eligible = ? IFU > Ipost* Ipost = Cpost year evaluation. evaluation forms 24 Post = 66 Post = 39 IFU2 > IFU* FU = 140 FU = 50 FU2 = 18 FU2 = 46
