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influence, and how do they relate to the overall problem of child maltreatment, domestic violence, or elder abuse? Did the child, adult, or family actually improve as a result of the program and, if so, how was this measured? Did the community experience a lower rate of family violence following the intervention? Did changes in skills or knowledge result in modifications in behavior among offenders or lead to new services in communities that reduced the violence and provided more safety or improved health? And are the results of a single program or comprehensive community intervention transferable to a larger and more diverse population of clients and multiple communities?
Both public and private agencies now seek to move beyond anecdotal reports in a search for data that can guide policy and program decisions. Yet service providers, public officials, clients, and researchers themselves are frustrated by the difficulties of measuring and assessing the impacts of treatment and prevention programs. The enormous complexity of the phenomena, the comparatively short history with service interventions, the shifting legal and social doctrines that shape public policy, the interactive nature of the problems and the services themselves, and the demographic transformations affecting American families and communities present tremendous challenges to the use of science in this field. The urgency and magnitude of these problems and the scale of resources that our society invests in treatment and prevention efforts demand better results.
Scope Of The Problem
Family violence victimization in the general population is widely regarded as a serious problem that affects large numbers of children and adults across the life span. Estimates of the scope of the problem vary according to the source of the information that provides the basis of the estimate and the definitions used in describing the nature of the problem. But although the exact dimensions of child maltreatment, domestic violence, and elder abuse are frequently disputed, conservative estimates suggest that these problems affect millions of children, women, and men in the United States. In 1996, a government survey (NIS-3) reported that 2.8 million cases of child maltreatment were known to local child protection agencies or community sources (including teachers, health care professionals, and other service providers) in 1993, when the data were collected (National Center on Child Abuse and Neglect, 1996b). This estimate indicates a rate of 41.9 children per 1,000, or 1 in 24 in the U.S. child population (National Center on Child Abuse and Neglect, 1996b:3-17).
No government survey has yet been published that estimates the national incidence of domestic violence in the United States. The National Crime Victimization Survey, which collects data about incidents reported as crimes, has reported that the annual rate of physical attacks by family members for women was 9.3 per 1,000 in 1992-1993 (Bachman and Saltzman, 1995). Population-based surveys suggest that the rate of adult violence involving family members may be