Understanding How Intimate Partner Violence Impacts School Age Children's Internalizing and Externalizing Problem Behaviors: A Secondary Analysis of Hawaii Healthy Start Program Evaluation Data.

We examined the role of maternal depression and parenting stress in the relationship between intimate partner violence (IPV) and child internalizing and externalizing problems, and explored whether child gender modified these pathways. This secondary analysis used data from the Hawaii Healthy Start Program. Logistic regression models examined the associations between IPV in 1st grade and child internalizing and externalizing behaviors in 1st, 2nd, and 3rd grades. Mediation models used bootstrapping methodology and stratified models examined effect modification. Adjusted models with 214 mothers demonstrated associations between IPV and internalizing (adjusted odds ratios (aOR)=2.62; 95% CI 1.11, 6.21) and externalizing (aOR=4.16; 95% CI 1.55, 11.19) behaviors. The association with externalizing behaviors was mediated by maternal depression and parenting stress, while internalizing behaviors was mediated by depression only. Stratified models found the association between IPV and externalizing behaviors was significant for girls only. Our results support the importance of multicomponent maternal IPV interventions.