Anna E Austin1, Nisha C Gottfredson2, Adam J Zolotor3, Carolyn T Halpern4, Stephen W Marshall5, Rebecca B Naumann5, Meghan E Shanahan6. 1. Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599-7445, United States; Injury Prevention Research Center, University of North Carolina at Chapel Hill, 137 East Franklin Street, Suite 500, Chapel Hill, NC, 27599-7505, United States. Electronic address: anna.austin@unc.edu. 2. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599-7445, United States. 3. Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, Chapel Hill, NC, 27599-7595, United States. 4. Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599-7445, United States. 5. Injury Prevention Research Center, University of North Carolina at Chapel Hill, 137 East Franklin Street, Suite 500, Chapel Hill, NC, 27599-7505, United States; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599-7445, United States. 6. Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599-7445, United States; Injury Prevention Research Center, University of North Carolina at Chapel Hill, 137 East Franklin Street, Suite 500, Chapel Hill, NC, 27599-7505, United States.
Abstract
BACKGROUND: Contact with child protective services (CPS) functions as an independent marker of child vulnerability. Alaska children are an important population for understanding patterns of CPS contact given high rates of contact overall and among specific demographic groups. OBJECTIVE: We aimed to identify longitudinal trajectory classes of CPS contact among Alaska Native/American Indian (AN/AI) and non-Native children and examine preconception and prenatal risk factors associated with identified classes. PARTICIPANTS AND SETTING: We used data from the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project, a linkage of 2009-2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) births with administrative data including CPS records. METHODS: We conducted growth mixture modeling to identify trajectory classes of CPS contact from birth to age five years. We used Vermunt's three-step approach to examine associations with preconception and prenatal risk factors. RESULTS: Among AN/AI children, we identified three classes: 1) no/low CPS contact (75.4%); 2) continuous CPS contact (19.6%), and 3) early, decreasing CPS contact (5.0%). Among non-Native children, we identified four classes: 1) no CPS contact (81.3%); 2) low, increasing CPS contact (9.5%); 3) early, rapid decline CPS contact (5.8%); and 4) high, decreasing CPS contact (3.3%). Maternal substance use had the largest impact on probabilities of class membership, increasing the probability of membership in classes characterized by CPS contact, among both AN/AI and non-Native children. CONCLUSIONS: Results reveal heterogeneity in longitudinal patterns CPS contact across early childhood among Alaska children and identify maternal substance use as an important target for primary prevention.
BACKGROUND: Contact with child protective services (CPS) functions as an independent marker of child vulnerability. Alaska children are an important population for understanding patterns of CPS contact given high rates of contact overall and among specific demographic groups. OBJECTIVE: We aimed to identify longitudinal trajectory classes of CPS contact among Alaska Native/American Indian (AN/AI) and non-Native children and examine preconception and prenatal risk factors associated with identified classes. PARTICIPANTS AND SETTING: We used data from the Alaska Longitudinal ChildAbuse and Neglect Linkage (ALCANLink) project, a linkage of 2009-2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) births with administrative data including CPS records. METHODS: We conducted growth mixture modeling to identify trajectory classes of CPS contact from birth to age five years. We used Vermunt's three-step approach to examine associations with preconception and prenatal risk factors. RESULTS: Among AN/AI children, we identified three classes: 1) no/low CPS contact (75.4%); 2) continuous CPS contact (19.6%), and 3) early, decreasing CPS contact (5.0%). Among non-Native children, we identified four classes: 1) no CPS contact (81.3%); 2) low, increasing CPS contact (9.5%); 3) early, rapid decline CPS contact (5.8%); and 4) high, decreasing CPS contact (3.3%). Maternal substance use had the largest impact on probabilities of class membership, increasing the probability of membership in classes characterized by CPS contact, among both AN/AI and non-Native children. CONCLUSIONS: Results reveal heterogeneity in longitudinal patterns CPS contact across early childhood among Alaska children and identify maternal substance use as an important target for primary prevention.
Authors: Kate M Scott; Michael Von Korff; Matthias C Angermeyer; Corina Benjet; Ronny Bruffaerts; Giovanni de Girolamo; Josep Maria Haro; Jean-Pierre Lépine; Johan Ormel; José Posada-Villa; Hisateru Tachimori; Ronald C Kessler Journal: Arch Gen Psychiatry Date: 2011-08
Authors: Emily Putnam-Hornstein; Janet U Schneiderman; Mario A Cleves; Joseph Magruder; Henry F Krous Journal: J Pediatr Date: 2013-10-15 Impact factor: 4.406