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1.
Parenting programs in high-income countries have been shown to reduce the risk of child maltreatment. However, there is limited evidence of their effectiveness in low- and middle-income countries. The objective of this study was to examine the initial effects of a parenting program in reducing the risk of child maltreatment in highly-deprived and vulnerable communities in Cape Town, South Africa. Low-income parents (N = 68) with children aged three to eight years were randomly assigned to either a group-based parenting program or a wait-list control group. Observational and parent-report assessments were taken at baseline and at immediate post-test after the intervention was delivered. Primary outcomes were parent-report and observational assessments of harsh parenting, positive parenting, and child behavior problems. Secondary outcomes were parent-report assessments of parental depression, parenting stress, and social support. Results indicated moderate treatment effects for increased frequency of parent-report of positive parenting (d = 0.63) and observational assessments of parent-child play (d = 0.57). Observational assessments also found moderate negative treatment effects for less frequent positive child behavior (d = −0.56). This study is the first randomized controlled trial design to rigorously test the effectiveness of a parenting program on reducing the risk of child maltreatment in sub-Saharan Africa using both observational and self-report assessments. Results provide preliminary evidence of effectiveness of reducing the risk of child maltreatment by improving positive parenting behavior. Further development is required to strengthen program components regarding child behavior management and nonviolent discipline strategies. Future research would benefit from a larger trial with sufficient power to determine program effectiveness. 相似文献
2.
Michael S. Hurlburt Katherine Nguyen Jamila Reid Carolyn Webster-Stratton Jinjin Zhang 《Child abuse & neglect》2013
Objective
A prevention form of the Incredible Years (IY) parenting program was offered to parents who had children enrolled in Head Start, regardless of whether they reported having a history of child maltreatment. This study compared whether parenting practices and child behavioral outcomes differed in families who self reported a history of child maltreatment relative to families who did not.Methods
A site-randomized controlled trial of the IY parenting program was conducted in 64 classrooms in seven Head Start centers in Seattle, Washington. Families of 481 children took part in the study, with 335 in the IY condition and 146 in the control condition. Parenting practices and child behavior were measured by blinded raters through in-home observations and self-report questionnaires prior to the start of the IY program, in the spring after the IY program had concluded, and 12–18 months after study enrollment when children were in kindergarten. Analyses examine the impact of the IY program on parenting practices and children's behavior, exploring whether the program had differential impacts for parents with and without a self-reported history of child maltreatment.Results
The IY program resulted in improvements along many parenting dimensions and on characteristics of observed child behavior. Program impacts were similar for parents who did and did not report a history of child maltreatment. However, parents with a reported history of prior maltreatment had greater initial room for improvement in areas such as harsh/critical parenting, nurturing/supportive parenting, and discipline competence than parents without such a history.Conclusions
The IY parenting program has positive impacts for parents who self-reported a history of child maltreatment. While similar benefits were observed for both groups of parents in this study, results support delivering evidence-based parenting programs of longer duration and higher intensity than often used by agencies serving parents in contact with child welfare.Practice
Agencies serving parents referred for child maltreatment should carefully examine the characteristics of the parenting programs they deliver. Use of a parenting program that has a sound base of empirical support, such as IY, and sufficient intensity and duration, is likely to make substantial changes in parents’ child-rearing practices. 相似文献3.
Child maltreatment can lead to a variety of negative outcomes in childhood including physical and mental health problems that can extend into adulthood. Given the transactional nature of child maltreatment and the difficulties that many maltreating families experience, child protection services typically offer various kinds of programs to maltreated children, their parents, and/or their families. Although the specific difficulties experienced by these families may vary, sub-optimal parenting practices are typically part of the picture and may play a central role in maltreated children’s development. Hence, to deal with child maltreatment, programs that focus on parenting practices are essential, and identifying the common components of effective programs is of critical importance. The objectives of the present study were to: 1) describe the components of evidence-based parenting programs aimed at parents who have maltreated their elementary school-aged children or are at-risk for doing so and 2) identify the components that are common to these programs, using the approach proposed by Barth and Liggett-Creel (2014). Fourteen evidence-based parenting programs aimed at parents who had maltreated their elementary school-aged children (ages 6–12) or were at-risk for doing so were identified using both a review of relevant online databases of evidence-based programs (California Evidence-Based Clearinghouse for Child Welfare, Blueprints for Healthy Youth Development, Youth.gov, and the National Registry of Evidence-based Programs and Practices). Common components were identified (operationalized as components present in two thirds of programs) and discussed. The identification of common components of evidence-based programs may help clinicians choose the best intervention methods. 相似文献
4.
Child maltreatment negatively affects children's development and wellbeing. This study investigated the associations between child maltreatment (i.e., emotional neglect, emotional abuse, and physical abuse) and interpersonal functioning, including parent–child relationship, teacher–student relationship, and peer relationships among children with oppositional defiant disorder (ODD). A total of 256 children with ODD and their parents and class master teachers from Mainland China completed questionnaires. Results showed a negative correlation between emotional abuse (parent-reported) and children's interpersonal relationships with parents, teachers, and peers. Emotional neglect and physical abuse were related to poor parent–child relationships. Latent profile analysis revealed three profiles of child maltreatment among children with ODD. ODD children with more severe levels of one type of maltreatment were also more likely to have experienced severe levels of other types of maltreatment. Children with ODD who were in the group of high maltreatment had the poorest quality of interpersonal relationships. Our findings highlight the urgent need to prevent child maltreatment and promote more positive parenting in families with ODD children. 相似文献
5.
Chelsea La Valle 《Mentoring & Tutoring: Partnership in Learning》2013,21(3):213-227
Parents of children with significant externalizing and internalizing behavioral problems habitually report greater parenting stress compared to parents of children without these challenges. One avenue to alleviate parenting stress and ameliorate youth outcomes is youth mentoring, which includes a supportive adult paired with a child with the objective of engendering positive outcomes. The researcher sought to (a) evaluate the effectiveness of mentoring programs for children with significant externalizing and internalizing behavioral problems on parenting stress and youth outcomes and (b) explore moderator variables that may influence program effectiveness. Five studies were included in the current meta-analysis. Results revealed a small effect of these specialized mentoring programs on youth outcomes and parenting stress. Moderator analyses revealed program characteristics that enhance effectiveness. Mentoring programs that target children with significant behavioral and emotional problems may function as an additional service to improve youth outcomes and family functioning. 相似文献
6.
Susan M. Sheridan Natalie A. Koziol Brandy L. Clarke Kristin M. Rispoli Michael J. Coutts 《Early education and development》2014,25(7):1057-1082
Research Findings: Children's early academic achievement is supported by positive social and behavioral skills, and difficulties with these skills frequently gives way to underachievement. Social and behavioral problems often arise as a product of parent–child interactional patterns and environmental influences. Few studies have examined the role of a salient aspect of children's environments, community locale, in the relationship between parenting practices and child outcomes. Using a large, nationally representative sample, we examined whether preschool parenting practices and children's social-behavioral skills in kindergarten were related to geographic setting (rural vs. city, suburban, and town). Results indicated that rural children experienced greater difficulties with parent-reported externalizing behaviors. Furthermore, rural parents displayed less emotional support than parents in other settings. Preschool parenting behaviors were associated with social skills and behavior problems in kindergarten, as reported by both parents and teachers. Parents' emotional supportiveness was found to account for the relationship between geographic setting and parent-reported children's social skills, such that rural parents who provided less emotional support had children with lower social skills in kindergarten. Practice or Policy: Findings of this research indicate that rural children may face particular risk for behavioral issues and highlight the need for increased behavioral supports in rural communities. Moreover, our results suggest that interventions designed to promote parents' support of children's emotions may have particular utility for rural families. 相似文献
7.
Intimate partner violence (IPV) and child maltreatment often co-occur in households and lead to negative outcomes for children. This article explores the extent to which SASA!, an intervention to prevent violence against women, impacted children's exposure to violence. Between 2007 and 2012 a cluster randomized controlled trial was conducted in Kampala, Uganda. An adjusted cluster-level intention to treat analysis, compares secondary outcomes in intervention and control communities at follow-up. Under the qualitative evaluation, 82 in-depth interviews were audio recorded at follow-up, transcribed verbatim, and analyzed using thematic analysis complemented by constant comparative methods. This mixed-methods article draws mainly on the qualitative data. The findings suggest that SASA! impacted on children's experience of violence in three main ways. First, quantitative data suggest that children's exposure to IPV was reduced. We estimate that reductions in IPV combined with reduced witnessing by children when IPV did occur, led to a 64% reduction in prevalence of children witnessing IPV in their home (aRR 0.36, 95% CI 0.06–2.20). Second, among couples who experienced reduced IPV, qualitative data suggests parenting and discipline practices sometimes also changed-improving parent–child relationships and for a few parents, resulting in the complete rejection of corporal punishment as a disciplinary method. Third, some participants reported intervening to prevent violence against children. The findings suggest that interventions to prevent IPV may also impact on children's exposure to violence, and improve parent–child relationships. They also point to potential synergies for violence prevention, an area meriting further exploration. 相似文献
8.
Parent–child interaction therapy: A manualized intervention for the therapeutic child welfare sector
《Child abuse & neglect》2013,37(8):578-584
Children who have experienced maltreatment can often display behavioral difficulties; their parents may lack disciplinary knowledge, be less sensitive to their children, and engage in coercive parenting practices. Parent–child interaction therapy (PCIT) is a well-known, evidence-based treatment (EBT) for child behavior problems and within the last decade has garnered significant evidence to suggest its utility for parents engaged in child maltreatment. This article uses a case example to describe PCIT treatment phases and PCIT research within the child maltreatment sector is synthesized with particular focus on treatment modifications. Successful augmentations and modifications include a motivation component, keeping therapeutic time shorter rather than longer, and whether to incorporate individual counseling and in-home PCIT are also considered. Practical strategies from both a therapeutic and research experience are discussed. 相似文献
9.
The way in which parents interact with their environment may have implications for their likelihood of abuse and neglect. This study examines the parent–environment relationship through community involvement and perception, using social disorganization theory. We hypothesize mothers who participate in their communities and have positive perceptions of them may be less likely to maltreat their children because of the potential protective capacity of neighborhood supports. Using information from the 5 year Fragile Families and Child Wellbeing Study (n = 2991), the mother's self-reported acts of psychological and physical maltreatment and neglect are measured. A mother's community involvement index is the number of community activities a mother was involved in, and community perception is measured by two five-item Likert scales assessing perception of community collective efficacy. We analyze the relationship between community variables and each of mother's maltreatment behaviors as well as the interaction between community factors using a series of nested logistic regressions. Higher levels of community involvement are associated with lower levels of psychological aggression. More positive perception of community social control is associated with lower levels of physical assault. A moderation effect of community perception suggests that a mother's perception of her community changes the relationship between community involvement and psychological child abuse. The results provide important policy and empirical implications to build positive and supportive communities as a protective factor in child maltreatment. Getting parents involved in their communities can improve the environment in which children and families develop, and decrease the likelihood that maltreatment will occur. 相似文献
10.
OBJECTIVE: The intergenerational transmission of child maltreatment is a controversial subject. Much of existing research is plagued with at least three fundamental weaknesses: (1) using case status to define subjects: (2) adopting a dichotomous perspective that does not consider the reality of maltreatment on various continua; and (3) using operational definitions that fail to differentiate between maltreatment subtypes. We controlled for these problems and examined the structure of child maltreatment and its influence on later parenting practices in an ethnically-diverse community sample. METHOD: Data from a community sample of parents (N = 383) were analyzed with a Structural Equation Modeling methodology. Reliable and valid continuous measures of child maltreatment (Child Trauma Questionnaire) and parenting practices (Parental Acceptance and Rejection Questionnaire) were used. RESULTS: Results revealed a moderately strong effect from a general factor of Child Maltreatment to a general factor of Poor Parenting for both mothers and fathers, supporting a common dysfunction transmission process. For mothers. Family Neglect by itself also led to poor parenting, and sexual abuse as a child led to aggressive parenting. For fathers, Child Maltreatment had a different structure, as sexual abuse was distinct from the factors of Family Abuse and Family Neglect. Also, for fathers, sexual abuse led to rejecting parenting practices. CONCLUSIONS: This study supports the intergenerational cycle of child maltreatment hypothesis in such a way that several weaknesses in much of existing research were controlled. Clinical implications and potential mechanisms of transmission are discussed. 相似文献
11.
Previous research has revealed a large prevalence of trauma experienced by children, creating high risk for the development of psychopathology. Research investigating the negative impacts of child maltreatment and other traumas has typically examined these experiences individually, controlling for co-occurring traumas, or has combined these experiences into a general variable of risk, thereby obscuring the complex relationships among environmental traumas and maltreatment. The current study expands on previous research by elucidating relationships between multiple contexts of overlapping traumas and maltreatment experienced by children, and by categorizing how these experiences join together to impact internalizing and externalizing symptomatology. Participants included 316 maltreated children and 269 nonmaltreated children (M age = 9.4, SD = 0.88) who attended a summer day camp research program for low-income children. Latent Class Analysis (LCA) identified three differential patterns of trauma exposure across children: 1) community violence and loss; 2) pervasive trauma; and 3) low trauma. Covariate analyses demonstrated that child maltreatment was significantly associated with class membership, suggesting that maltreated children were more likely to experience diverse traumas extending beyond their maltreatment experiences (pervasive trauma class). A two-way analysis of variance also demonstrated that trauma latent class membership and child maltreatment each represented unique predictors of internalizing and externalizing symptoms, with each having an independent effect on symptomatology. This investigation provides unique insight into the differential impact of patterns of trauma exposure and child maltreatment, providing support for further research and clinical practice addressing multiple levels of a child’s ecology. 相似文献
12.
Cases of child maltreatment are being increasingly reported in Taiwan. However, the trend or changes of child maltreatment in Taiwan are fragmentary and lack empirical evidence. This study analyzed the epidemiological characteristics of substantiated child maltreatment cases from the previous decade, using mortality as an indicator to investigate the care of children who experienced substantiated maltreatment in the past to determine any new developments. Data for analysis and estimates were retrieved from the Department of Statistics in the Ministry of the Interior from 2004 to 2013. Trend analyses were conducted using the Joinpoint Regression Program. The child maltreatment rate in Taiwan was found to have nearly tripled from 2004 to 2013. A greater increase in the maltreatment of girls than boys and the maltreatment of aboriginal children than non-aboriginal children was noted from 2004 to 2013. When stratified by age group, the increase in maltreatment was most pronounced in children aged 12–17 years, and girls aged 12–17 years experienced the greatest increase in maltreatment. In terms of the proportional changes of different maltreatment forms among substantiated child maltreatment cases, child neglect was decreasing. The increase in sexual abuse was higher than for any other form of maltreatment and surpassed neglect by the end of 2013. Furthermore, the mortality rate of children with substantiated maltreatment record is increasing in Taiwan, whereas the mortality rate among children without any substantiated maltreatment record is decreasing. The results of this study highlight the need for policy reform in Taiwan regarding child maltreatment. 相似文献
13.
Caldera D Burrell L Rodriguez K Crowne SS Rohde C Duggan A 《Child abuse & neglect》2007,31(8):829-852
OBJECTIVES: To assess the impact of a voluntary, paraprofessional home visiting program on promoting child health and development and maternal parenting knowledge, attitudes, and behaviors. METHODS: This collaborative, experimental study of 6 Healthy Families Alaska (HFAK) programs enrolled 325 families from 1/00 to 7/01, randomly assigned them to HFAK and control groups, interviewed mothers at baseline, and followed families until children were 2 years old (85% follow-up). Child outcomes included health care use, development and behavior. Parent outcomes included knowledge of infant development, parenting attitudes, quality of the home environment, and parent-child interaction. HFAK records were reviewed to measure home visiting services. Home visitors were surveyed to measure knowledge, perceived effectiveness and perceived training adequacy. RESULTS: There was no overall impact on child health, but HFAK group children had more favorable developmental and behavioral outcomes. HFAK and control mothers had similar parenting outcomes except that HFAK mothers had greater parenting self-efficacy (35.1 vs. 34.6 based on the Teti Self-Efficacy Scale, p<.05). Fewer HFAK families had a poor home environment for learning (20% vs. 31%, p<.001). HFAK families were more likely to use center-based parenting services (48% vs. 39%, p<.05). The impact was greater for families with lower baseline risk (Family Stress Checklist scores<45). There was little evidence of efficacy for families with a higher dose of service. CONCLUSIONS: The program promoted child development and reduced problem behaviors at 2 years. Impact could be strengthened by improving home visitor effectiveness in promoting effective parenting. Future research is needed to determine whether short-term benefits are sustained. 相似文献
14.
There is increasingly strong evidence that children with disabilities are at higher risk for maltreatment when compared to children without disabilities. There is also concern about the adequacy of child welfare services for children and parents with disabilities, particularly those disabilities that result in a communication impairment. This article describes a successful community practice effort in Los Angeles County that resulted in the establishment of a comprehensive array of linguistically and culturally competent child abuse prevention and treatment services for the maltreated deaf child and for the deaf parent at risk for child abuse perpetration. Social movement theory is used to analyze a change effort that was developed and implemented by a broad coalition of members of the Deaf and hearing communities. Elements of the problem, social movement theory, the coalition, the change strategy, and the results are described. 相似文献
15.
Duggan A Caldera D Rodriguez K Burrell L Rohde C Crowne SS 《Child abuse & neglect》2007,31(8):801-827
OBJECTIVES: To assess the impact of a voluntary, paraprofessional home visiting program in preventing child maltreatment and reducing the multiple, malleable psychosocial risks for maltreatment for which families had been targeted. METHODS: This collaborative, experimental study focused on 6 Healthy Families Alaska (HFAK) programs; 325 families were enrolled in 2000-2001, randomized to intervention and control groups, and interviewed to measure baseline attributes. Follow-up data were collected when children were 2 years old (85% follow-up rate). Outcomes included maltreatment reports, measures of potential maltreatment and parental risks, for example, poor mental health, substance use, and partner violence. HFAK records were reviewed to measure home visiting services. Home visitors were surveyed to measure perceived effectiveness and training adequacy. RESULTS: Parental risks were common at baseline, and one-sixth of families had a substantiated child protective services report in the child's first 2 years of life. There was no overall program effect on maltreatment reports, and most measures of potential maltreatment. Home visited mothers reported using mild forms of physical discipline less often than control mothers. The groups were similar in their use of more severe forms of physical discipline. There was no program impact on parental risks. There was no impact on outcomes for families with a 'high dose' of home visiting. Home visitors often failed to address parental risks and seldom linked families with community resources. Contradictions in the model compromised effectiveness. CONCLUSIONS: The program did not prevent child maltreatment, nor reduce the parental risks that had made families eligible for service. Research is needed to develop and test strategies to improve the effectiveness of home visiting. 相似文献
16.
The interplay of gender,parental behaviors,and child maltreatment in relation to psychopathic traits
Many studies have reported an effect of childhood maltreatment and parenting behavior with the future development of psychopathic traits. However, there is a limited amount of research on parenting behavior and adult psychopathic traits as possible identifiers of childhood maltreatment. The aim of this study is three-fold (1) identify specific parenting behaviors and adult psychopathic traits that predict forms of childhood maltreatment, (2) explore gender differences, and (3) expand on other studies on psychopathy by focusing on a representative sample of the community. There are significant associations between recalled childhood maltreatment and parenting behavior, and psychopathic traits. Parental rejection was the most recurrent predictor of childhood maltreatment with a significant positive relation to almost all its forms. Paternal overprotection was positively associated with sexual abuse, while the opposite was true for maternal overprotection. Psychopathic traits displayed in adulthood were also strong indicators of childhood maltreatment; females with high levels of boldness were more likely to have experienced sexual abuse in childhood, and those high in disinhibition were more likely to have experienced physical neglect and sexual abuse. While males were generally higher in terms of psychopathic traits, females reported more childhood abuse and negative parental behaviors. These findings provide support for using parenting behavior and psychopathic traits as markers of childhood maltreatment. 相似文献
17.
Comprehensive reviews of child death are increasingly conducted throughout the world, although limited information is available about how this information is systematically used to prevent future deaths. To address this need, we used cases from 2005 to 2009 in the U.S. National Child Death Review Case Reporting System to compare child and offender characteristics and to link that information with actions taken or recommended by review teams. Child, caretaker, and offender characteristics, and outcomes were compared to team responses, and findings were compared to published case series. Among 49,947 child deaths from 23 states entered into the Case Reporting System during the study period, there were 2,285 cases in which child maltreatment caused or contributed to fatality. Over one-half had neglect identified as the maltreatment, and 30% had abusive head trauma. Several child and offender characteristics were associated with specific maltreatment subtypes, and child death review teams recommended and/or planned several activities in their communities. Case characteristics were similar to those published in other reports of child maltreatment deaths. Teams implemented 109 actions or strategies after their review, and we found that aggregating information from child death reviews offers important insights into understanding and preventing future deaths. The National Child Death Review Case Reporting System contains information about a large population which confirms and expands our knowledge about child maltreatment deaths and which can be used by communities for future action. 相似文献
18.
OBJECTIVE: To better understand how neighborhood and individual factors are related to child maltreatment. METHOD: Using an ecological framework, a multi-level model (Hierarchical Linear Modeling) was used to analyze neighborhood structural conditions and individual risk factors for child abuse and neglect. Parents (n = 400) of children under the age of 18 were systematically selected from 20 randomly selected census-defined block groups with different risk profiles for child maltreatment report rates. Parents were administered the Neighborhood Environment for Children Rating Scales, the Child Abuse Potential Inventory, the Zimet measure of social support, and the Conflict Tactics Scales as a measure of childhood experience with violence. RESULTS: Neighborhood factors of impoverishment and child care burden significantly affect child abuse potential after controlling for individual risk factors. However, neighborhood effects are weaker than they appear to be in aggregate studies of official child maltreatment reports. Variation in child abuse potential within neighborhoods is greater than between neighborhoods. However, adverse neighborhood conditions weakend the effects of known individual risk and protective factors, such as violence in the family of origin. CONCLUSIONS: If individual potential for child maltreatment is more evenly distributed across neighborhoods than reported maltreatment, then neighborhood and community play an important, if as yet unspecified, role in child maltreatment. Multi-level models are a promising research strategy for disentangling the complex interactions of individual and contextual factors in child maltreatment. 相似文献
19.
This article presents findings of a state-wide trauma informed child-welfare initiative with the goal of improving well-being, permanency and maltreatment outcomes for traumatized children. The Massachuetts Child Trauma Project (MCTP), funded by the Administration of Children and Families, Children’s Bureau was a multi-year project implementing trauma-informed care into child welfare service delivery. The project’s implementation design included training and consultation for mental health providers in three evidence-based treatments and training of the child-welfare workforce in trauma-informed case work practice. The learning was integrated between child-welfare and mental health with Trauma Informed Leadership Teams which included leaders from both systems and the greater community. These teams developed incremental steps toward trauma-informed system improvement. This study evaluated whether MCTP was associated with reductions in child abuse and neglect, improvements in placement stability, and higher rates of permanency during the first year of implementation. Children in the intervention group had fewer total substantiated reports of maltreatment, including less physical abuse and neglect than the comparison group by the end of the intervention year. However, children in the intervention group had more maltreatment reports (substantiated or not) and total out-of-home placements than did their counterparts in the comparison group. Assignment to MCTP, however, was not associated with an increase in kinship care or adoption. Overall, the results are promising in reinforcing the importance of mobilizing communities toward improvements in child-welfare service delivery. 相似文献
20.
Sheikhattari P Stephenson R Assasi N Eftekhar H Zamani Q Maleki B Kiabayan H 《Child abuse & neglect》2006,30(3):231-245
OBJECTIVE: This study examines the determinants of three types of child maltreatment: physical maltreatment, mental maltreatment, and child neglect among school children in the Kurdistan Province of Iran. The analysis examines the impact of socioeconomic, familial, demographic, and household dynamic factors on the three child maltreatment outcomes, and compares the differential impact of these factors across the three types of child maltreatment. A greater understanding of the factors associated with child maltreatment has the potential to inform public health interventions aimed at reducing specific forms of maltreatment and at identifying at risk populations. METHODS: Data were collected from 1,370 school students, age 11-18. Separate logistic models are fitted for six binary outcomes examining self-reported experiences of physical maltreatment in the home or school, mental maltreatment in the home or school, and child neglect in the home or school. RESULTS: Male children were more likely to report experiencing any kind of child maltreatment than girls. Residency in a rural area, poor parental relationships and the use of addictive substances by household members were associated with increased odds of reporting child maltreatment. Poor school performance was associated with the reporting of experiencing maltreatment at school. CONCLUSION: Each of the forms of child maltreatment is highly correlated with socioeconomic, demographic, and living condition factors. The results point to the strong influence that familial factors have in shaping a child's likelihood of reporting maltreatment. Characteristics of the mother were associated with maltreatment, but not characteristics of the father. The results highlight a number of mechanisms through which public health interventions may seek to reduce the prevalence of child maltreatment in Kurdistan; different approaches are needed to reduce child maltreatment in the home and school environments. 相似文献