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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Impact of intimate partner violence on children's well-child care and medical home

TitleImpact of intimate partner violence on children's well-child care and medical home
Publication TypeJournal Article
Year of Publication2008
AuthorsBair-Merritt, MH, Crowne, SS, Burrell, L, Caldera, D, Cheng, TL, Dugqan, AK
JournalPediatrics
Volume121
Paginatione473-e480
ISBN Number00314005 (ISSN)
KeywordsAdult, article, battered woman, Battered Women, behavior disorder, caregiver, Caregivers, child abuse, Child Behavior Disorders, child care, child health care, Child Health Services, Child Welfare, Child, Preschool, cohort analysis, Cohort Studies, demography, depression, family stress, Female, follow up, Follow-Up Studies, health care utilization, Health service use, home environment, human, Humans, immunization, Immunizations, Infant, Infant, Newborn, Intimate partner violence, major clinical study, Male, Medical home, mother child relation, Mother-Child Relations, neglect, newborn, Partner violence, Pediatric provider-caregiver relationship, Pregnancy, preschool child, priority journal, Probability, psychological aspect, questionnaire, Questionnaires, Retrospective Studies, retrospective study, Risk Assessment, social aspect, Spouse Abuse, statistical analysis, statistics, substance abuse, United States, Utilization Review
Abstract

OBJECTIVES. Intimate partner violence has been linked to poor child health. A continuous relationship with a primary care pediatric provider can help to detect intimate partner violence and connect families with needed services. The objectives of this study were to determine the relationship between intimate partner violence and (1) maternal report of a regular site for well-child care, (2) maternal report of a primary pediatric provider, (3) well-child visits in the first year of life, (4) up-to-date immunizations at 2 years of age, (5) maternal report of medical neglect, and (6) maternal report of the pediatric provider-caregiver relationship. METHODS. This retrospective cohort study evaluated data from 209 at-risk families participating in the evaluation of the Healthy Families Alaska program. Research staff interviewed mothers near the time of an index child's birth and again at the child's second birthday. Medical charts were abstracted for information on well-child visits and immunizations. RESULTS. Mothers who disclosed intimate partner violence at the initial interview (n = 62) were significantly less likely to report a regular site for well-child care or a primary pediatric provider. In multivariable models, children of mothers who disclosed intimate partner violence tended to be less likely to have the recommended 5 well-child visits within the first year of life and were significantly less likely to be fully immunized at 2 years of age. Differences in medical neglect were not statistically significant. Of mothers who reported a specific primary pediatric provider, those with intimate partner violence histories trusted this provider less and tended to rate less favorably pediatric provider- caregiver communication and the overall quality of the pediatric provider-caregiver relationship. CONCLUSIONS. Future research should explore effective ways to link intimate partner violence-exposed children with a medical home and a primary pediatric provider and to improve relationships between pediatric providers and caregivers who face violence at home. Copyright © 2008 by the American Academy of Pediatrics.