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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence (2002)

Chapter: Appendix G Summary of Evaluation Studies on Training of Health Care Professionals on Child Abuse and Neglect

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Previous Chapter: Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence

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Suggested Citation: "Appendix G Summary of Evaluation Studies on Training of Health Care Professionals on Child Abuse and Neglect." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Appendix G
Summary of Evaluation Studies on Training of Health Care Professionals on Child Abuse and Neglect

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Child Abuse and Neglect

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Medical students, residents, fellows, and attending physicians in pediatrics (Palusci & McHugh, 1995)	Type: Mixed Length: 9-15 hrs.in a clinical rotation Clinical aids: None	Other rotation comparison	Two-group, nonequivalent group	Knowledge of child sexual abuse	Self-report (30 items)
Residents in pediatrics (Dubowitz & Black, 1991)	Type: Mixed Length: Six 90-min. sessions Clinical aids: None	None	Two-group, comparison group	Knowledge, attitudes, and skills of child abuse	Self-report (31 items)
Residents in pediatrics (Dubowitz & Black, 1991)		None	Two-group, comparison group	Perceived competency to manage child abuse cases	Self-report (1 item)
Residents in pediatrics (Sugarman et al., 1997)	Type: Mixed Length: 8 hrs. Clinical aids: None Number of participants:22		One group	Knowledge of child sexual abuse	Self-report (33 items)

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Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	Immediately after training		Enrolled = 15 Post = 15 (100%)	Pre = 15 Pre = 15 (80%)	I_post > I_pre* Post = 12	I_post > C_post*	The study also included a reference group who received no training and was administered the pretest. It consisted of 127 students, residents, and physicians who attended report and continuity clinic conferences. All groups did not significantly differ at the pretest.
Yes	1	3-4	Eligible = 31 Pre = 31 Post = 31 (100%)	Eligible = 19 Pre = 19 Post = 19 (100%)	I_post1 > I_pre*	I_post > C_post* I_FU > C_FU	The pretest scores of the two groups did not significantly differ.
						I_post > C_post* I_FU > C_FU*
Yes	Immediately after training		Eligible = Pre = 22 Post = 22 (100%)	Not reported	I_post1 > I_pre*

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Child Abuse and Neglect

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Physicians, nurses, and caseworkers (Hibbard et al., 1987)	Type: Mixed Length: 1 day Clinical aids: Anatomically correct dolls; handbook of potential interventions		One group	Knowledge of child abuse	Self-report
Physicians, nursepractitioners, family practice and public health nurses, social w rkers, and secondary health educators (Sullivan & Clancy,1990)	Type: Mixed Length: 1 day Clinical aids: None		One group	Number of sexual abuse indicators recalled	Self-report
				Number of physical indicators of child abuse recalled	Self-report
				Number of psychological indicators of child abuse recalled	Self-report
				Number of behavioral indicators of child abuse recalled	Self-report
				Number of specific actions to take in interviews	Self-report

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Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	0.5	6	Eligible = 51 Pre = 38 (75%) Post = 35 (69%) FU =21 (41%)		Medical staff: I_post1 >I_pre* I_FU >I_pre* Social workers: I_post1 >I_pre* I_FU>I_pre*		Increased use of anatomically dolls was noted at the 6-month follow-up, but no data were reported.
Yes	Immediately after training	3, 6	Eligible = 350 Posttest only: Assigned = 85 Post = 82 (97%) Pre- and posttest: Assigned = 96 Post = 65 (68%) Pre- and FU: Assigned = 88 Post = 65 (74%) Pre- and FU2: Assigned = 81 Post = 41 (81%)		I_post1 >I_pre* I_FU>I_pre* I_FU2 <I_post		Groups were randomized to one of the four testing conditions. Because the design (anonymity of subjects)did not permit pairing pretest, posttest, and follow-up scores, the results on within-group change should be interpreted with caution. Results indicated no pretest effect on the immediate posttest. Significant differences on all but sexual abuse indicators are for all posttests and follow-up combined.
					I_post1 >I_pre*
					I_post1 >I_pre*
					I_post1 >I_pre
					I_post1 >I_pre*

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Child Abuse and Neglect

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Child protective service workers, including social workers (Cheung et al., 1991)	Type: Mixed Length: 6 hrs. Clinical aids: None		One group	Ability to complete initial case planning	Vignette (ratings)
				Ability to formulate goals	Vignette (ratings)
				Ability to set objectives for family	Vignette (ratings)
				Ability to develop a contract with family	Vignette (ratings)
Child protective service workers, including social workers (Leung &Cheung, 1998)	Type: Mixed Length: 3 mo. training program Clinical aids: None		One group	Perceived information and experience to:
				Identify abuse	Self-report (1 item)
				Identify risk	Self-report (1 item)
				Recognize indicators	Self-report (1 item)
				Attitudes (e.g., value of family preservation and cultural differences)	Self-report (9-item subscale)

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Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	Immediately after training		Eligible = 18 Pre = 18 Post = 18		I_post1 > I_pre
					I_post1 > I_pre*
					I_post1 > I_pre
					I_post1 > I_pre*
Yes	Immediately after training		Eligible = 413 Pre = 188 Post = 188 (100%)				The questionnaire on perceived knowledge and experience included 16 items, all of which showed statistically significant improvement. Sample sizes for the performance evaluation varied, given that most of the workers were not yet eligible for their second-
					I_post1 > I_pre*
					I_post1 > I_pre*
					I_post1 > I_pre*
Yes	Immediately after training		Eligible = 23 Pre = 20 Post = 20 (100%)		I_post1 > I_pre*

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Child Abuse and Neglect

Nature of Training Provided

Expected Outcomes and Measure

Target Population (study citation)

Intervention Group

Comparison Group (if applicable)

Study Design

Major Outcomes

Measure

Type: Mixed

Length: 3 mo. training program

Clinical aids: None

Not specified but some training as random sample of current caseworkers

Two-group, comparison group

Performance on job, including use of interviewing techniques, determining presence of child abuse or neglect, implementation of case management plans, and sufficient case documentation

Supervisor evaluation forms