%0 Journal Article %J Inj Prev %D 2015 %T Assessing the accuracy of the International Classification of Diseases codes to identify abusive head trauma: a feasibility study. %A Berger, Rachel P %A Parks, Sharyn %A Fromkin, Janet %A Rubin, Pamela %A Pecora, Peter J %K Brain Injuries %K Child Abuse %K Child, Preschool %K Craniocerebral Trauma %K Feasibility Studies %K Female %K Humans %K Infant %K International Classification of Diseases %K Male %K Sensitivity and Specificity %X

OBJECTIVE: To assess the accuracy of an International Classification of Diseases (ICD) code-based operational case definition for abusive head trauma (AHT).

METHODS: Subjects were children <5 years of age evaluated for AHT by a hospital-based Child Protection Team (CPT) at a tertiary care paediatric hospital with a completely electronic medical record (EMR) system. Subjects were designated as non-AHT traumatic brain injury (TBI) or AHT based on whether the CPT determined that the injuries were due to AHT. The sensitivity and specificity of the ICD-based definition were calculated.

RESULTS: There were 223 children evaluated for AHT: 117 AHT and 106 non-AHT TBI. The sensitivity and specificity of the ICD-based operational case definition were 92% (95% CI 85.8 to 96.2) and 96% (95% CI 92.3 to 99.7), respectively. All errors in sensitivity and three of the four specificity errors were due to coder error; one specificity error was a physician error.

CONCLUSIONS: In a paediatric tertiary care hospital with an EMR system, the accuracy of an ICD-based case definition for AHT was high. Additional studies are needed to assess the accuracy of this definition in all types of hospitals in which children with AHT are cared for.

%B Inj Prev %V 21 %P e133-7 %8 2015 Apr %G eng %N e1 %R 10.1136/injuryprev-2013-040924 %0 Journal Article %J Child Welfare %D 2012 %T Family Group Decision Making (FGDM) with Lakota families in two tribal communities: tools to facilitate FGDM implementation and evaluation. %A Marcynyszyn, Lyscha A %A Bear, Pete Small %A Geary, Erin %A Conti, Russ %A Pecora, Peter J %A Day, Priscilla A %A Wilson, Stephen T %K Child %K Child Welfare %K Community-Institutional Relations %K Culture %K Decision Making %K Family %K Female %K Follow-Up Studies %K Grief %K Humans %K Indians, North American %K Intergenerational Relations %K Male %K Models, Organizational %K Personal Satisfaction %K Program Evaluation %K Social Work %K South Dakota %K Stress, Psychological %X

This article describes an adapted Family Group Decision Making (FGDM) practice model for Native American communities, the FGDM family and community engagement process, and FGDM evaluation tools as one example for other native communities. Challenges and successes associated with the implementation and evaluation of these meetings are also described in the context of key historical and cultural factors, such as intergenerational grief and trauma, as well as past misuse of data in native communities.

%B Child Welfare %V 91 %P 113-34 %8 2012 %G eng %N 3 %0 Journal Article %J Am J Orthopsychiatry %D 2012 %T Institutional predictors of developmental outcomes among racially diverse foster care alumni. %A Garcia, Antonio R %A Pecora, Peter J %A Harachi, Tracy %A Aisenberg, Eugene %K Adult %K African Americans %K Consumer Behavior %K Educational Status %K Employment %K Ethnic Groups %K European Continental Ancestry Group %K Female %K Foster Home Care %K Hispanic Americans %K Humans %K Logistic Models %K Male %K Mental Disorders %X

Child welfare practitioners are confronted with the responsibility of relying on best practice to ensure children in foster care transition successfully into adulthood after leaving the foster care system. Yet, despite recent reforms and efforts to address their needs, research clearly shows that foster care alumni are still more likely to experience negative developmental outcomes compared to adults in the general population. The purpose of this study was to better understand how child-serving systems of care adequately prepare racially diverse foster care alumni to thrive. Controlling for gender, age, placement instability, and circumstances of exit from foster care, study findings highlighted salient racial and ethnic differences relative to which factors predicted the odds of mental health, education, and employment outcomes. Implications for developing and implementing culturally sensitive, evidence-based prevention and intervention programs to promote positive developmental outcomes among racially diverse foster care alumni are discussed.

%B Am J Orthopsychiatry %V 82 %P 573-84 %8 2012 Oct %G eng %N 4 %R 10.1111/j.1939-0025.2012.01181.x %0 Journal Article %J Child Welfare %D 2012 %T Strengthening families and communities to prevent child abuse and neglect: lessons from the Los Angeles Prevention Initiative Demonstration Project. %A McCroskey, Jacquelyn %A Pecora, Peter J %A Franke, Todd %A Christie, Christina A %A Lorthridge, Jaymie %K Child %K Child Abuse %K Child Health Services %K Child Welfare %K Community Networks %K Family %K Humans %K Los Angeles %K Preventive Health Services %K Program Evaluation %X

The Prevention Initiative Demonstration Project, funded by the Los Angeles County Department of Children and Family Services (DCFS), is a community-specific strategy delivered through eight regional networks designed to address the full spectrum of community-based prevention. This article summarizes a strong and meaningful pattern of improvements found in the second year evaluation for three groups of families--those living in high-risk communities but not involved with DCFS, those being investigated by DCFS for possible child maltreatment, and those with open DCFS cases.

%B Child Welfare %V 91 %P 39-60 %8 2012 %G eng %N 2 %0 Journal Article %J Child Welfare %D 2011 %T Posttraumatic stress disorder among foster care alumni: the role of race, gender, and foster care context. %A Jackson, Lovie J %A O'Brien, Kirk %A Pecora, Peter J %K Adult %K Adult Survivors of Child Abuse %K African Americans %K European Continental Ancestry Group %K Female %K Foster Home Care %K Humans %K Logistic Models %K Male %K Middle Aged %K Social Class %K Stress Disorders, Post-Traumatic %K Time %K Young Adult %X

Little is known about the prevalence of posttraumatic stress disorder (PTSD) in adult alumni of foster care and its demographic and contextual correlates. This is one of the first studies to report on racial/ethnic and gender differences and the influence of foster care experiences (i.e., revictimization during foster care, placement change rate, and placement in kinship care) on past year PTSD. Findings revealed significant gender disparities and a moderating influence of kinship care on the relationship between gender and PTSD, as well as increased risk associated with a history of emotional and sexual abuse. Recommendations are made for clinical and systemic intervention.

%B Child Welfare %V 90 %P 71-93 %8 2011 %G eng %N 5 %0 Journal Article %J Adm Policy Ment Health %D 2010 %T Why current and former recipients of foster care need high quality mental health services. %A Pecora, Peter J %K Adolescent %K Adolescent Health Services %K Affective Symptoms %K Child %K Child Behavior Disorders %K Child Health Services %K Child Welfare %K Community Mental Health Services %K Education %K Foster Home Care %K Health Policy %K Health Services Needs and Demand %K Health Services Research %K Humans %K Outcome and Process Assessment (Health Care) %K Quality Assurance, Health Care %K Substance-Related Disorders %K United States %X

This commentary presents data about the emotional, behavioral, and substance abuse disorders of youth in foster care and former recipients of foster care ("alumni") in the United States to underscore the reasons why high quality mental health services are essential.

%B Adm Policy Ment Health %V 37 %P 185-90 %8 2010 Mar %G eng %N 1-2 %R 10.1007/s10488-010-0295-y