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2017 Annual Meeting

September 12–14, 2017

Aurora, Colorado

The links below contained detailed information for the upcoming 2017 Safe States Alliance Annual Meeting, taking place September 12-14, 2017 in Aurora, Colorado.

Please note:

Introducing the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) Project: Making Smarter Use of Available Data

Tuesday, September 12, 2017 at 3:30 PM–4:45 PM MDT
Conference Room 1
Learning Objectives
Statement of Purpose

Health informatics projects integrating statewide birth populations with child protection records have emerged as a viable approach to conducting longitudinal research of child maltreatment. These large linkage projects however can be resource intensive, are limited to what is captured in administrative records, and rely on non-linkage assumptions for follow-up. We describe a resource efficient mixed-design data linkage project to calculate the incidence proportion to first maltreatment report, screen-in, and substantiation.

Methods/Approach

The Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project integrates the 2009-2011 Pregnancy Risk Assessment Monitoring System (PRAMS) survey with multiple administrative sources in Alaska, including child protection and a novel source, the permanent fund dividend (PFD). The PFD database contains records of Alaska residents that apply for oil revenue dividends and is a unique data source used to track the complete cohort over time and unlike other birth cohort studies allows us to account for out-of-state emigration. We calculated the incidence proportion F(t) using a weighted Aalen hazard-based estimation of the survivorship function S(t). Stratified results were calculated and validation processes conducted to quantify bias resulting in birth cohort studies relying on non-linkage assumptions or using restrictive record linkage parameters.

Results

The PRAMS estimates were within one percentage point of the full cohort estimate. The crude incidence of experiencing at least one report, screen in report, or substantiated report of maltreatment among the 2009-2011 cohort were 31.3%, 25.3%, and 8.5% before age 7, respectively. These estimates are on average 10% (8.1% - 10.9%) higher than those produced without accounting for censorship. For some subpopulations over 50% of the births had a report of maltreatment. Annual prevalence estimates among children < 7 years in Alaska indicate that approximately 10% experience a report of harm, and 2% substantiated.

Conclusions & Significance to the Field

The ALCANLink methodology is an efficient method for estimating the incidence proportion of maltreatment in a representative birth cohort and can be used for conducting comprehensive predictive and etiologic assessments. Further, these methods are transferable to other states using the PRAMS survey and may enable more accurate between state comparisons of maltreatment. The incidence proportion clearly documents that when measured over the life course more children are potentially exposed to maltreatment then estimated using annual prevalence estimates.

Presenters

Jared Parrish, State of Alaska MCH-Epidemiology
Biography

Dr. Parrish is currently the senior epidemiologist with the MCH-Epidemiology Unit of the Alaska Division of Public Health and has spent over 10 years working on improving surveillance methodologies for child maltreatment. He is nationally recognized for his work on integration of data to quantify child maltreatment and improving maltreatment fatality classification consistency. He is skilled at utilizing epidemiologic methods and leveraging these methods for applied research that can be used to inform policy and practice. Dr. Parrish serves on multiple committees focused on improving national estimates of maltreatment related mortality, and has provided states and counties across the U.S. technical assistance on implementing maltreatment surveillance.  Dr. Parrish focus his research on quantifying the influence of systematic error on effect estimates, data integration, and incorporating novel methods for applied surveillance with an emphasis on improving timeliness, efficacy, and utility of data that lead to prevention.

Co-Authors

Primary Contact

Jared Parrish, State of Alaska MCH-Epi
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