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评估美国陆军应对家庭虐待指控的两种方法:协调社区响应的影响和成本。

Evaluation of Two Approaches for Responding to Allegations of Family Maltreatment in the U.S. Army: Coordinated Community Response Impacts and Costs.

机构信息

Family Translational Research Group, New York University, New York, NY 10010, USA.

Department of Agricultural Economics, Sociology and Education, Clearinghouse for Military Family Readiness, The Pennsylvania State University, University Park, PA 16802, USA.

出版信息

Mil Med. 2022 Jul 1;187(7-8):e987-e994. doi: 10.1093/milmed/usab115.

Abstract

INTRODUCTION

The U.S. Air Force (USAF) conducted a program of research to develop and disseminate reliable and valid criteria for partner and child maltreatment (comprising abuse [physical, emotional/psychological, and sexual] and neglect). These criteria are now used in all branches of the U.S. military. The U.S. Army was the first service outside the USAF to adopt the criteria sets and computerized decision support tool but maintained the original committee composition (the "Case Review Committee" [CRC]) instead of adopting the entire assessment, allegation determination, and treatment planning process (the "Field-tested Assessment, Intervention-planning, and Response" [FAIR] system). The Army commissioned this study to compare the CRC and FAIR processes by testing (1) intra-committee process (i.e., three facets of committee functioning-fidelity to regulations, cohesion and team process, outsized influence of unit representatives); (2) coordinated community response to maltreatment (i.e., perceptions of fairness to alleged offenders and victims, impact on unit representatives, and (3) collaboration between the Family Advocacy Program (FAP, the military's maltreatment response agency) and outside agencies; and (4) the time expended and cost.

MATERIALS AND METHODS

New York University's Institutional Review Board approved the study protocol, and the Army's Human Research Protection Office provided permission to collect data. The ten Army garrisons with the most annual maltreatment cases participated. Committee members, FAP social workers, unit commanders, and independent observers completed assessments of individual meetings and of their overall impression of the processes. A test of whether the means significantly differed between phases was then performed separately for each outcome, and 95% CIs of the unstandardized mean difference between phases were estimated.

RESULTS

Independent observers rated FAIR meetings as significantly more faithful to regulations. Unit representatives (i.e., commanders and/or first sergeants) perceived the committee to function better during FAIR (although other committee members and independent observers did not perceive differences). Unit representatives not only rated FAIR as significantly more fair to both alleged offenders and victims (ratings from other committee members did not differ), but also were more likely to attend FAIR meetings and, when they did, rated their ability to serve soldiers and families higher during FAIR. However, FAP social workers rated their relationships with units as being better during CRC, and outside agencies rated their relationship with FAP as significantly better during CRC. Costs to the Army were nearly identical in the two committee structures.

CONCLUSION

Results indicated that the CRC and FAIR processes cost almost identical amounts to run and that the FAIR system was superior in ways most likely to impact service members: (1) independent observers judged its meetings to be more faithful to Army and DoD Instructions; (2) unit representatives were more likely to attend and believed the FAIR system to be fairer (to both alleged offenders and victims) and better functioning. Care should be taken, however, in nurturing relationships between FAP and (1) unit representatives and (2) outside agencies, which may have weakened during FAIR.

摘要

简介

美国空军(USAF)开展了一项研究计划,旨在制定和传播有关伴侣和儿童虐待(包括虐待[身体、情感/心理和性]和忽视)的可靠和有效的标准。这些标准现在已在美国军队的所有分支中使用。美国陆军是美国空军以外第一个采用标准集和计算机化决策支持工具的军种,但保留了最初的委员会组成(“案件审查委员会”[CRC]),而不是采用整个评估、指控确定和治疗计划过程(“实地测试评估、干预规划和反应”[FAIR]系统)。陆军委托进行这项研究,以通过测试(1)委员会内部流程(即委员会运作的三个方面——遵守法规、凝聚力和团队流程、单位代表的过大影响);(2)对虐待的协调社区反应(即对被指控的违法者和受害者的公平感、对单位代表的影响,以及(3)家庭倡导计划(FAP,军队的虐待反应机构)与外部机构之间的合作;(4)所花费的时间和成本,来比较 CRC 和 FAIR 流程。

材料和方法

纽约大学机构审查委员会批准了研究方案,陆军的人体研究保护办公室批准了收集数据的许可。十个有最多年度虐待案件的陆军驻地参与了该研究。委员会成员、FAP 社会工作者、单位指挥官和独立观察员完成了对个别会议和整个流程印象的评估。然后,针对每个结果,分别对阶段之间的平均值是否显著不同进行了测试,并估计了阶段之间未标准化平均差异的 95%置信区间。

结果

独立观察员认为 FAIR 会议更严格地遵守法规。单位代表(即指挥官和/或第一军士)认为委员会在 FAIR 期间运作得更好(尽管其他委员会成员和独立观察员没有察觉到差异)。单位代表不仅认为 FAIR 对被指控的违法者和受害者都更公平(其他委员会成员的评价没有差异),而且更有可能参加 FAIR 会议,并且在参加时,他们在 FAIR 期间对为士兵和家庭服务的能力评价更高。然而,FAP 社会工作者认为他们与单位的关系在 CRC 期间更好,而外部机构则认为他们与 FAP 的关系在 CRC 期间更好。这两种委员会结构对陆军的成本几乎相同。

结论

结果表明,CRC 和 FAIR 流程的运行成本几乎相同,而 FAIR 系统在最有可能影响服务人员的方面具有优势:(1)独立观察员判断其会议更严格地遵守陆军和国防部的指令;(2)单位代表更有可能参加会议,并认为 FAIR 系统对被指控的违法者和受害者(双方)更公平,运作更好。然而,应该注意的是,在培育 FAP 与(1)单位代表和(2)外部机构之间的关系时要小心,这些关系可能在 FAIR 期间变得薄弱。

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