Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, 801 Albany Street, Boston, MA 02119, United States of America.
Department of Pediatrics, Yale School of Medicine, 20 York Street, New Haven, CT 06510, United States of America.
Child Abuse Negl. 2022 Sep;131:105781. doi: 10.1016/j.chiabu.2022.105781. Epub 2022 Jul 9.
Caregivers' substance use is associated with child maltreatment.
Examine trends from 2005 to 2018 in percentages of three outcomes with caregivers' drug or alcohol use: child protective services (CPS) referrals, substantiated maltreatment reports, and foster care placements.
22 U.S. states that contributed child-level maltreatment outcomes and caregivers' substance use data to the National Child Abuse and Neglect Data System from 2005 to 2018.
Joinpoint regression was used to examine the average annual percent change (AAPC) in outcomes with caregivers' drug or alcohol use and to identify temporal changes.
From 2005 to 2018, CPS referrals with caregivers' drug use increased (AAPC 2.33, p < .001), while referrals with alcohol use remained unchanged (AAPC -0.11, p = .92) (trend difference p = .04). Substantiated reports with caregivers' drug and alcohol use increased (AAPC drug use 3.63, p < .001, AAPC alcohol use 1.28, p = .03), with a greater increase observed with drug use (difference p = .03). Foster care placements with caregivers' drug use increased (AAPC 2.54, p < .001), while placements with alcohol use did not change (AAPC -1.22, p = .29), (difference p = .005). Within the study period, changes in trends with caregivers' drug use included increased substantiated reports from 2010 to 2018 (p < .001) and increased foster care placements from 2009 to 2018 (p < .001). With caregivers' alcohol use, CPS referrals and foster care placements decreased from 2007 to 2018 (all p < .001).
Trends differed for outcomes with caregivers' drug versus alcohol use. Findings can inform policies to improve care for families affected by substance use.
照料者的物质使用与儿童虐待有关。
检查从 2005 年到 2018 年，照料者药物或酒精使用的三种结果（儿童保护服务（CPS）转介、证实的虐待报告和寄养安置）的百分比趋势。
2005 年至 2018 年，有 22 个美国州向全国儿童虐待和忽视数据系统提供了儿童虐待结果和照料者物质使用数据。
使用 Joinpoint 回归检查有照料者药物或酒精使用的结果的平均年度百分比变化（AAPC），并确定时间变化。
从 2005 年到 2018 年，CPS 转介中与照料者药物使用相关的转介增加（AAPC 2.33，p<.001），而与酒精使用相关的转介保持不变（AAPC-0.11，p=.92）（趋势差异 p=.04）。与照料者药物和酒精使用相关的证实报告增加（AAPC 药物使用 3.63，p<.001，AAPC 酒精使用 1.28，p=.03），药物使用的增幅更大（差异 p=.03）。与照料者药物使用相关的寄养安置增加（AAPC 2.54，p<.001），而与酒精使用相关的安置没有变化（AAPC-1.22，p=.29）（差异 p=.005）。在研究期间，与照料者药物使用相关的趋势变化包括 2010 年至 2018 年证实报告增加（p<.001）和 2009 年至 2018 年寄养安置增加（p<.001）。与照料者酒精使用相关，CPS 转介和寄养安置从 2007 年到 2018 年减少（均 p<.001）。
照料者药物使用与酒精使用的结果趋势不同。研究结果可以为改善受物质使用影响的家庭的护理政策提供信息。
