How can the negative impact of intimate partner violence (IPV) on child health be minimized? IPV often continues in families despite social or legal interventions to stop the violence. Children therefore remain vulnerable to adverse health outcomes. This suggests that, to protect children's health, we must shape IPV interventions to reduce risks and to increase protective factors even if IPV continues. This requires a theoretically-guided, empirically-based understanding of the mechanisms by which IPV adversely influences child health, with a focus on the mediating influences. The goal of the proposed research is to gain such an understanding. The overarching framework guiding this research is that IPV leads to poor child health indirectly through its influence on maternal emotional health and parenting, which in turn affect child outcomes. Two related considerations include that patterns (based on variables such as severity, frequency and directionality) of IPV exist and that these patterns likely affect children differently. This proposal outlines two studies. The first is a cohort study of children followed from birth to middle childhood in which advanced analytical methods including structural equation modeling will be used to:
Aim 1 : Define the latent construct of IPV, assessing typologies of IPV and identifying patterns of IPV over time;
Aim 2 : Determine the relationship between these IPV constructs and children's health and health care use;
Aim 3 : Assess the role of maternal emotional health and parenting as mediators of the relationship between IPV and child health. A second qualitative study involving semi-structured interviews with abused women with young children will:
Aim 4 : Characterize abused women's perceptions of the relationship among IPV, their emotional health, their parenting and their child's health.
These aims fit with NICHD's mission of "all children achieving their potential for healthy and productive lives." The proposed career development program for this candidate, a pediatrician with a degree in epidemiology, focuses on: 1) understanding the etiology and epidemiology of IPV;2) obtaining a theoretical understanding of the impact of family conflict on children's health;3) learning higher level data analysis methods;and 4) acquiring qualitative research skills. The candidate's long-term career goal is to lead multidisciplinary efforts to facilitate the healthy development of children exposed to IPV. Upon completion of this award, she will submit an R01 application for a longitudinal cohort study collecting primary data on the health of a local cohort of children with and without IPV exposure. From a public health perspective, childhood is a critical time period in establishing an individual's lifetime health trajectory;IPV has the potential to significantly compromise children's health. A better understanding of the IPV-child health relationship will facilitate the design of effective, targeted interventions.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HD057180-05
Application #
8225173
Study Section
Special Emphasis Panel (ZHD1-DSR-M (HB))
Program Officer
Maholmes, Valerie
Project Start
2008-03-06
Project End
2013-07-01
Budget Start
2012-03-01
Budget End
2013-07-01
Support Year
5
Fiscal Year
2012
Total Cost
$113,940
Indirect Cost
$8,440
Name
Johns Hopkins University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Bair-Merritt, Megan H; Crowne, Sarah Shea; Thompson, Darcy A et al. (2010) Why do women use intimate partner violence? A systematic review of women's motivations. Trauma Violence Abuse 11:178-89
Bair-Merritt, Megan H; Jennings, Jacky M; Chen, Rusan et al. (2010) Reducing maternal intimate partner violence after the birth of a child: a randomized controlled trial of the Hawaii Healthy Start Home Visitation Program. Arch Pediatr Adolesc Med 164:16-23
Bair-Merritt, Megan H (2010) Intimate partner violence. Pediatr Rev 31:145-50; quiz 150
Rabin, Rebecca F; Jennings, Jacky M; Campbell, Jacquelyn C et al. (2009) Intimate partner violence screening tools: a systematic review. Am J Prev Med 36:439-445.e4