This proposal is designed to prepare this applicant, through educational and research experiences, for an independent academic career in the field of child maltreatment research. Dr. Lane will work closely with three mentors at the University of Maryland, Baltimore: Dr. Howard Dubowitz from the Department of Pediatrics, and Drs. Patricia Dischinger and Dr. Patricia Langenberg from the Department of Epidemiology and Preventive Medicine. Dr. Lane plans to enhance her skills in three specific areas: (1) Identification of where prevention interventions are most needed, through an enhanced understanding of risk and protective factors and expanded skills in epidemiology; (2) Knowledge in design and implementation of prevention interventions, including the ethical issues that may arise; (3) Skills in the evaluation of interventions to prevent maltreatment. The didactic portion of this training will include coursework in the design and evaluation of prevention interventions, advanced epidemiology and biostatistics, cost-effectiveness analysis, and responsible conduct of research. The scholar-initiated research will focus on the epidemiology of overt and occult abusive abdominal trauma, as well as child maltreatment prevention.
The specific aims are to: (1) Estimate the incidence of overt and occult abusive abdominal trauma, (2) Compare clinical outcomes of children with abusive abdominal trauma to those with non-abusive abdominal trauma, (3) Identify factors that are associated with a positive screen for occult abdominal trauma among children with suspected abuse, and (4) Determine the cost-effectiveness of a child maltreatment prevention program. Data from several sources will be used. The KID Inpatient Database, a national sample of pediatric hospitalizations, will be used to examine the incidence of overt abusive abdominal trauma. A screening program for occult abdominal trauma will be developed to estimate its incidence among children with suspected abuse. A cost effectiveness analysis will be conducted for Dr. Dubowitz's SEEK III study, which aims to reduce child abuse incidence via risk factor screening in pediatric primary care. In addition to publications, data from this mentored research award will be used to develop independent proposals in child abuse epidemiology and prevention. This proposal has both short- and long-term public health relevance. The specific research projects will help establish evidence-based practice in the medical management and prevention of child abuse. The training component will provide Dr. Lane with the skills to continue this work in future research projects. ? ? ?
