Background

Cross-sectional analyses have identified factors associated with the decision to provide continued child welfare services. Determinations that children are at risk of maltreatment have been found to influence investigative decision-making in Ontario, over and above all other family and case characteristics.

Purpose

This study uses longitudinal administrative data to assess the decision to transfer a family to ongoing child welfare services within twelve months of an initial investigation.

Methods

We developed an entry cohort from administrative data held in the Ontario Child Abuse and Neglect Data System (OCANDS), which included all families investigated during 2013 in participating agencies. We conducted descriptive comparative analyses and used results to generate a generalized linear model to determine predictors of transfer.

Results

Of the 34,397 families investigated in 2013 by participating agencies, 23% were transferred to ongoing child welfare services within 12 months. Rates of transfer were highest when the primary caregiver was under 25; caregiver-child conflict or caregiver capacity were the primary reason for the investigation; immediate safety was a concern; and future risk of maltreatment was high. In the multivariable model, families considered high or very high risk were more likely to be transferred (RR: 2.13; 95% CI: 2.04, 2.22, p < 0.001), as were families investigated for caregiver-child conflict (RR: 2.53; 95% CI: 2.34, 2.77; p < 0.001).

Conclusions

Concerns about risk of harm appear to drive decision-making from the point of referral through the decision to transfer to ongoing services in a sample of agencies in Ontario. It is unclear whether child welfare services are the appropriate mechanism for effectively addressing circumstances that may put children at risk, particularly when the structure and delivery of services have been designed to intervene when children have already been harmed.

中文翻译：

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风险在儿童福利决策中的作用：调查后对转移至正在进行的儿童保护服务的家庭进行的前瞻性队列研究

背景

横断面分析已确定了与提供持续儿童福利服务的决定相关的因素。在所有其他家庭和案件特征之外，已经发现确定儿童有遭受虐待风险的决定会影响安大略省的调查决策。

目的

这项研究使用纵向行政数据来评估在初次调查后的12个月内将家庭转为进行中的儿童福利服务的决定。

方法

我们根据安大略省虐待儿童和忽视儿童数据系统（OCANDS）中的行政数据开发了一个入境队列，其中包括参与机构在2013年期间调查的所有家庭。我们进行了描述性比较分析，并使用结果生成了广义线性模型来确定转移的预测因子。

结果

参与机构在2013年调查的34,397个家庭中，有23％在12个月内转移到了正在进行的儿童福利服务中。当主要照料者低于25岁时，转移率最高。照顾者与孩子之间的冲突或照顾者的能力是调查的主要原因；眼前的安全是一个问题。而且未来遭受虐待的风险很高。在多变量模型中，被认为具有高风险或极高风险的家庭更容易转移（RR：2.13； 95％CI：2.04，2.22，p  <0.001），以及因照顾者与孩子之间的冲突而进行调查的家庭（RR：2.53； 2.5％）。 95％CI：2.34，2.77；p  <0.001）。

结论

对伤害风险的担忧似乎推动了决策的制定，从转介到决定转移到安大略省样本机构中正在进行的服务。尚不清楚儿童福利服务是否是有效解决可能使儿童处于危险之中的情况的适当机制，特别是在设计服务的结构和提供以在儿童受到伤害时进行干预的情况下。