Background

The public health significance of the opioid epidemic is well-established. However, few states collect data on opioid problems among families involved in child welfare services. The absence of data creates significant barriers to understanding the impact of opioids on the service system and the needs of families being served.

Objective

This study sought to validate binary and count-based indicators of opioid-related maltreatment risk based on mentions of opioid use in written child welfare summaries.

Data and procedures

We developed a comprehensive list of terms referring to opioid street drugs and pharmaceuticals. This terminology list was used to scan and flag investigator summaries from an extensive collection of investigations (N = 362,754) obtained from a state-based child welfare system in the United States. Associations between mentions of opioid use and investigators' decisions to substantiate maltreatment and remove a child from home were tested within a framework of a priori hypotheses.

Results

Approximately 6.3% of all investigations contained one or more opioid use mentions. Opioid mentions exhibited practically signficant associations with investigator decisions. One in ten summaries that were substantiated had an opioid mention. One in five investigations that led to the out-of-home placement of a child contained an opioid mention.

Conclusion

This study demonstrates the feasibility of using simple text mining procedures to extract information from unstructured text documents. These methods provide novel opportunities to build insights into opioid-related problems among families involved in a child welfare system when structured data are not available.

中文翻译：

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一种基于文本的方法来测量参与儿童福利系统的家庭的阿片类药物相关风险

背景

阿片类药物流行病的公共卫生意义是公认的。然而，很少有州收集有关参与儿童福利服务的家庭中阿片类药物问题的数据。数据的缺乏为理解阿片类药物对服务系统的影响和所服务家庭的需求造成了重大障碍。

客观的

本研究试图根据书面儿童福利摘要中提到的阿片类药物使用来验证阿片类药物相关虐待风险的二进制和基于计数的指标。

数据和程序

我们制定了一份涉及阿片类街头药物和药品的完整术语列表。该术语表用于扫描和标记从美国基于州的儿童福利系统获得的大量调查 ( N  = 362,754) 中的调查员摘要。在先验假设的框架内测试了提及阿片类药物使用与调查人员证实虐待和将儿童带离家中的决定之间的关联。

结果

大约 6.3% 的调查包含一个或多个阿片类药物使用提及。阿片类药物的提及与调查人员的决定表现出实际上显着的关联。十分之一得到证实的摘要提到了阿片类药物。五分之一的调查导致孩子在户外安置，其中提到了阿片类药物。

结论

这项研究证明了使用简单的文本挖掘程序从非结构化文本文档中提取信息的可行性。当结构化数据不可用时，这些方法提供了新的机会来深入了解参与儿童福利系统的家庭中的阿片类药物相关问题。