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PURPOSE OF REVIEW: The purpose of this review was to synthesize the empirical literature regarding key risk and protective factors for child maltreatment at each level of the socioecological model and to identify directions for future research and practice. RECENT FINDINGS: Prior research has largely focused on risk and protective factors at the individual and interpersonal levels of the socioecological model. More recently, research has begun to examine risk and protective factors at the community and societal levels, with results suggesting that programmatic and policy interventions that reduce risk and enhance protection at these levels are promising primary prevention strategies for child maltreatment. SUMMARY: Future research should continue to focus on risk and protective factors at the community and societal levels with the aim of building the evidence base for population-wide prevention strategies. Such strategies have the potential to create contexts in which families and children thrive.

Currently, little is known about patterns of co-occurring risk and protective factors among young children. Understanding variations in co-occurring risk and protective factors among children in Alaska is important as experiences of collective trauma may contribute to differences in the intersection of risk and protective factors between Alaska Native/American Indian (AN/AI) and non-Native children. Using data from the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project, a linkage of the 2009–2011 Alaska Pregnancy Risk Assessment Monitoring System survey and administrative data sources, and the 2012–2014 Childhood Understanding Behaviors Survey, we conducted latent class analysis to identify classes of AN/AI (N=593) and non-Native (N=1,018) children in terms of seven risk factors (poverty, maternal depression, maternal binge drinking, parental incarceration, intimate partner violence exposure, other violence exposure, child maltreatment) and four protective factors (father figure involvement, reading by adults, family meals, peer interactions) experienced prior to age three years. We identified two classes among AN/AI children: 1) high risk-moderate protection (29.1%) and 2) low socioeconomic status-high protection (70.9%). We identified two classes among non-Native children: 1) moderate risk-high protection (32.9%) and 2) low risk-high protection (67.1%). A test of invariance revealed that risk and protective factor probabilities differed significantly for corresponding classes of AN/AI and non-Native children. Overall, results demonstrate heterogeneity within and between AN/AI and non-Native children in early experiences of risk and protection and suggest that interventions will be more effective if tailored to the experiences and developmental needs of specific demographic groups of Alaska children.

We examined the impact of the implementation of The Triple P-Positive Parenting Program in North Carolina (NC) on reducing child maltreatment, a serious public health problem in the US with lasting harmful effects on children. In 2012 and 2013, 34 of 100 counties in NC implemented Triple P. A panel data set with county-level child welfare data and emergency department (ED) discharge data from 2008 to 2015 for 100 counties in NC was constructed. A quasi-experimental design using difference-in-differences analysis estimated the association between the implementation of Triple P and the rate of (1) investigated child maltreatment reports; (2) entry into foster care; and (3) ED visits concerning for child maltreatment. Implementation of Triple P was associated with in a 4% decrease in the county rate of investigated reports of child maltreatment (RR = 0.96, 95% CI [0.93, 0.99]) and a 7% decrease in the county rate of children in foster care (RR = 0.93, 95% CI [0.88, 0.98]). Each of these findings was robust to one but not both sensitivity tests performed. There was no reduction in county-level rates of ED visits with ICD-9-CM codes concerning for child maltreatment. Implementation of Triple P in NC outside of the parameters of scientific study is associated with small reductions in the rates of child maltreatment reports and foster care placements. Additional research is needed to understand whether such small reductions justify the substantial investment communities are making in Triple P.

Achieving population level reductions in children maltreatment may require a statewide, systems level approach to create safe, stable, nurturing relationships and environments for all children. To assess this approach, the Centers for Disease Control and Prevention funded five states from 2013 to 2018 to implement a collective impact approach centered around four goals 1) Raise awareness and commitment to promote safe, stable, nurturing relationships and environments and prevent child maltreatment; 2) Use data to inform action; 3) Create the context for healthy children and families through norms change and evidence-based, trauma-informed programs; 4) Create the context for healthy children and families through policies. This paper describes North Carolina’s approach to achieving these goals, including the functions of the backbone organization(s), how the initiative identified stakeholders and developed a shared agenda, how the workgroups operated and what they achieved, communication strategies implemented, and other accomplishments achieved by the initiative. We also discuss successes and challenges faced by the NC Essentials for Childhood initiative.

Background: A single measure that distills complex body mass index (BMI) trajectories into one value could facilitate otherwise complicated analyses. This study creates and assesses the validity of such a measure: average excess BMI. Methods: We use data from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health (n=17 669). We calculate average excess BMI by integrating to find the area above a healthy BMI trajectory and below each subject-specific trajectory and divide this value by total study time. To assess validity and utility, we (1) evaluate relationships between average excess BMI from adolescence to adulthood and adult chronic conditions, (2) compare associations and fit to models using subject-specific BMI trajectory parameter estimates as predictors, and (3) compare associations to models using BMI trajectory parameter estimates as outcomes. Results: Average excess BMI from adolescence to adulthood is associated with increased odds of hypertension (OR = 1.56; 95% CI: 1.47, 1.67), hyperlipidemia (OR = 1.36; 95% CI: 1.26, 1.47), and diabetes (OR = 1.57; 95% CI: 1.47, 1.67). The odds associated with average excess BMI are higher than the odds associated with the BMI intercept, linear, or quadratic slope. Correlations between observed and predicted health outcomes are slightly lower for some models using average excess BMI as the focal predictor compared to those using BMI intercept, linear, and quadratic slope. When using trajectory parameters as outcomes, some covariates associate with the intercept, linear, and quadratic slope in contradicting directions. Conclusions: This study supports the utility of average excess BMI as an outcome. The higher an individual’s average excess BMI from adolescence to adulthood, the greater their odds of chronic conditions. Future studies investigating longitudinal BMI as an outcome should consider using average excess BMI, whereas studies that conceptualize longitudinal BMI as the predictor should continue using traditional latent growth methods.

Background Health informatics projects combining statewide birth populations with child welfare records have emerged as a valuable approach to conducting longitudinal research of child maltreatment. The potential bias resulting from linkage misspecification, partial cohort follow-up, and outcome misclassification in these studies has been largely unexplored. This study integrated epidemiological survey and novel administrative data sources to establish the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project. Using these data we evaluated and quantified the impact of non-linkage misspecification and single source maltreatment ascertainment use on reported maltreatment risk and effect estimates. Methods The ALCANLink project integrates the 2009–2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) sample with multiple administrative databases through 2014, including one novel administrative source to track out-of-state emigration. For this project we limited our analysis to the 2009 PRAMS sample. We report on the impact of linkage quality, cohort follow-up, and multisource outcome ascertainment on the incidence proportion of reported maltreatment before age 6 and hazard ratios of selected characteristics that are often available in birth cohort linkage studies of maltreatment. Results Failure to account for out-of-state emigration biased the incidence proportion by 12% (from 28.3%w to 25.2%w), and the hazard ratio (HR) by as much as 33% for some risk factors. Overly restrictive linkage parameters biased the incidence proportion downwards by 43% and the HR by as much as 27% for some factors. Multi-source linkages, on the other hand, were of little benefit for improving reported maltreatment ascertainment. Conclusion Using the ALCANLink data which included a novel administrative data source, we were able to observe and quantify bias to both the incidence proportion and HR in a birth cohort linkage study of reported child maltreatment. Failure to account for out-of-state emigration and low-quality linkage methods may induce bias in longitudinal data linkage studies of child maltreatment which other researchers should be aware of. In this study multi-agency linkage did not lead to substantial increased detection of reported maltreatment. The ALCANLink methodology may be a practical approach for other states interested in developing longitudinal birth cohort linkage studies of maltreatment that requires limited resources to implement, provides comprehensive data elements, and can facilitate comparability between studies. Electronic supplementary material The online version of this article (doi:10.1186/s40621-017-0119-6) contains supplementary material, which is available to authorized users.

This issue marks the first issue of the Journal of Primary Prevention for which our new editorial team has been responsible. We are very grateful to Khristine Queja of Springer for giving us this opportunity, and for all the considerable help and support we received from her, from the outgoing editor, Dr. Susan Tortolero, associate editor, Dr. Melissa Peskin, and from her colleagues Dennis Li and Lionel Santibanez. We hope that you, as readers and reviewers, appreciate the quality, depth, and variety of content that our journal offers, and look forward to hearing from you. We also hope you will submit manuscripts to our journal, and strongly encourage you to consider serving as a guest editor for a special issue, responsible for soliciting manuscripts and reviewers relating to a theme of importance to public health and primary prevention. We are actively seeking manuscripts that address the prevention of high risk behaviors, the reduction of associated problems and harms, and the promotion and maintenance of healthy functioning and psychosocial wellness. We publish a wide spectrum of studies that include the epidemiology and determinants of high risk behavior and environments, as well as the development, evaluation, translation, sustainability, and costs/benefits of preventive interventions. Because our goal is to publish articles that represent primary prevention activities across the globe, we particularly welcome international submissions. We will do our best to make an initial determination of your manuscript’s suitability for the journal within two weeks of its receipt. We will then let you know promptly if we believe it is not appropriate. To expedite the review process, we ask you (1) include at least three keywords that describe the content area of your manuscript, and (2) provide at least three reviewers (and their email addresses) whom you believe will provide a competent and fair review. Authors of manuscripts sent out for review can expect to receive a response within three to four months; if you do not hear from us within that time, please feel free to contact us. Typical delays, over which we have limited control, are caused by difficulties securing completed reviews within the specified period. Our final selection of articles for publication is based on their contribution to the field of prevention, the clarity of their presentation, the strength of their research methodology, and the significance and accessibility of their findings for scientific, policy, and general audiences. You can easily keep track of the review process as it pertains to your manuscript through the journal’s manuscript management system, which may be found here: http://www.editorialmanager.com/jopp/. Abstracts are limited to 300 words. Please pay close attention to the format and content of your abstract, since it is a focus for our initial screening decisions, and C. Ringwalt T. Gwynne M. Shanahan University of North Carolina, Chapel Hill, NC, USA