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Introduction: Parent education has a positive impact on children, parents, families, and the community. Children at Risk and Bracewell & Giuliani LLP conducted a policy scan of state statutes regarding parent education. Methodology: To identify state statutes that address parent education, we conducted a search of statutes in all 50 states using keywords and the online legal research systems. After all state-level policies were ascertained, we selected the most relevant statutes to parent education and identified major themes. Results: The policy scan identified statutes regarding non-mandated parent education in 40 out of the 50 states. Common themes include: home visitation programs, funding through a Children's Trust Fund, early childhood initiatives, use of evidence-based programs, and a community-based component to the parent education statute. Discussion: In a needs assessment of parent education in Houston, Texas, stigma and funding were identified as the biggest barriers to increasing the availability of parent education. Funding was addressed in a few state policies, but stigma was not addressed. While parent support programs have many demonstrated positive effects, the effect of the various mandated parent support strategies remains unproven. Conclusion: While most states have statutes regarding parent education, more evaluation and research is needed on how these policies are implemented and their measured impact on families in the state. [This article was co-written by Bracewell & Giuliani LLP.]

This article offers compelling reasons for a public health approach to child maltreatment prevention. It outlines a theoretical and conceptual framework to maximize the reach of interventions to a large cross-section of the population, to ensure overall wellbeing and reduce the incidence of child maltreatment. The authors maintain that such an approach would lead to improvements in the surveillance system, publicized social norms and policies, utilized evidence based practice, and enhance existing systems. They also believe this approach would result in increased and/or shifted funding for primary prevention programs. This program could serve as a model for other states or counties to enhance their own child maltreatment prevention efforts, with the state health department playing a key role.

Introduction: An evolving body of research has demonstrated that parent education has a positive impact on children, parents, and the community. CHILDREN AT RISK conducted a needs assessment of parent support programs in Houston, Texas to determine if there was perceived need and community support for a community-wide approach to evidence-based parent education. Setting: The needs assessment was conducted by a research and advocacy non-profit that had the support of academic advisors in Houston, Texas. Methodology: The needs assessment included 70 key informant interviews, 3 focus groups, data collection, a literature review, and a participating stakeholder survey from 28 organizations. Findings: Less than 1% of parents have access to evidence-based parent education in Houston, Texas despite a perceived need and a willingness from community organizations to make evidence-based parenting support programs more available to parents. Conclusion: Conducting a rigorous needs assessment in conjunction with building partnerships and a coalition is a successful strategy to develop and move forward with recommendations that are supported by research and the community.

Purpose We report on a successful quality improvement project designed to increase access to perinatal mental health services through universal screening for postpartum depression (PPD) and facilitating referrals for evaluation and treatment, at a multi-site, integrated system of pediatric and obstetric practices in Houston, Texas. Description Obstetric practices administered screenings twice during pregnancy and at 6 weeks postpartum. Pediatric practices screened women at the 2 week and 2, 4, and 6-month well-baby visit. Women with a score of 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS) or women that reported thoughts of self-harm were offered a referral to a mental health provider. Data on screening and referrals were collected from the electronic medical record. Results A total of 102,906 screens for PPD were completed between May 2014 and July 2018. Of those, 6487 (6.3%) screened positive. The total number of women referred to treatment were 3893 (3.8%). Of referred women 2172 (55.8%) completed an appointment with a mental health provider within 60 days of referral. Rates of completed appointments varied by the level of integration of the mental health provider and referring physician: women referred by pediatrics in a Level 1 coordinated system completed 20.0% of referrals; obstetrics Level 4 co-located system, 76.6%; and obstetrics Level 5 integrated model, 82.7%. Conclusion This project demonstrated that with planning, systems review and trained staff, PPD screening can be integrated into obstetric and pediatric practices and high screening and referral rates can be achieved., Author(s): Lucy J. Puryear [sup.1] , Yen H. Nong [sup.2] , Nancy P. Correa [sup.3] , Katherine Cox [sup.4] , Christopher S. Greeley [sup.5] Author Affiliations: (Aff1) 0000 0001 2160 [...]

The Western Journal of Emergency Medicine has received a detailed critique by Dr Christopher Greeley of the article, ‘‘Challenging the Pathophysiologic Connection between Subdural Hematoma, Retinal Hemorrhage, and Shaken Baby Syndrome’’ by Dr Steven Gabaeff, published in May 2011, Volume XII, Issue 2. The author’s response is even more detailed. The Journal recognizes that these 2 authorities are diametrically opposed in their opinions, and in the interest of fair academic discourse, we are publishing both the letter to the editor and response to the editor in electronic form for those interested in this highly contentious debate.We leave it to the reader to judge the original article, its critique, and rebuttal, on their own merits.The Editor

Intimate partner violence affects one in three U.S. women. Children often witness the violence. Methods: A 4-year cohort analysis of 300 mother-child dyads used latent growth curve techniques to examine the impact of partner violence on mothers' and children's mental health and function over time. The dyads entered the study when the mother sought safe shelter or justice services. Data was collected every four months, 13 times. Results: Four models were derived, each with good fit. Maternal age, Adverse Childhood Events, and ethnicity determined the level of maternal PTSD, depression, and anxiety at baseline. Mothers' self-efficacy and marginalization determined if maternal mental health symptoms decreased or increased over 4-years. Maternal symptom levels determined if child dysfunctions persisted over time. Conclusion: This analysis provides longitudinal evidence that maternal mental health determines children's recovery from or persistence of behavioral dysfunctions. Primary prevention and informed referral has the potential to improve child outcomes., Author(s): Judith McFarlane [sup.1] , Nina M. Fredland [sup.1] , Lene Symes [sup.1] , Weidan Zhou [sup.2] , Ernest N. Jouriles [sup.3] , Mary Ann Dutton [sup.4] , Christopher S. [...]

Through qualitative feedback from professionals in healthcare, mental health, and child welfare, this study explored the impact of the COVID-19 pandemic on the health and well-being of children in the child welfare system. Positive outcomes and challenges related to the care of children in foster or kinship care in Texas during the COVID-19 pandemic are described. Themes identified included disparities in the child welfare system; utilization of telehealth; cross-sector communication and collaboration; safety considerations; and placement stability and support. The article concludes with recommendations in each of these areas for ensuring the health and well-being of children in foster and kinship care during a pandemic. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD), a perinatal mood and anxiety disorder (PMAD), is a leading cause of complications of pregnancy and childbirth. In the United States, approximately 20 percent of women suffer from PMADs. In Houston, Texas, an estimation of 12,000 – 15,000 women experience PPD each year. Within the Texas Children's Paediatrics network, a large paediatric network located in Houston, Texas, mothers are screened during paediatric well‐child visits and those screening positive receive a referral to a psychiatrist with the network. However, there are not enough psychiatrists to meet the demand of services and Black, Latina, and women on Medicaid during pregnancy are less likely to attend a psychiatric visit compared to White, non‐Hispanic women. This study used a randomised control trial design to measure the effectiveness of an alternative treatment option for a racially diverse population of postpartum women with mild to moderate symptoms of PPD, a five‐session home visitation program using the Problem‐Solving Tools for PPD (PST4PPD) model delivered by master's level social workers. The control group was allocated to standard treatment with a psychiatrist. A total of 118 women gave consent and were randomised, 72 to home visiting and 46 to psychiatry. Results demonstrated that all participating mothers had significant decreases in PPD symptoms. The change in PPD symptoms among those in the home visitation program was not significantly different from the change in the control condition, indicating that the home visitation program was as effective as psychiatric treatment in significantly reducing PPD symptoms. Additionally, a high proportion of women in the home visitation program completed visits and demonstrated increased maternal self‐efficacy. Based on these results, a short‐term home visitation program by a social worker (PST4PPD) appears to be a promising treatment option for postpartum women with mild to moderate PPD symptoms. [ABSTRACT FROM AUTHOR]