Véronique Belisle, Isabelle Daigneault, Sonia Hélie, Geneviève Paquette
Résumé : Context.
Maltreated children are heavy and costly medical service users; however, no study has investigated the trajectories of medical service use for physical or mental health among maltreated children or the effects of parenting programs on these trajectories. Objectives.
This study has three objectives. The first is to compare trajectories of medical service use between birth and adolescence of maltreated girls and boys to those of children from the general population. The second is to verify if the reception of parenting services alters trajectories of subsequent medical service usage among maltreated boys and girls. The third is to identify components of parenting programs that alter trajectories of subsequent medical service usage among maltreated boys and girls. Method.
These questions will be examined by incorporating data from three administrative datasets. Specifically, data on: (i) doctor’s visits will be provided by the Régie de l’assurance maladie du Québec
(RAMQ), which is the public single-payer medicare provider in Québec; (ii) hospital stays will be provided from the Ministère de la santé et des services sociaux
, and; (iii) services received by maltreated children while in youth protection will be provided from the Projet integration jeunesse
. Information from all three databases will be extracted from the child’s birth to December 2023. Four groups of participants will be used in this project. The first group will be comprised of all children who had at least one substantiated maltreatment report for child physical or emotional abuse or neglect and whose parents received a parenting program in two large university affiliated child protection agencies in Quebec between 2007 and 2017, when the child was between 5 and 10 years old (n = 1104). The second and third groups will be comprised of matched children who had at least one maltreatment report for physical or emotional abuse or neglect, but whose parents either received the services of a psycho-social clinician to help with parenting practices at home but not a parenting program (second group), or no parenting support (treatment as usual; third group). These two groups will be matched using the propensity score matching technique to the children in the first group. The fourth group will be children from the general population matched for sex and age from the same geographical areas. This fourth group will be randomly generated by RAMQ and will be used for comparison of medical service use trajectories. Therefore, the total sample size for this study will be 4416 children (4 groups * 1104 children). Expected Outcomes.
Understanding the trajectories of medical services and the services that are most often used by maltreated children is important in order to help knowledge users anticipate children’s needs and provide targeted and potentially preventative interventions. Greater understanding of the impact that parenting programs may have on subsequent trajectories of medical service usage among maltreated children will assist knowledge users in their decisions regarding which programs to offer within youth protection services. Finally, identifying common components of parenting programs that may modify trajectories of subsequent medical service usage would be useful information for clinicians when choosing programs to implement in clinical settings, or for providing guidance in the modification of their practices so as to achieve better outcomes for maltreated children.
Organisme.s subventionnaire.s :
Instituts de Recherche en Santé du Canada (IRSC) - Programme Subvention Projet