This Request for Applications (RFA) is being re-issued to continue to stimulate collaborative research on all forms of child abuse and neglect and to foster dissemination and outreach efforts that bridge research, clinical practice and policy.
This funding opportunity announcement (FOA) will use the specialized research center mechanism (P50) to call for multidisciplinary centers to serve as the CAPSTONE for research on child abuse and neglect and to serve as a national resource for the field. The Center(s) will conduct innovative and high quality research including: 1) trials testing the efficacy and effectiveness of clinical interventions; 2) longitudinal prospective studies examining the long term effects of specific and understudied types of maltreatment including abusive head trauma, medical child abuse and neglect, chronic sexual abuse; 3) studies examining the neurobiology of abuse and neglect and implications for health outcomes; and 4) studies testing the development of screening tools and clinical assessment measures for early identification and treatment of specific types of abuse and neglect to decrease morbidity and mortality and to identify potential comorbidities. The Centers are also required to propose a dissemination and outreach core which will provide opportunities for students and faculty at all levels, to be exposed to cutting edge educational tools and technologies, research, and expertise within the field of child maltreatment. A central goal of this core will be to engage the scientific and lay professional communities in participatory activities such as technical assistance, evidence-based practice, participation in grand rounds, conferences and seminars, or webinars based on information emanating from the other cores. The format for the community engagement activities will be tailored to the expertise of the Center and the needs of the community.
The National Institutes of Health (NIH) has a strong record of funding research on the prevalence, causes, course, and consequences of child abuse and neglect. These efforts have been designed to better understand the nature, scope, and extent of child maltreatment, as well as the effect of abusive behavior on the health of its victims. Despite the important findings from these studies and invigorated interest in child maltreatment as a significant public health concern, there is yet a need for more comprehensive multidisciplinary approaches to addressing this problem and greater collaboration among researchers to pursue complex lines of inquiry, share resources, create a common language and, most importantly, to infuse the research pipeline with well-prepared early career investigators who are poised to examine and tackle this problem from multiple vantage points.
Accordingly, the need exists for collaboration among physicians, nurses, psychologists, social workers, teachers, legal professionals, medical examiners and other members of the child protection community to work together to prevent abusive and/or neglectful behavior and to disrupt the possible biological, psychological, and developmental effects through appropriate strategies at times of critical risk. Thus, effective screening technologies are needed to better recognize signs and symptoms of abuse and neglect to develop and implement trauma-informed and culturally appropriate prevention and treatment strategies.
Children with a history of abuse are at increased risk for physical and psychological concerns. Research suggests that child abuse and/or neglect is associated with a higher number of physician-diagnosed infectious diseases such as urinary tract infections, sinusitis, bronchitis, and cellulitis, as well conditions such as hypertension, diabetes, dermatitis, and asthma. Child sexual abuse is particularly deleterious form of abuse. Children who have experienced sexual abuse reportedly engage in higher rates of sexual risk taking in adolescence and adulthood and are subsequently at higher risk of HIV infection. Recent research calls attention to the need to study whether the chronicity and severity of sexual abuse in childhood and adolescence are associated with reproductive and gynecologic health concerns in adulthood. More collaborative research is needed to elucidate these concerns and to test developmentally appropriate therapeutic interventions to address the concomitant psychosocial impacts.
Inflicted neurotrauma or abusive head trauma is the most common etiology of fatal and disabling head injury in young infants. The mechanisms, treatment, and prevention of this problem remain understudied. The scientific basis of shaking as a precipitant of fatal or disabling head injury in infants and young children remains unclear. Survivors are typically affected by numerous, long-term cognitive and neurologic sequelae, including motor and visual deficits, epilepsy, and speech, language and behavioral problems. Much more collaborative research is needed from fields including biomechanics, radiology, pathology, neurology and others to shed light on this phenomenon for more comprehensive assessments, therapies and treatments.
Child fatalities are the most tragic consequence of maltreatment. Data sharing has long been recognized as a key component of efforts to prevent child abuse and neglect fatalities; however, costs and concerns about confidentiality have impeded progress in this area. Collaboration and information sharing across disciplines and systems has traditionally been difficult because of uncertain lines of authority and technical limitations. The inability to see data across systems impedes the ability of care providers to share real-time information that could inform practice to save children’s lives, and it inhibits research that could lead to better policies and practices. Thus, collecting and analyzing these data could help to build a knowledge base for fatality prevention efforts. The inclusion of data on life-threatening injuries in this knowledge base would provide a significant increase in available data, since research suggests that, for every infant under 1 year of age who dies as a result of maltreatment, more than 10 infants are hospitalized with severe abuse-related injuries. These data suggest that tens of thousands of children suffer life-threatening injuries from maltreatment each year (CECANF, 2016)
To address these issues and research gaps, this FOA will use the specialized research center mechanism (P50) to support multidisciplinary centers which will serve as the CAPSTONE for research in child maltreatment and as a national resource for the field. The goal of this Funding Opportunity Announcement (FOA) is to inform the field of our strong interest in stimulating the next generation of research in child maltreatment. We recognize that this is a bold step and doing so will involve myriad practical, legal, ethical, and methodological constraints. However, without special encouragement to the scientific community, such innovative, high-risk, high-payoff collaborative research will likely lag behind the research efforts we have funded in the past.
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