making a compelling case for family violence prevention
DESCRIPTION
Presented by Kenneth Steinman, PhD, at The HealthPath Foundation of Ohio's Community Connections Workshop on April 20, 2012.TRANSCRIPT
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Making a Compelling Casefor
Family Violence PreventionKenneth Steinman, PhD, MPH
Community Connections WorkshopGahanna, OHApril 20, 2012
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Learning Objectives
1. Describe the “spectrum of prevention”
2. Describe 3 principles for making a compelling case for family violence
3. Access and use data for grant-writing
Outline» Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t we use them? Why bother?
» How should I use data?
» Q&A
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» When it works, nothing happens!
» Individual costs >> benefits˃ even when societal costs << benefits
» Someone pays, someone else benefits
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Prevention is a hard sell
» is often easier than intervention˃ less political, more agencies
» can be cost-effective˃ economies of scale
» can work!
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And yet, prevention…
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Prevention is a spectrum
Prevention Institute (1999)
» more than teaching healthy behaviors
» multiple, complementary levels
» at each level, identify most important effort(s)
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6. Influencing policy and legislation
5. Changing organizational practices
4. Fostering coalitions and networks
3. Educating providers
2. Promoting community education
1. Strengthening individual knowledge and skills
Spectrum of Prevention
Prevention Institute (1999)
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6. Influencing policy and legislation
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5. Changing organizational practices
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2. Promoting community education
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1. Strengthening individual knowledge and skills
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199519961997199819992000200120022003200420052006200720082009201010
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2019.9
12.4
% of US adults smoking daily, 1995-2010
BRFSS (2011)
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6. Influencing policy and legislation
5. Changing organizational practices
4. Fostering coalitions and networks
3. Educating providers
2. Promoting community education
1. Strengthening individual knowledge and skills
How about Family Violence?
Prevention Institute (1999)
Outline» Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t we use them? Why bother?
» How should I use data?
» Q&A
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Framing the problem(Consider) Show how our problem is…
» Common
» Consequential
» Changeable
» Common: “Every day, I see…”
» Consequential: “I lost my childhood…”
» Changeable: “The program saved me…”
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Stories show how FV is…
» Common
» Consequential
» Changeable
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How can data show FV is...?
» 1 in 5 US adults smoke daily, 1995
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Smoking seen as… common
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tobacco
diet and activity patterns
alcohol
microbial agents
toxic agents
firearmsActual causes of death, US, 1990
McGinnis & Foege, 1993
…consequential
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…changeable
Smoking ban linked to drop in preterm
births, small babies
MyHealthNewsDaily
» Common
» Consequential
» Changeable
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How can data show FV is...?
Outline» Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t we use them? Why bother?
» How should I use data?
» Q&A
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What are Family Violence Data?
Quantifiable information about
risk factors for,
scope of,
consequences of
family violence.
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FamilyViolence
Risk factor
Risk factor
Risk factor
Consequence
Consequence
Consequence
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Elder abuse
Substance abuse among adult caregivers
Elder’s social isolation
Elder’s significant needs for assistance
Accelerated move to LTC facility
APS investigations and interventions
Premature Mortality
Each year in Clark County…
2,137 seniors live alone in rental properties
>1,300 elders are physically abused, neglected or financially exploited
62 APS reports are filed for abuse, neglect or exploitation
Changeable CommonConsequential
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Where dowe find data?
Sources of FV data in Ohio» Case reports
˃ OIBRS, SACWIS, OVDRS
» Case tallies˃ Adult protective services summary reports (ODJFS)˃ Police call data (BCI)˃ Shelter data (AGO)˃ Civil protection orders (SCO)
» Surveys˃ YRBS: teen dating violence˃ OFHS: physical IPV 27
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www.hpio.net/familyviolence
Why don’t we use data?
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I don’t care what the research says, we
need to do [X]!
I’ve helped fill out the forms these
data are based on. I know they’re
flawed.
Quantitative studies suppress victims’
voices.
You can get statistics to say anything you want.
The numbers don’t capture what’s really
going on here.
I’m afraid to use statistics because I don’t really get
them.
The study’s not valid because it didn’t include Latinas.
The study’s not valid because it didn’t include women who
didn’t seek help.
The study’s not valid because it didn’t include
emotional abuse.
Why don’t we use data?» Every source is imperfect
˃ especially for complex issues like FV
» Different “case” definitions ˃ fear of undercounting
» Difficult to find and report ˃ Access local level data˃ Skills to report findings accurately 30
So why bother?
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» If you don’t count it, it doesn’t count
» Build credibility
» The data favor FV
Outline» Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t we use them? Why bother?
» How should I use data?
» Q&A
32
How should I use data?» Planning
» Evaluation
» Grant-Writing
» Advocacy33
Use data to find an answer
Use data to support an answer
Showing FV is…common» Lifetime prevalence (“Have you ever?”)
˃ compelling˃ hard to change
» Annual incidence (new cases past year)˃ current scope˃ hardest to measure
» Case reports˃ incomplete ˃ easiest to measure, hard to compare
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Showing FV is…common» Rates
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» Raw numbers
Showing FV is…consequential» Association with other outcomes
˃ e.g., illness & injury; employment; disability˃ hard to quantify
» Cost˃ economic analyses˃ agency burden
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Showing FV is…changeable» Highlight differences
˃ By jurisdiction˃ By time
» Program evaluation
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0
10
20
30
40
50
60
70
80
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Mean # of Child Maltreatment Incidents per year (with 95% CI) per 1,000 Children Under 18 in 88 Ohio counties, 2001-2007
Statewide mean=33.8
Slide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio and The Ohio State University College of Public Health, 614.292.3373 or [email protected]
Source: Ohio SACWIS
When using data…» Keep it local
» Put it in context
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Keep it LOCAL
US: 2,135,000
Ohio: >88,000
Montgomery County: >4,100
IPV annual incidence
Put it in CONTEXT» Period
˃ How does my county compare to last year?
» Place˃ How does my county compare to others?
» Problem˃ How does IPV compare to other problems in my
county ?
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# new civil protection order filings per 1,000 residents:5 major metropolitan counties, 1996-2008
0
1
2
3
4
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Franklin
Source: Supreme Court of OhioSlide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio and the Ohio State University College of Public Health. 614.292.3373 [email protected]
# new civil protection order filings per 1,000 residents:3 major metropolitan counties, 1996-2008
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 20080
1
2
3
4
Franklin
Hamilton
Lucas
Source: Supreme Court of OhioSlide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio and the Ohio State University College of Public Health. 614.292.3373 [email protected]
54,409
30,719
66,000physical intimate partnerviolence*
motor vehicle accidentinjuries
new cases of cancer
Selected threats to women’s health in Ohio
Estimated number of cases per year
*not including sexual violence or emotional abuse
For sources, see notes. Slide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio and The Ohio State University College of Public Health, 614.292.3373 or [email protected]
Using County Profiles
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» www.hpio.net/familyviolence
» Common, Consequential, Changeable
Family Violence in
180 – 280 children are abused or neglected 550 – 720
adults are physically abused by a current or former intimate partner
680 – 870seniors in the community are abused, neglected or financially exploited
325reports of abuse or neglect are filed with children’s services
n/a people are arrested for intimate partner violence 50 – 100
seniors in LTC facilities are abused, neglected or financially exploited
87 children are placed in custody 35 people file petitions for
civil protection orders 79reports of abuse, neglect or exploitation are filed for seniors in the community
36adults seek shelter in domestic violence shelters in the county
18reports of abuse, neglect or exploitation are filed for seniors in LTC facilities
Belmont County
Each year in our county…
These data describe common types of violence perpetrated by family members or caregivers in our county each year. We present the best available, most recent estimates. Nonetheless, our figures are conservative and represent only part of the burden family violence places on our families and communities. All figures are estimates or annual averages.
• It is difficult to measure the true prevalence of family violence; many victims never come to the attention of authorities.
• Reports to local children’s service agencies typically exceed the estimated number of abused or neglected children. This is likely due to multiple reports filed for a single child. Also, many children are placed in custody for reasons other than abuse or neglect (e.g., delinquency).
• n/a = figure not available because of missing data.• Elder abuse/neglect figures exclude self-neglect and victims <60 years old. (LTC = long term care)
This profile is part of an 88-county series provided by the Ohio Family Violence Prevention Project – a collaborative project of the Health Policy Institute of Ohio and the Ohio State University College of Public Health with support from the HealthPath Foundation of Ohio. For additional copies and a detailed description of how we calculated these figures, please visit: www.healthpolicyohio.org/OFVPP_CountyProfiles.htmlSuggested citation: Health Policy Institute of Ohio. Family Violence in [county name] County. Columbus, OH: Health Policy Institute of Ohio; 2010.
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117
85
330
seniors (age 60+, est. # / year) adult women (age 18+, est. # / year) teenage girls (age 15-19, est. # /year)
motor vehicle crash injuries
new cancer cases
elder abuse/neglect
injuries from falls
new cancer cases
mothers without 1st trimester prenatal care
motor vehicle crash injuries
physical intimate partner violence
pregnancies
motor vehicle crash injuries
dating violence
cigarette use
In Belmont County, how does family violence compare to other threats among…?
Belmont County
Mean of 29 Appalachian
countiesState mean
Civil protection order petitions(per 10,000 adults) 6.4 28.9 21.6
Reports of abuse, neglect or exploitation in LTC facilities
(per 100 resident beds)1.8 2.2 2.3
Is family violence increasing?How do we compare to other counties?
• Belmont County has a lower rate of petitions for civil protection orders (CPO’s) compared to similar counties in Ohio.
• Belmont County has about the same rate of reports of abuse, neglect or exploitation in LTC facilities compared to similar counties in Ohio.
• Differences in data collection limit our ability to compare other indicators of family violence across counties.
It is hard to say. Some data sources suggest family violence is increasing; others suggest it is stable or decreasing. Within a county, changes over time are largely due to changes in victims’ ability to access
6.45.5
6.5
2000-02 2003-05 2006-08
services. This graph, for example, suggests no significant change in petitions for CPO’s in our county. This trend could reflect no changes in the awareness or ability of victims to request CPO’s. For a discussion of when differences are noteworthy, please see the introduction.
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274
Mean annual rate of petitions for civil protection orders, per 10,000 adults,
Belmont County, 2000-2008
To talk with someone about family violence, contact:Child Abuse Hotline: 1-800-4-A-CHILDOhio Domestic Violence Network 1-800-934-9840Ohio Area Agencies on Aging: 1-866-243-5678
490-960320-560
680-870
• For example: each year in our county between 350 and 480 adult women experience physical intimate partner violence; in comparison, 274 adult women are injured in motor vehicle crashes.
150-230
350-480
In Belmont County, DV is common
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» Each year in our county at least 350 adult women experience physical intimate partner violence. In comparison, 274 are injured in motor vehicle crashes and are 230 newly diagnosed with cancer.
In Belmont County, DV is consequential
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» Each year in our county, local courts handle 35 petitions for civil protection orders and 36 adults seek shelter in local domestic violence shelters.
In Belmont County, DV is changeable
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» Compared to Belmont County, the rate of petitions for civil protection orders is nearly four times greater in other Appalachian counties (6.4 vs. 28.9 per 10,000 adults). Supporting our legal advocacy program will help us close this gap.
The HealthPath Foundation of OhioService Area
ADAMS
ALLENASHLAND
ASHTABULA
ATHENS
AUGLAIZE
BELMONT
BROWN
BUTLER
CARROLL
CHAMPAIGN
CLARK
CLERMONT
CLINTON
COLUMBIANA
COSHOCTON
CRAWFORD
CUYAHOGA
DARKE
DEFIANCE
DELAWARE
ERIE
FAIRFIELD
FRANKLIN
FULTON
GALLIA
GEAUGA
GREENE
GUERNSEY
HAMILTON
HANCOCK
HARDIN
HARRISON
HENRY
HIGHLAND
HOCKING
HOLMES
HURON
JACKSON
JEFFERSONKNOX
LAKE
LAWRENCE
LICKING
LOGAN
LORAIN
LUCAS
MADISON
MAHONING
MARION
MEDINA
MEIGS
MERCER
MIAMI
MONROEMONTGOMERY
MORGAN
MORROW
MUSKINGUM
NOBLE
OTTAWA
PAULDING
PERRYPICKAWAY
PIKE
PORTAGE
PREBLE
PUTNAM
RICHLAND
ROSS
SANDUSKY
SCIOTO
SENECA
SHELBY
STARK
SUMMIT
TRUMBULL
TUSCARAWAS
UNION
VAN WERT
VINTON
WARRENWASHINGTON
WAYNE
WILLIAMS
WOOD
WYANDOT
FAYETTE
Another County?
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Just beware…» FV is not equally common everywhere
» FV is not always getting worse
» Not all programs and policies work
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0
50
100
150
FY2007 FY2008 FY2009*
# of adult protective service reports in Preble County, Ohio: FY2007 – FY 2009
Source: Ohio Dept of Job & Family Services; US Census Bureau *projected
Slide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio and The Ohio State University College of Public Health, 614.292.3373 or [email protected]
Outline» Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t we use them? Why bother?
» How should I use data?
» Q&A
54
55
Learning Objectives
1. Describe the “spectrum of prevention”
2. 3 principles for making a compelling case for family violence
3. Access and use data for grant-writing
C C C
www.hpio.net/familyviolence
56
Questions/Comments
What if this makes
my agency look bad?
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Thank you