2.2 SURVEILLANCE
Data provides a foundation for your prevention efforts. It can help inform decision-making, program planning, implementation, and evaluation; it can also be used to inform policy development; resource allocation; and partnership building.
Child maltreatment surveillance can pose many challenges. Multiple sectors address child maltreatment but they often don’t speak the same language. They have disparate data elements and often don’t have common child maltreatment definitions. However, systematically collecting, analyzing, and using data for decision-making is important to support effective planning, implementation, and evaluation for all public health programs.
The following are things you can do to enhance child maltreatment prevention surveillance.
Uniform Definitions:
Multiple sectors addressing child health and safety (e.g., child protective services, juvenile justice, law enforcement, public health, health care practitioners) often have their own child maltreatment definitions and related data systems. The CDC’s Child Maltreatment Surveillance Uniform Definitions for Public Health and Recommended Data Elements
can be a resource for states if uniform definitions are not currently in use.
Data Collection and Linkages:
Indicators of child maltreatment are often embedded in various data sources. Start by identifying what data are accessible to you.
Linking data is very important in creating a comprehensive picture of child maltreatment. Formal agreements, such as Memoranda of Understanding or data sharing agreements between programs can help establish access to data.
Health departments should also seek opportunities for collecting additional data. For example, you can add questions on modifiable risk and protective factors of child maltreatment to electronic health records or incorporate the Adverse Childhood Experiences Study module into your state’s Behavioral Risk Factor Surveillance System survey.
Translate and Disseminate:
Effectively using data also requires staff have the necessary skills to communicate findings to diverse audiences. Identify key audiences to provide them with information. Data should be translated into easy-to-understand language in order to educate others about burden, cost, risk and protective factors, and other relevant data on child maltreatment.
Finally, surveillance capacity varies across states. Within your state it may be available through one or more units in your health department. Take advantage of epidemiological expertise in other units if it doesn’t exist in your program.
- Behavioral Risk Factor Surveillance System survey (BRFSS)
- Child death review
- Child Welfare/Protective Services
- Early childhood program data sets (e.g., Head Start, Child Care, Part C, IDEA)
- Electronic medical records
- Hospital discharge data
- Medicaid
- Mental health
- National Child Abuse and Neglect Data System (NCANDS)
- National Health and Nutrition Examination Survey (NHANES)
- National Health Interview Survey
- National Immunization Study
- National Violent Death Reporting System (NVDRS)
- Pregnancy Risk Assessment Monitoring System (PRAMS)
- Program specific data such as home visiting, WIC, etc.
- Substance use
- Vital Statistics
- Youth Risk Behavior Survey (YRBS)
Consider:
Uniform Definitions:
- What child maltreatment and child maltreatment prevention definitions are used by the health department?
- Are definitions of child maltreatment uniform across health department programs and across all state agencies? If not, what are the barriers to establishing uniform definitions?
- Have you thought about how to establish uniform definitions across the state?
Data Collection and Linkages:
- What structures within your health department support data collection and analysis?
- What data sources are available and are they accessed and used? How?
- Are data shared across programs? Why/why not?
- Are you identifying opportunities for active surveillance of child maltreatment-related measures and indicators?
- What plan exists for enhancing and maintaining surveillance capacity?
2.3 Leverage Resources