Kenneth Steinman, PhD, MPH    kjsteinman@gmail.comCommunity Connections Workshop        Gahanna, OH        April 20, 2012 ...
1. Describe the “spectrum of prevention”2. Describe 3 principles for making a   compelling case for family violence3. Acce...
» Framing prevention» Framing the problem» What are “family violence” data? Why don’t  we use them? Why bother?» How shoul...
» When it works, nothing happens!» Individual costs >> benefits  ˃even when societal costs << benefits» Someone pays, some...
» is often easier than intervention  ˃less political, more agencies» can be cost-effective  ˃economies of scale» can work!...
» more than teaching healthy behaviors» multiple, complementary levels» at each level, identify most important effort(s)  ...
6. Influencing policy and legislation5. Changing organizational practices4. Fostering coalitions and networks3. Educating ...
6. Influencing policy and legislation                                        8
5. Changing organizational practices                                       9
2. Promoting community education                                   10
111. Strengthening individual knowledge and skills
% of US adults smoking daily, 1995-201020   19.91918171615141312                                                          ...
6. Influencing policy and legislation5. Changing organizational practices4. Fostering coalitions and networks3. Educating ...
» Framing prevention» Framing the problem» What are “family violence” data? Why don’t  we use them? Why bother?» How shoul...
(Consider) Show how our problem is…» Common» Consequential» Changeable                                      15
» Common: “Every day, I see…”» Consequential: “I lost my childhood…”» Changeable: “The program saved me…”                 ...
» Common» Consequential» Changeable                  17
» 1 in 5 US adults smoke daily, 1995                                       18
Actual causes of death, US, 1990                          firearms                  toxic agents                          ...
20
» Common» Consequential» Changeable                  21
» Framing prevention» Framing the problem» What are “family violence” data? Why don’t  we use them? Why bother?» How shoul...
Quantifiable information about       risk factors for,          scope of,      consequences of       family violence.     ...
Risk factor              Consequence               FamilyRisk factor              Consequence              ViolenceRisk fa...
Substance abuse                             APS investigations     among adult caregivers                         and inte...
26
» Case reports  ˃OIBRS, SACWIS, OVDRS» Case tallies  ˃Adult protective services summary reports (ODJFS)  ˃Police call data...
www.hpio.net/familyviolence                              28
The study’s not valid                      The study’s not valid because it    because it didn’t include                  ...
» Every source is imperfect  ˃especially for complex issues like FV» Different “case” definitions  ˃fear of undercounting»...
» If you don’t count it, it doesn’t count» Build credibility» The data favor FV                                           ...
» Framing prevention» Framing the problem» What are “family violence” data? Why don’t  we use them? Why bother?» How shoul...
» Planning                  Use data to find an answer» Evaluation» Grant-Writing                  Use data to support an ...
» Lifetime prevalence (“Have you ever?”)  ˃compelling  ˃hard to change» Annual incidence (new cases past year)  ˃current s...
» Rates» Raw numbers                35
» Association with other outcomes  ˃e.g., illness & injury; employment; disability  ˃hard to quantify» Cost  ˃economic ana...
» Highlight differences  ˃By jurisdiction  ˃By time» Program evaluation                          37
Mean # of Child Maltreatment Incidents per year (with 95% CI)    per 1,000 Children Under 18 in 88 Ohio counties, 2001-200...
» Keep it local» Put it in context                      39
IPV annual incidence                                   US: 2,135,000                                   Ohio: >88,000   40 ...
» Period  ˃How does my county compare to last year?» Place  ˃How does my county compare to others?» Problem  ˃How does IPV...
# new civil protection order filings per 1,000 residents:                     5 major metropolitan counties, 1996-2008432 ...
# new civil protection order filings per 1,000 residents:                     3 major metropolitan counties, 1996-200843  ...
Selected threats to women’s health                                    in Ohio                      Estimated number of cas...
» www.hpio.net/familyviolence» Common, Consequential, Changeable                                      45
Belmont CountyThese data describe common types of violence perpetrated by family members or caregivers in our county each ...
In Belmont County, how does family violence compare to other threats among…?teenage girls (age 15-19, est. # /year) adult ...
» Each year in our county at least 350 adult  women experience physical intimate partner  violence. In comparison, 274 are...
» Each year in our county, local courts handle  35 petitions for civil protection orders and 36  adults seek shelter in lo...
» Compared to Belmont County, the rate of  petitions for civil protection orders is nearly  four times greater in other Ap...
51
» FV is not equally common everywhere» FV is not always getting worse» Not all programs and policies work                 ...
# of adult protective service reports in Preble County, Ohio:                             FY2007 – FY 2009       150      ...
» Framing prevention» Framing the problem» What are “family violence” data? Why don’t  we use them? Why bother?» How shoul...
1. Describe the “spectrum of prevention”2. 3 principles for making a compelling case   for family violence3. Access and us...
What if this   makes my agency look bad?               56
57
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Making a Compelling Case for Family Violence Prevention

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Presented by Kenneth Steinman, PhD, at The HealthPath Foundation of Ohio's Community Connections Workshop on April 20, 2012.

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Making a Compelling Case for Family Violence Prevention

  1. 1. Kenneth Steinman, PhD, MPH kjsteinman@gmail.comCommunity Connections Workshop Gahanna, OH April 20, 2012 1
  2. 2. 1. Describe the “spectrum of prevention”2. Describe 3 principles for making a compelling case for family violence3. Access and use data for grant-writing 2
  3. 3. » 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 3
  4. 4. » When it works, nothing happens!» Individual costs >> benefits ˃even when societal costs << benefits» Someone pays, someone else benefits 4
  5. 5. » is often easier than intervention ˃less political, more agencies» can be cost-effective ˃economies of scale» can work! 5
  6. 6. » more than teaching healthy behaviors» multiple, complementary levels» at each level, identify most important effort(s) 6Prevention Institute (1999)
  7. 7. 6. Influencing policy and legislation5. Changing organizational practices4. Fostering coalitions and networks3. Educating providers2. Promoting community education1. Strengthening individual knowledge and skills 7Prevention Institute (1999)
  8. 8. 6. Influencing policy and legislation 8
  9. 9. 5. Changing organizational practices 9
  10. 10. 2. Promoting community education 10
  11. 11. 111. Strengthening individual knowledge and skills
  12. 12. % of US adults smoking daily, 1995-201020 19.91918171615141312 12.41110 1995 1997 1999 2001 2003 2005 2007 2009 12 BRFSS (2011)
  13. 13. 6. Influencing policy and legislation5. Changing organizational practices4. Fostering coalitions and networks3. Educating providers2. Promoting community education1. Strengthening individual knowledge and skills 13Prevention Institute (1999)
  14. 14. » 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 14
  15. 15. (Consider) Show how our problem is…» Common» Consequential» Changeable 15
  16. 16. » Common: “Every day, I see…”» Consequential: “I lost my childhood…”» Changeable: “The program saved me…” 16
  17. 17. » Common» Consequential» Changeable 17
  18. 18. » 1 in 5 US adults smoke daily, 1995 18
  19. 19. Actual causes of death, US, 1990 firearms toxic agents tobacco microbial agents alcohol diet and activity patterns 19McGinnis & Foege, 1993
  20. 20. 20
  21. 21. » Common» Consequential» Changeable 21
  22. 22. » 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 22
  23. 23. Quantifiable information about risk factors for, scope of, consequences of family violence. 23
  24. 24. Risk factor Consequence FamilyRisk factor Consequence ViolenceRisk factor Consequence 24
  25. 25. Substance abuse APS investigations among adult caregivers and interventions Elder Accelerated move to Elder’s social isolation abuse LTC facility Elder’s significant needs for assistance Premature MortalityEach year in Clark County…2,137 seniors live alone in rental properties>1,300 elders are physically abused, neglected or financially exploited 2562 APS reports are filed for abuse, neglect or exploitation
  26. 26. 26
  27. 27. » 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 27 ˃OFHS: physical IPV
  28. 28. www.hpio.net/familyviolence 28
  29. 29. The study’s not valid The study’s not valid because it because it didn’t include didn’t include women who didn’t emotional abuse. seek help. The study’s not valid because it didn’t include Latinas. The numbers don’t capture what’s really going on here. You can get statistics to say anything you want. Quantitative studies I don’t care what the suppress victims’ voices.research says, we need to do [X]! I’m afraid to use I’ve helped fill outstatistics because the forms these data I don’t really get are based on. I know 29 them. they’re flawed.
  30. 30. » 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 30 ˃Skills to report findings accurately
  31. 31. » If you don’t count it, it doesn’t count» Build credibility» The data favor FV 31
  32. 32. » 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
  33. 33. » Planning Use data to find an answer» Evaluation» Grant-Writing Use data to support an answer» Advocacy 33
  34. 34. » Lifetime prevalence (“Have you ever?”) ˃compelling ˃hard to change» Annual incidence (new cases past year) ˃current scope ˃hardest to measure» Case reports ˃incomplete 34 ˃easiest to measure, hard to compare
  35. 35. » Rates» Raw numbers 35
  36. 36. » Association with other outcomes ˃e.g., illness & injury; employment; disability ˃hard to quantify» Cost ˃economic analyses ˃agency burden 36
  37. 37. » Highlight differences ˃By jurisdiction ˃By time» Program evaluation 37
  38. 38. Mean # of Child Maltreatment Incidents per year (with 95% CI) per 1,000 Children Under 18 in 88 Ohio counties, 2001-2007 80 70 60 50 Statewide mean=33.8 40 30 20 10 0 38 Source: Ohio SACWISSlide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohioand The Ohio State University College of Public Health, 614.292.3373 or ofvpp@cph.osu.edu
  39. 39. » Keep it local» Put it in context 39
  40. 40. IPV annual incidence US: 2,135,000 Ohio: >88,000 40 Montgomery County: >4,100
  41. 41. » 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 ? 41
  42. 42. # new civil protection order filings per 1,000 residents: 5 major metropolitan counties, 1996-2008432 Franklin10 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Source: Supreme Court of Ohio 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 ofvpp@cph.osu.edu
  43. 43. # new civil protection order filings per 1,000 residents: 3 major metropolitan counties, 1996-200843 Franklin2 Hamilton1 Lucas0 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Source: Supreme Court of Ohio 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 ofvpp@cph.osu.edu
  44. 44. Selected threats to women’s health in Ohio Estimated number of cases per year new cases of cancer 30,719 motor vehicle accident 54,409 injuries physical intimate partner 66,000 violence* *not including sexual violence or emotional abuseFor sources, see notes. Slide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohioand The Ohio State University College of Public Health, 614.292.3373 or ofvpp@cph.osu.edu
  45. 45. » www.hpio.net/familyviolence» Common, Consequential, Changeable 45
  46. 46. Belmont CountyThese data describe common types of violence perpetrated by family members or caregivers in our county each year. We presentthe best available, most recent estimates. Nonetheless, our figures are conservative and represent only part of the burden familyviolence places on our families and communities. All figures are estimates or annual averages.Each year in our county… adults are physically abused seniors in the community are 180 – 280 children are abused or neglected 550 – 720 by a current or former 680 – 870 abused, neglected or intimate partner financially exploited reports of abuse or seniors in LTC facilities are 325 neglect are filed with n/a people are arrested for intimate partner violence 50 – 100 abused, neglected or children’s services financially exploited reports of abuse, neglect or 87 children are placed in custody 35 people file petitions for civil protection orders 79 exploitation are filed for seniors in the community adults seek shelter in reports of abuse, neglect or 36 domestic violence shelters in 18 exploitation are filed for the county seniors in LTC facilities • 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.html Suggested citation: Health Policy Institute of Ohio. Family Violence in [county name] County. Columbus, OH: Health Policy Institute of Ohio; 2010.
  47. 47. In Belmont County, how does family violence compare to other threats among…?teenage girls (age 15-19, est. # /year) adult women (age 18+, est. # / year) seniors (age 60+, est. # / year) physical cigarette use intimate partner injuries from 320-560 violence 350-480 falls 490-960 dating violence 150-230 motor vehicle 274 elder 680-870 crash injuries abuse/neglect mothers without pregnancies 117 1st trimester 130 new cancer prenatal care cases 330 motor vehicle new cancer motor vehicle crash injuries 59 cases 230 crash injuries 85• 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. How do we compare to other counties? Is family violence increasing? Mean of 29 It is hard to say. Mean annual rate of petitions for Belmont Appalachian State Some data sources civil protection orders, per 10,000 adults, County counties mean suggest family Belmont County, 2000-2008 Civil protection order petitions violence is (per 10,000 adults) 6.4 28.9 21.6 increasing; others suggest it is stable Reports of abuse, neglect or or decreasing. exploitation in LTC facilities 1.8 2.2 2.3 Within a (per 100 resident beds) county, changes• Belmont County has a lower rate of petitions for civil protection over time are 6.5 5.5 6.4 orders (CPO’s) compared to similar counties in Ohio. largely due to 2000-02 2003-05 2006-08 changes in victims’• Belmont County has about the same rate of reports of ability to access for example, suggests no significant services. This graph, abuse, neglect or exploitation in LTC facilities compared to change in petitions for CPO’s in our county. This trend could similar counties in Ohio. reflect no changes in the awareness or ability of victims to• Differences in data collection limit our ability to compare other request CPO’s. For a discussion of when differences are indicators of family violence across counties. noteworthy, please see the introduction. Child Abuse Hotline: 1-800-4-A-CHILD To talk with someone about family violence, contact: Ohio Domestic Violence Network 1-800-934-9840 Ohio Area Agencies on Aging: 1-866-243-5678
  48. 48. » 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. 48
  49. 49. » Each year in our county, local courts handle 35 petitions for civil protection orders and 36 adults seek shelter in local domestic violence shelters. 49
  50. 50. » 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. 50
  51. 51. 51
  52. 52. » FV is not equally common everywhere» FV is not always getting worse» Not all programs and policies work 52
  53. 53. # of adult protective service reports in Preble County, Ohio: FY2007 – FY 2009 150 100 50 0 FY2007 FY2008 FY2009* 53 Source: Ohio Dept of Job & Family Services; US Census Bureau *projectedSlide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohioand The Ohio State University College of Public Health, 614.292.3373 or ofvpp@cph.osu.edu
  54. 54. » 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. 55. 1. Describe the “spectrum of prevention”2. 3 principles for making a compelling case for family violence3. Access and use data for grant-writing www.hpio.net/familyviolence 55
  56. 56. What if this makes my agency look bad? 56
  57. 57. 57
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