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      The Australian Child Maltreatment Study (ACMS): protocol for a national survey of the prevalence of child abuse and neglect, associated mental disorders and physical health problems, and burden of disease

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          Abstract

          Introduction

          Child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence) is widely understood to be associated with multiple mental health disorders, physical health problems and health risk behaviours throughout life. However, Australia lacks fundamental evidence about the prevalence and characteristics of child maltreatment, its associations with mental disorders and physical health, and the associated burden of disease. These evidence gaps impede the development of public health strategies to better prevent and respond to child maltreatment. The aims of this research are to generate the first comprehensive population-based national data on the prevalence of child maltreatment in Australia, identify associations with mental disorders and physical health conditions and other adverse consequences, estimate attributable burden of disease and indicate targeted areas for future optimal public health prevention strategies.

          Methods and analysis

          The Australian Child Maltreatment Study (ACMS) is a nationwide, cross-sectional study of Australia’s population aged 16 years and over. A survey of approximately 10 000 Australians will capture retrospective self-reported data on the experience in childhood of all five types of maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence). A customised, multimodule survey instrument has been designed to obtain information including: the prevalence and characteristics of these experiences; diagnostic screening of common mental health disorders; physical health; health risk behaviours and health service utilisation. The survey will be administered in March–November 2021 to a random sample of the nationwide population, recruited through mobile phone numbers. Participants will be surveyed using computer-assisted telephone interviews, conducted by trained interviewers from the Social Research Centre, an agency with extensive experience in studies of health and adversity. Rigorous protocols protect the safety of both participants and interviewers, and comply with all ethical and legal requirements. Analysis will include descriptive statistics reporting the prevalence of individual and multitype child maltreatment, multiple logistic and linear regression analyses to determine associations with mental disorders and physical health problems. We will calculate the population attributable fractions of these putative outcomes to enable an estimation of the disease burden attributable to child maltreatment.

          Ethics and dissemination

          The study has been approved by the Queensland University of Technology Human Research Ethics Committee (#1900000477, 16 August 2019). Results will be published to the scientific community in peer-reviewed journals, scientific meetings and through targeted networks. Findings and recommendations will be shared with government policymakers and community and organisational stakeholders through diverse engagement activities, a dedicated Advisory Board and a systematic knowledge translation strategy. Results will be communicated to the public through an organised media strategy and the ACMS website.

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          Most cited references92

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          Multiple imputation using chained equations: Issues and guidance for practice

          Multiple imputation by chained equations is a flexible and practical approach to handling missing data. We describe the principles of the method and show how to impute categorical and quantitative variables, including skewed variables. We give guidance on how to specify the imputation model and how many imputations are needed. We describe the practical analysis of multiply imputed data, including model building and model checking. We stress the limitations of the method and discuss the possible pitfalls. We illustrate the ideas using a data set in mental health, giving Stata code fragments. 2010 John Wiley & Sons, Ltd.
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            Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.

            The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described. A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0-7) and risk factors for the leading causes of death in adult life. More than half of respondents reported at least one, and one-fourth reported > or = 2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P or = 50 sexual intercourse partners, and sexually transmitted disease; and 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life. We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
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              The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis

              A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2021
                11 May 2021
                : 11
                : 5
                : e047074
                Affiliations
                [1 ]departmentSchool of Law , Queensland University of Technology , Brisbane, Queensland, Australia
                [2 ]Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
                [3 ]departmentAustralian Centre for Health Law Research, Faculty of Law , Queensland University of Technology , Brisbane, Queensland, Australia
                [4 ]departmentInstitute for Lifecourse Development, Faculty of Education, Health & Human Sciences , University of Greenwich , London, UK
                [5 ]departmentChild and Youth Mental Health , Queensland Institute of Medical Research (QIMR) , Herston, Queensland, Australia
                [6 ]departmentCrimes against Children Research Center, Family Research Laboratory, Department of Sociology , University of New Hampshire , Durham, New Hampshire, USA
                [7 ]The University of Edinburgh School of Social and Political Science , Edinburgh, UK
                [8 ]departmentInstitute of Child Protection Studies , Australian Catholic University , Melbourne, Victoria, Australia
                [9 ]departmentSchool of Public Health , The University of Queensland , Saint Lucia, Queensland, Australia
                [10 ]departmentSchool of Public Health , University of Queensland , Herston, Queensland, Australia
                [11 ]departmentInstitute for Social Science Research , University of Queensland , Brisbane, Queensland, Australia
                [12 ]Social Research Centre , Melbourne, Victoria, Australia
                [13 ]departmentGraduate School of Education , University of Western Australia , Perth, Western Australia, Australia
                Author notes
                [Correspondence to ] Professor Ben Mathews; b.mathews@ 123456qut.edu.au
                Author information
                http://orcid.org/0000-0003-0421-0016
                http://orcid.org/0000-0002-9742-1957
                http://orcid.org/0000-0003-4700-1425
                Article
                bmjopen-2020-047074
                10.1136/bmjopen-2020-047074
                8118019
                33980529
                a59d9df0-9ef8-41a5-9a9d-4e4321cf4332
                © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 18 November 2020
                : 30 March 2021
                : 20 April 2021
                Funding
                Funded by: National Health and Medical Research Council;
                Award ID: APP1158750
                Funded by: FundRef http://dx.doi.org/10.13039/501100001072, Australian Institute of Criminology;
                Award ID: P20/237
                Funded by: FundRef http://dx.doi.org/10.13039/501100000931, Department of Social Services, Australian Government;
                Award ID: 90012492
                Categories
                Epidemiology
                1506
                1692
                Protocol
                Custom metadata
                unlocked

                Medicine
                epidemiology,mental health,child protection,community child health,public health
                Medicine
                epidemiology, mental health, child protection, community child health, public health

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