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Estimating Surveillance Bias in Child Maltreatment Reporting During Home Visiting Program Involvement
Margaret L Holland1,2,3, Denise Esserman4, Rose M Taylor1,5
1School of Nursing, Yale University, Orange, CT, USA.
Child Maltreatment
|September 2, 2022
Summary
Surveillance bias significantly impacts home visiting program evaluations. Approximately 25.6% of investigated reports may stem from program involvement, not actual child maltreatment.
Area of Science:
- Child development and public health program evaluation.
Background:
- Home visiting (HV) programs aim to prevent child maltreatment.
- The impact of surveillance bias on HV program evaluations is not well understood.
Approach:
- Compared investigated Child Protective Services (CPS) reports for families in an HV program versus similar families not in the program.
- Used propensity score matching and a difference-in-differences analysis to estimate bias.
- Reviewed CPS reports to identify direct referrals from home visitors.
Key Points:
- An estimated 25.6% of investigated CPS reports in the HV group may be attributable to surveillance bias.
- 10% of CPS reports reviewed came directly from home visitors.
- Children in the study ranged from 60 days to 5 years old at program exit.
Conclusions:
- Surveillance bias can substantially inflate the number of investigated reports for families involved in HV programs.
- Program evaluations must incorporate methods to account for surveillance bias to accurately assess HV program effectiveness.
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