Making a Compelling Case for Family Violence Prevention

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Making a Compelling Casefor

Family Violence PreventionKenneth Steinman, PhD, MPH

[email protected]

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)

http://www.preventioninstitute.org/index.php?option=com_jlibrary&view=article&id=105&Itemid=127

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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



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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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4. Fostering coalitions and networks

3. Educating providers



How about Family Violence?







» 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...?





» 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





» Q&A

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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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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

http://www.hpio.net/publications/OhioFamilyViolence.html

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

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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

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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

http://www.hpio.net/familyviolence

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

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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


physical intimate partner violence

pregnancies


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]






» Q&A

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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

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Questions/Comments

What if this makes

my agency look bad?

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Thank you

Making a Compelling Case for Family Violence Prevention

Business

Transcript of Making a Compelling Case for Family Violence Prevention