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Neglect in Indian Country is disproportionately prevalent and associated with extremely high rates of alcohol problems (approximately 80% of neglect cases based upon prior studies). However, the extent to which alcohol services are utilized by neglecting American Indian (AI) caretakers has not been studied, nor have factors related to service use. The proposed study will evaluate how well alcohol treatment service needs are identified, how well alcohol treatment services are utilized, and what barriers to service utilization exist among a population of AI parents or caretakers who have entered the child protection system with cases of moderate to severe child neglect. Also, the study will evaluate the association between receipt of alcohol services and maltreatment potential and child maltreatment recidivism. The study will inform current practice and policy to help reduce health disparities in AI communities affected by alcohol related child neglect by helping to identify critical factors involved in successful service receipt or failure. The study will advance the purpose of the Cherokee tribe of Oklahoma’s proposal for a Oklahoma Native American Research Center for Health (ONARCH) by enhancing the research skills of the Native American investigator and staff in the project, and through an active collaboration between the Cherokee tribe of Oklahoma and the Muscogee Creek Nation of Oklahoma, the University of Oklahoma Health Sciences Center, Center on Child Abuse and Neglect (OUHSC/CCAN), and the Oklahoma Department of Human Services (DHS). The proposed study will use a single cohort longitudinal design in order to evaluate the utilization of alcohol treatment and Child Protective Service (CPS) related services over time among AI caretakers identified for neglect by the CPS/Indian Child Welfare (ICW) systems and meeting criteria (described later) for moderate-severe neglect and for the presence of an alcohol disorder. Comprehensive assessments will be collected at baseline and one-year, with shorter service utilization and alcohol symptom assessments quarterly. Services, social and symptom data will be collected five points in time (baseline, 3, 6, 9, and 12 months). |
