Outcomes and outputs affiliated with Children's Advocacy Centers in the United States: A scoping review

Kristi K Westphaln; Wendy Regoeczi; Marie Masotya; Bridget Vazquez-Westphaln; Kaitlin Lounsbury; Lolita McDavid; HaeNim Lee; Jennifer Johnson; Sarah Ronis; Expert contributors

doi:10.1016/j.chiabu.2020.104828

Outcomes and outputs affiliated with Children's Advocacy Centers in the United States: A scoping review

Child Abuse Negl. 2021 Jan:111:104828. doi: 10.1016/j.chiabu.2020.104828. Epub 2020 Dec 15.

Authors

Kristi K Westphaln¹, Wendy Regoeczi², Marie Masotya³, Bridget Vazquez-Westphaln⁴, Kaitlin Lounsbury⁵, Lolita McDavid⁶, HaeNim Lee⁷, Jennifer Johnson⁸, Sarah Ronis⁹; Expert contributors

Collaborators

Expert contributors:
James Herbert¹⁰, Theodore Cross¹¹, Wendy Walsh¹²

Affiliations

¹ Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland, OH, USA; UH Rainbow Babies and Children's Hospital, Cleveland, OH, USA. Electronic address: kkw26@case.edu.
² College of Liberal Arts and Social Sciences, Cleveland State University, Cleveland, OH, USA. Electronic address: w.regoeczi@csuohio.edu.
³ UH Rainbow Center for Child Health and Policy, Cleveland, OH, USA. Electronic address: Marie.Masotya@UHhospitals.org.
⁴ Department of Psychiatry, Psychology Division, Harbor UCLA Medical Center, Los Angeles, CA, USA. Electronic address: bridget.vzqz@gmail.com.
⁵ National Children's Alliance, Washington, DC, USA. Electronic address: klounsbury@nca-online.org.
⁶ UH Rainbow Babies and Children's Hospital, Cleveland, OH, USA; Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA. Electronic address: Lolita.McDavid@UHhospital.org.
⁷ Department of Social Welfare and Counseling, Dongguk University, South Korea. Electronic address: hnl22@dgu.ac.kr.
⁸ Canopy Children's Advocacy Center, Cleveland, OH, USA. Electronic address: jjohnson@dvcac.org.
⁹ UH Rainbow Babies and Children's Hospital, Cleveland, OH, USA; UH Rainbow Center for Child Health and Policy, Cleveland, OH, USA; Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA. Electronic address: sarah.ronis@UHhospitals.org.
¹⁰ Canopy Children's Advocacy Center, Cleveland, OH, USA; Australian Centre for Child Protection, Adelaide, SA, USA; University of South Australia, Adelaide, SA, USA.
¹¹ School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL, USA.
¹² Crimes Against Children Research Center, University of New Hampshire, Durham, NH, USA.

PMID: 33339637
DOI: 10.1016/j.chiabu.2020.104828

Abstract

Background: The Children's Advocacy Center (CAC) model is the predominant multidisciplinary model that responds to child sexual abuse (CSA) in the United States (US). While the CAC model has made important contributions in case coordination and referrals for specialty services, little is known about child- or family-oriented outcomes.

Objective: Explore the trends and gaps involving outcome and output measures affiliated with CACs in the US.

Participants & setting: A scoping review of the literature was conducted on English language articles published between 1985-2019 that involved CACs and children less than 18 years of age.

Methods: An electronic database search using the terms "Children's Advocacy Center(s)," "Child Advocacy Center(s)," and "CAC(s)" identified titles and abstracts. Data from articles selected for full text review were evaluated by a multidisciplinary team using a mixed methods approach.

Results: Measures of CAC impact frequently focus on service and programmatic outputs with person-centered outcomes left often reported. The most prevalent output measures related to case prosecution and forensic interviews. Person-centered outcomes most commonly emphasized child mental health and caregiver satisfaction. The majority of articles were limited by weak or unspecified study designs.

Conclusion: The current literature on CACs suggests that while they are successful in coordinating services and facilitating referrals, little is known about how engagement with CACs impacts short- and long-term outcomes for children and families. Further research beyond cross sectional or quasi-experimental designs is necessary to better understand how variability in CAC structure, function, and resources can be optimized to meet the needs of the diverse communities that they serve. This is especially salient given the national dissemination of the CAC model. Without such additional studies, knowledge will remain limited regarding the enduring impacts of CACs on the lives of those impacted by CSA.

Keywords: CACs; Child abuse; Childhood abuse; Children’s Advocacy Centers; Outcomes; Outputs.

Publication types

Review

MeSH terms

Caregivers / psychology
Child
Child Abuse, Sexual / prevention & control*
Child Advocacy / standards*
Child Advocacy / trends
Child Protective Services / standards*
Child Protective Services / trends
Family / psychology
Humans
Intersectoral Collaboration
Outcome Assessment, Health Care
Program Evaluation
United States