The Policy to Practice Gap: Factors Associated With Practitioner Knowledge of CAPTA 2010 Mandates for Identifying and Intervening in Cases of Prenatal Alcohol and Drug Exposure

Abstract

This article describes results from a state-wide survey of social services professionals (n = 259) regarding knowledge of the Child Abuse Prevention and Treatment Act Reauthorization of 2010 (CAPTA), clinically based markers of prenatal substance exposure (PSE), and appropriate child protection responses following a PSE referral. Few respondents were aware of CAPTA, and knowledge of clinical markers of PSE and appropriate child protective services responses to prenatal exposure varied according to substance type (alcohol or drugs). Regression models revealed that fewer years in practice and fewer annual drug referrals predicted more drug-exposure knowledge. Fewer years in practice and awareness of CAPTA predicted more alcohol-exposure knowledge. Policy implementation strategies are needed to increase the likelihood that CAPTA achieves its desired intent, particularly with professionals who have been in the field longer and may be less open to changing practice behaviors.

Keywords

Child Abuse Prevention and Treatment Act Reauthorization of 2010 policy implementation research prenatal substance exposure prenatal alcohol exposure prenatal drug exposure child protective services

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References

Akin

B. A.

Brook

Lloyd

M. H.

(2015). Examining the role of methamphetamine in permanency: A competing risks analysis of reunification, guardianship, and adoption. American Journal of Orthopsychiatry, 85(2), 119–130.

Anthony

E. K.

Austin

M. J.

Cormier

D. R.

(2010). Early detection of prenatal substance exposure and the role of child welfare. Children and Youth Services Review, 32(1), 6–12.

Behnke

Smith

V. C.

(2013). Prenatal substance abuse: Short- and long-term effects on the exposed fetus. Pediatrics, 131(3), e1009–e1024.

Berger

L. M.

Waldfogel

(2000). Prenatal cocaine exposure: Long-run effects and policy implications. Social Service Review, 74(1), 28–54.

Brook

McDonald

Gregoire

Press

Hindman

(2010). Parental substance abuse and family reunification. Journal of Social Work Practice in the Addictions, 10(4), 393–412.

Center for Substance Abuse Treatment. (2010). Drug testing in child welfare: Practice and policy considerations (HHS Pub. No. (SMA) 10-4556). Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from http://www.ncsacw.samhsa.gov/files/DrugTestinginChildWelfare.pdf

Chasnoff

I. J.

Landress

H. J.

Barrett

M. E.

(1990). The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida. New England Journal of Medicine, 322(17), 1202–1206.

Chavkin

(1990). Drug addiction and pregnancy: Policy crossroads. American Journal of Public Health, 80(4), 483–487.

Child Welfare Information Gateway. (2014). Parental substance use and the child welfare system. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.

10.

Doab

Fowler

Dawson

(2015). Factors that influence mother–child reunification for mothers with a history of substance use: A systematic review of the evidence to inform policy and practice in Australia. International Journal of Drug Policy, 26(9), 820–831.

11.

Famularo

Kinscherff

Fenton

(1992). Parental substance abuse and the nature of child maltreatment. Child Abuse & Neglect, 16(4), 475–483. doi:http://dx.doi.org/10.1016/0145-2134(92)90064-X

12.

Institute of Medicine & National Research Council. (2014). New directions in child abuse and neglect research. Washington, DC: National Academies Press.

13.

Lipsky

(2010). Street-level bureaucracy, 30th annual edition: Dilemmas of the individual in public service. New York, NY: Russell Sage Foundation.

14.

Lloyd

M. H.

Akin

B. A.

(2014). The disparate impact of alcohol, methamphetamine, and other drugs on family reunification. Children and Youth Services Review, 44(September), 72–81. doi.org/10.1016/j.childyouth.2014.05.013

15.

Mertler

C. A.

Reinhart

R. V.

(2016). Advanced and multivariate statistical methods: Practical application and interpretation. New York, NY: Routledge.

16.

Price

Bergin

Luby

Watson

Squires

Funk

. . . Little

(2012). Implementing Child Abuse Prevention and Treatment Act (CAPTA) requirements to serve substance-exposed newborns: Lessons from a collective case study of four program models. Journal of Public Child Welfare, 6(2), 149–171.

17.

Young

N. K.

Gardner

Otero

Dennis

Chang

Earle

Amatetti

(2009). Substance-exposed infants: State responses to the problem (HHS Pub. No.(SMA), 09-4369). Washington, DC: U.S. Department of Health and Human Services.