Client characteristics and service use at the first hospital-based Canadian child and youth advocacy center: An analysis of case tracking data

Abstract

BackgroundThe Child and Youth Advocacy Center (CYAC) model supports a coordinated response for young victims of abuse and their families. The model is prevalent in the United States, with more recent growth across Canada. ObjectiveThis descriptive study summarizes case tracking data to profile the client population, referral characteristics, use of services, and associations between client characteristics and service use in child maltreatment investigations referred to the first hospital-based Canadian CYAC over time. This data illustrates the potential to use CYAC case tracking data in understanding the use of, and client populations served by, this emerging collaborative service model in Canada.Participants and Setting Participants included children and youth served at SeaStar Child and Youth Advocacy Center in Halifax, Nova Scotia (N = 1,364) in its first seven years of operation. MethodsDescriptive statistics were calculated for client and case characteristics. Differences in characteristics between time periods were assessed using Chi-square tests. Risk ratios (RR) with 95% confidence intervals (CI) for the associations between characteristics and the use of specific services were estimated using log-binomial regression. ResultsThe most common indication for referral to this CYAC was sexual assault (53.3 %). Most clients were female (60.9 %), with a median client age of 10.0 years (IQR 6.0 to 13.0 years). In over half of all cases the alleged perpetrator was a family member (56.0 %) and most alleged perpetrators were adults (79.9 %). Medical exams were provided in 13.4 % of referrals and were less likely in children aged > 7 years (age 7–12, RR = 0.38, CI 0.27–0.51; and age > 12, RR = 0.41, CI 0.29–0.58), in referrals for sexual assault compared to physical assault (RR = 0.69, CI 0.52–0.90), and when the alleged perpetrator was an acquaintance rather than a family member (RR = 0.48, CI 0.34–0.67). Child and youth advocate support was provided in 76.1 % of cases and was slightly more likely in sexual assault and ‘other’ types of referrals (RR = 1.14, CI 1.06–1.22; and RR = 1.13, CI 1.02–1.26, respectively). Canine Assisted Intervention (CAI) was offered in 38.6 % of cases and was more likely in referrals for sexual assault (RR = 1.23, CI 1.01–1.50). Of those who had CAI, 41 % had an Accredited Facility Dog present with them during their forensic interview; this accompaniment in interview was more likely for clients who were older (RR = 2.15, CI 1.15–4.01) and female (RR = 2.56, CI 1.34–4.90). There were few differences in client and case characteristics or service use over time. ConclusionsThis study provides descriptive context of child maltreatment investigations referred to a Canadian hospital-based CYAC. Given the recognized variability among CYACs in scope and setting, this profile contributes to a broader understanding of the client population and service uptake at a CYAC which varies from the prototypical US-based model most often represented in the existing literature. This information contributes to a more detailed understanding of the CYAC model in practice in Canada, which can help to inform the growth and development of CYACs in the future.