Methods: The study used an experimental design within a cross-sectional survey framework. A series of vignettes were constructed, describing a child at risk. Three factors were randomly manipulated: child’s ethnic background (Jewish/Arab), child's socio-economical background (Middle-Class/Low-Class), and child’s gender (Male/Female). Professionals were asked to assess risk to the child, and their reporting intention for the case. The sample was a purposive convenience sample, intended to maximize variation, consisting of 517 healthcare-professionals working in community-based HMO clinics, in Israel. Each professional was asked to respond to five randomly selected vignettes (from a pull of nine vignettes). Responses included the perceived risk to the child. Each questionnaire also asked of the workers’ socio-demographic background, professional training, and specific professional role. Linear and logistic regression-analyses were carried at the vignette level, controlling statistically for within worker clustering using robust standard-errors within a Generalized Estimating Equations (GEE) model.
Results: As hypothesized, child’s gender, ethnic, and socio-economic background, have all turned to have significant effects on subjective risk-assessment and reporting intentions. Being a girl, Arab, and belonging to low socio-economic class increased the likelihood that child's condition will be identified as the result of abuse and neglect, and of reporting the child for further investigation.
Conclusions and Implications: This study reinforces prior findings in regard to effects of healthcare professionals' personal attitudes and believes on their ability to identify child maltreatment correctly. The results are discussed in terms of their implications on service delivery, including the perceived danger of intervening in the lives of innocent families and investing scares resources at the wrong place. Recommendations are made in relation to professionals' education and training.