Amy A. Hunter

Date of Graduation


Document Type


Degree Type



School of Public Health



Committee Chair

Ian RH Rockett

Committee Co-Chair

Danielle Davidov

Committee Member

George Kelley

Committee Member

Dustin Long

Committee Member

Jiyoung Tabone


Child maltreatment is a serious public health issue. The decisions made by Child Protective Services (CPS) in response to reports of maltreatment may influence a child's risk of subsequent maltreatment. Studies have found a direct relationship between adverse childhood events (ACEs), (e.g., experiencing maltreatment, exposure to violence) and negative health outcomes across the lifespan (e.g., disease, developmental delays, suicidality, injury and death). Traditional CPS investigations focus on determining details of abuse events, and use that information to assess child safety and risk of future harm. The introduction of differential response policy provides supportive and preventive services to mitigate the risk of maltreatment without a full investigation. It is unclear how the introduction of this policy alters child risk for consequent maltreatment. This dissertation examines and compares the risk of child maltreatment re-report, a measure of the effectiveness of CPS efforts, in children who received either a traditional investigation or a differential response. Using constructs of Family Systems Theory, we conducted qualitative and quantitative analysis to evaluate these associations. Results suggest that children receiving differential response experience equal or lesser risk of re-report than do children receiving investigation. However, our results also revealed discrepancies in data quality that introduced bias in our results. Improvements in data collection and CPS implementation are needed to accurately describe the relationship between policy and maltreatment re-report.