Date of Award

Summer 2020

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Haglund, Kristin A.

Second Advisor

Mersky, Joshua P.

Third Advisor

Sheets, Lynn K.


Child maltreatment is a public health concern in the United States. The consequences of child maltreatment pose both immediate and lifelong health threats to victimized children. Given the health consequences of child maltreatment, health care providers (HCPs) are legally required to report any reasonable suspicion of child maltreatment to child protective services (CPS). Sentinel injuries (SIs) are some of the earliest and most readily identifiable red flags of child maltreatment. SIs are any unexpected bruising or intra-oral injuries in non-mobile infants. SIs are highly correlated with child maltreatment and may be the only sign of child maltreatment in an otherwise healthy appearing infant. However, not all HCPs are familiar with SIs as red flags of child maltreatment. When SIs are not identified and reported to CPS, infants are left at risk for continued harm. While knowledge of SIs is important, child abuse researchers and behavioral theorists have identified that knowledge alone does not predict HCPs behaviors when identifying and reporting suspected child maltreatment. Other predictors may include implicit biases, and interpersonal and interprofessional relationships. Interprofessional education (IPE) offers an ideal format for education on SIs as IPE proposes to improve interprofessional relationships, such as those needed in child maltreatment reporting and investigations. However, the content for an IPE intervention on SIs has not yet been identified. The purpose of this study was to identify the needed content for an IPE intervention on SIs. This study used a qualitative description method. Twenty-seven individuals participated in semi-structured interviews, in both individual and group formats. Participants included HCPs, CPS, child protection team (CPT) members, law enforcement (LE), attorneys, and victim advocates. Using thematic analysis, six themes were identified: (a) valuing interprofessional colleagues is shown through disagreeing respectfully, (b) professionals in different child welfare roles work under different laws, (c) interprofessional communication is intentional and potentially time intensive, (d) assumptions lead to failures in teamwork, (e) treating families ethically, and (f) barriers in identification and reporting of SIs. Findings from the study can be used to develop an IPE intervention on SIs, with the aim to increase HCPs’ identification and reporting of SIs.

Available for download on Sunday, September 11, 2022

Included in

Nursing Commons