help ASAP please

[MichaelD55@xxxxxxx]

My health based, child abuse prevention program is being asked to document 
the potential effectiveness of expanding our program. We maintain a 
countywide health system for detection and reporting child abuse/neglect. Our 
basic program includes a    -   - directory of teams
    - protocols
    - a data system based on reports 
    - training and technical assistance
Most of our reports involve infants. Most hospitals and some clinics can 
follow some cases to assist with service. 

I want to justify a countywide program with a primary focus on physical abuse 
and neglect of infants, prenatal substance abuse and other high risk 
pregnancies. I do not want to build an expensive "model program" that will 
not be replicated.
    - We have a core data system based on copies of reports from multiple 
hospitals and clinics and maintain a working relationship with the more 
active hospitals. 
    - Our child fatality review system provides data fatal abuse/neglect that 
I will use as a central measure of failure. We hope to expand this to include 
children hospitalized for trauma (particularly head trauma) 
    - We are rebuilding a Public Health Nurse system to provide short term 
case management with some children, particularly abused and NFTT infants and 
some pregnancies.
    - Our mens and women's jails some strong parenting programs an estimated 
8 - 12% pregnancy rate for women and a high rate of parent status for men 
(both have a high rate of substance abuse)
    - We have the potential to work with our foster care system, domestic 
violence intervention system, probation, parole, law enforcement, prosecuting 
attorneys, dependency court, drug courts, schools, preschools, child care 
(most service systems belong to our multiagency child abuse intervention 
system)
    - We hope to develop a measure of NFTT besides growth charts
    - We will address some measure of developmental delay

Think public health. Think data driven intervention. Think physical injury 
and measurable developmental delay. Think parent child interaction. Think of c
lassic literature not a complex bibliography. Help and thank you.

1) What literature can I reference to document the outcome of unreported 
physical abuse and neglect in young children?

2) What literature can I reference to document outcome of pregnancies with 
psychosocial risk factors (not just teen pregnancy)

3) What programs can I endorse that have a demonstrated effectiveness with 
infants and high risk pregnancies? (We are already building a system of Home 
Visitation using David Olds model)

Michael Durfee MD
Los Angeles