{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T04:03:34Z","timestamp":1784347414200,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["F31HD111297"],"award-info":[{"award-number":["F31HD111297"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n The purpose of this study is to compare health outcomes and flourishing between children (age 6\u201317) whose mothers experience high versus low exposure to post\u2010separation abuse and coercive control (PSA).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Exploratory sequential mixed\u2010methods study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Cross\u2010sectional survey with community\u2010based, convenience sample of family court\u2010involved mothers in the United States (\n N<\/jats:italic>\n \u2009=\u2009497). Independent variable measured by subscales of the Healthcare, Economic, and Legal PSA and Coercive Tactics Scale (HELP\u2010T). Health outcomes measured by items from National Survey of Children's Health.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Children whose mothers experience more frequent PSA face a dual burden: increased odds of unmet mental health needs coupled with increased odds of mental health diagnoses, somatic symptoms and special health care needs. Children in the high\u2010exposure Healthcare PSA group were twice as likely (aOR: 2.01,\n p<\/jats:italic>\n \u2010value\u2009<\u20090.001, 95% CI: 1.4\u20132.9) to report stomach\/intestinal problems, 2.3 times more likely (\n p<\/jats:italic>\n \u2010value\u2009<\u20090.001, 95% CI: 1.5\u20133.4) to report chronic pain including headaches in the last 12\u2009months, 2.13 times more likely (\n p<\/jats:italic>\n \u2010value\u2009<\u20090.001, 95% CI: 1.4\u20133.8) to have ever received a diagnosis of anxiety and 2.72 times (\n p<\/jats:italic>\n \u2010value\u2009<\u20090.001, 95% CI: 1.60\u20134.63) more likely to have unmet mental health needs as compared to children in the low\u2010exposure group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The findings from this study advance the growing body of evidence on how co\u2010parent perpetrated PSA and coercive control harm children's health and access to healthcare.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n This study is the first to our knowledge to demonstrate the association between maternal exposure to co\u2010parent perpetrated PSA and children's health outcomes, establishing a foundation for future intervention work to improve children's health and access to health care.<\/jats:p>\n <\/jats:sec>\n \n Public Contribution<\/jats:title>\n Members of the public were involved in recruitment and cognitive interviewing.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jan.70681","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T03:21:52Z","timestamp":1784344912000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association of Post\u2010Separation Abuse and Coercion With Children's Health and Flourishing"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3192-7293","authenticated-orcid":false,"given":"Kathryn J.","family":"Spearman","sequence":"first","affiliation":[{"name":"Ross and Carol Nese College of Nursing and Child Maltreatment Solutions Network The Pennsylvania State University University Park Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Perrin","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Nursing Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6269-3234","authenticated-orcid":false,"given":"Christina","family":"Bethell","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4840-6574","authenticated-orcid":false,"given":"Kamila A.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Nursing Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5320-9746","authenticated-orcid":false,"given":"Jennifer","family":"Hardesty","sequence":"additional","affiliation":[{"name":"University of Illinois Urbana\u2010Champaign Urbana Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3821-5037","authenticated-orcid":false,"given":"Jacquelyn","family":"Campbell","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Nursing Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"e278","DOI":"10.1542\/peds.2005-1473","article-title":"Physical Health Outcomes of Childhood Exposure to Intimate Partner Violence: A Systematic Review","volume":"117","author":"Bair\u2010Merritt M. 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