RT Journal Article SR Electronic T1 Characteristics of child welfare investigations reported by healthcare professionals in Ontario: secondary analysis of a regional database JF BMJ Paediatrics Open JO BMJ Paediatrics Open FD BMJ Publishing Group Ltd SP e001167 DO 10.1136/bmjpo-2021-001167 VO 5 IS 1 A1 Livingston, Eliza A1 Joh-Carnella, Nicolette A1 Lindberg, Daniel M A1 Vandermorris, Ashley A1 Smith, Jennifer A1 Kagan-Cassidy, Miya A1 Giokas, Danielle A1 Fallon, Barbara YR 2021 UL http://bmjpaedsopen.bmj.com/content/5/1/e001167.abstract AB Objectives This study examines the characteristics and outcomes of child welfare investigations reported by hospital-based and community-based healthcare professionals.Methods A sample of 7590 child maltreatment-related investigations from the Ontario Incidence Study of Reported Child Abuse and Neglect-2018, a cross-sectional study, was analysed. Bivariate analyses compared characteristics of hospital and community healthcare-reported investigations. Chi-square automatic interaction detector analyses were used to predict the most influential factors in the decision to provide a family with services following a child welfare investigation from each referral source.Results Community healthcare-reported investigations were more likely to have a primary concern of physical abuse while hospital-reported investigations were more likely to be focused on assessing risk of future maltreatment. Hospital-reported investigations were more likely to involve noted primary caregiver (eg, mental health issues, alcohol/drug abuse, victim of intimate partner violence (IPV)) and household risk factors. The most significant predictor of service provision following an investigation was having a caregiver who was identified as a victim of IPV in hospital-reported investigations (χ2=30.237, df=1, adj. p<0.001) and having a caregiver for whom few social supports was noted in community healthcare-reported investigations (χ2=18.892, df=1, adj. p<0.001).Conclusion Healthcare professionals likely interact with children who are at high risk for maltreatment. This study’s findings highlight the important role that healthcare professionals play in child maltreatment identification, which may differ across hospital-based and community-based settings and has implications for future collaborations between the healthcare and child welfare systems.Data are available on reasonable request. The dataset used and analysed during the current study may be made available in collaboration with BF, study coauthor and the principal investigator of the OIS-2018, on reasonable request.