A Safe Environment for Every Kid (SEEK II)
Our broad goal is to help prevent child maltreatment (CM) by modifying pediatric practice to be more responsive to important biopsychosocial needs of many children and families. Training pediatricians to address key risk factors for CM, thereby enhancing parenting and family functioning, reducing the risk for CM while helping ensure children's health and safety, are accomplishing this. We are building upon the existing pediatric primary care system and strengthen the training of pediatricians. The project also builds on our extensive research and clinical expertise in CM and in prevention (Black & Dubowitz, 1999, Dubowitz et al., 1998, 1999, in press; Dubowitz & Guterman, 2005, Gaudin & Dubowitz, 1997).
We have developed and implemented an enhanced model of pediatric primary care, taking advantage of the enormous opportunities of the existing pediatric primary care system, with its regular contact with young children and parents (Dubowitz & Newberger, 1989; Dubowitz, 1989, 1990; Green, 1994). Pediatricians typically devote over half their time to checkups, focusing on prevention. There is increasing recognition that pediatric care must incorporate aspects of parental and family functioning and collaborate with community resources (Academy of Pediatrics, 1998; Green, 1994b). The broad goal of this project is to implement concepts that have been embraced by the field of pediatrics, but have not been applied and tested.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Subject)
Primary Purpose: Prevention
|Official Title:||Preventing Child Maltreatment: A Role for Community Pediatricians|
- Parent to Child Conflict Tactics Scale [ Time Frame: Initial contact, 6 months & 12 months after start of study participation ] [ Designated as safety issue: Yes ]
- Department of Human Services, Department of Child Protection records. [ Time Frame: Child's birth through March 2009 ] [ Designated as safety issue: Yes ]
|Study Start Date:||May 2006|
|Study Completion Date:||May 2010|
|Primary Completion Date:||March 2009 (Final data collection date for primary outcome measure)|
Experimental: Model Care
The Model Care approach was implemented in 7 practices, where healthcare providers (HPs) were trained to address major risk factors for CM, including maternal depression, alcohol/substance abuse, intimate partner violence, and stress. We taught the relevance of these problems for children's health and safety, and how they can be briefly assessed and initially addressed. The initial training consisted of 1 four hour sessions. Use of the Parent Screening Questionnaire (PSQ) was discussed, as was the importance of applying it universally during regular checkups. HPs received laminated cards or an electronic version with salient information, and parent handouts on each targeted issues. We held one hour booster sessions approximately every 6 months over the subsequent 2.5 years.
Other: Model Care
The Model Care provided training to pediatric health care providers to assess parental psychosocial risk factors to child maltreatment.
No Intervention: Standard Care
Health Care providers in Standard Care group served as the controls. They continued to practice as usual.
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|United States, Maryland|
|University of Maryland, School of Medicine|
|Baltimore, Maryland, United States, 21201|
|Principal Investigator:||Howard Dubowitz, MD MS||University of Maryland|