A Safe Environment for Every Kid (SEEK) II (SEEK2)

This study aims to enhance pediatric primary care to make it more responsive to psychosocial needs facing many families. We hypothesized that by identifying and addressing certain problems, such as depressed mothers, parental drug use, and domestic violence, we would help decrease child abuse and neglect.

This study aims to enhance pediatric primary care to make it more responsive to psychosocial needs facing many families. We hypothesized that by identifying and addressing certain problems, such as depressed mothers, parental drug use, and domestic violence, we would help decrease child abuse and neglect.

The first step was to train pediatric residents on the importance of addressing the targeted problems. Then, we developed a brief screening tool to use when children under six years came in for the regular checkups. Parents would complete this while waiting for their doctor. Finally, the doctor and/or social worker would try address any problems the parent identified.

• Behavioral: Enhanced pediatric primary care
  Residents received special training to address targeted psychosocial problems. Parents bringing in children (0 - 5 years) completed a screening questionnaire and gave this to their doctor. The resident briefly assessed the identified problems and helped address them. A social worker was present to assist.
• Behavioral: Standard pediatric primary care
  Residents did not receive special training on the targeted psychosocial problems. They did not use the parent screening questionnaire, and they did not have a dedicated social worker.

• Experimental: A
  Residents in this group received special training on addressing pyschosocial problems. They then used a parent screening questionnaire, and addressed identified problems. A study social worker was also part of this intervention.
  Intervention: Behavioral: Enhanced pediatric primary care
• No Intervention: B
  This arm involved residents receiving the regular education through the program. They did not use the screening questionnaire to identify psychosocial problems, and did not have a dedicated social worker to assist them.
  Intervention: Behavioral: Standard pediatric primary care

• Dubowitz H, Feigelman S, Lane W, Prescott L, Blackman K, Grube L, Meyer W, Tracy JK. Screening for depression in an urban pediatric primary care clinic. Pediatrics. 2007 Mar;119(3):435-43.
• Feigelman S, Dubowitz H, Lane W, Grube L, Kim J. Training pediatric residents in a primary care clinic to help address psychosocial problems and prevent child maltreatment. Acad Pediatr. 2011 Nov-Dec;11(6):474-80. Epub 2011 Sep 29.

Inclusion Criteria:

• Child 0 - 5 years
• Family English speaking
• Parent agrees to participate

Exclusion Criteria:

• Child in foster care
• Another child in the family already enrolled