(s abstract): Child maltreatment (CM) and intimate partner violence (IPV) jeopardize the health and safety of many children and families. Attention has primarily focused on addressing these problems """"""""after the fact."""""""" There is a need for rigorously evaluated prevention strategies. This project aims to enhance pediatric primary care to help prevent CM, and to address IPV. Pediatric primary care offers an excellent opportunity: regular """"""""check-ups"""""""" aim to prevent injury and disease. It is hypothesized that the Model Care will help pediatricians address risk factors for CM (e.g., IPV, maternal depression), thus diminishing its likelihood, and improving children's health and safety. The proposed project will take place in 20 pediatric private practices in Maryland, involving approximately 80 pediatricians. These practices cover a diverse patient population; approximately one-third are low income, and one-third are minority. The first component involves training pediatricians to identify and assist families at high risk for CM. The second component involves the Model Care, including: 1) screening parents at their preschooler check-ups, 2) assessing problems, 3) initial pediatric and/or social work intervention, and 4) referral to community resources. This model represents a modest but important modification of the existing child health care system. Via random assignment, half will be trained to implement the Model Care. The control group will provide standard care. The investigators will evaluate the impact of training on pediatricians' attitudes, knowledge, comfort, competence, and practice; and also evaluate the effectiveness of the Model Care upon: 1) screening practices, 2) identifying risk factors for CM, 3) whether risk factors are addressed, 4) the prevalence and severity of risk factors, and 5) rates and severity of CM and IPV. ? ? This project is innovative and fits with the goals of """"""""Healthy People 2010"""""""" and """"""""CDC's Research Agenda"""""""". It applies sound theory and clinical experience, attending to common psychosocial problems. It has the potential to make an important contribution to knowledge and practice. If the risk factors are identified, and this leads to the problems being effectively addressed, this will justify replicating the model. The Model Care approach could be replicated with far-reaching implications for the nature of pediatric practice in the U.S. ? ?
| Dubowitz, Howard (2014) The Safe Environment for Every Kid (SEEK) Model: helping promote children's health, development, and safety: SEEK offers a practical model for enhancing pediatric primary care. Child Abuse Negl 38:1725-33 |
| Dubowitz, Howard; Lane, Wendy G; Semiatin, Joshua N et al. (2011) The safe environment for every kid model: impact on pediatric primary care professionals. Pediatrics 127:e962-70 |
