A Safe Environment for Every Kid (SEEK): A Model for Primary Care

NCT00819702 | Completed DMC

• 2 other identifiers: HP-00040157 (H-27327)1R49CE000588
• Study Type: interventional
• Target: 905
• Locations: 1 country
• Sites: 1

Brief Summary

Our broad goal is to help prevent child maltreatment (CM) by modifying pediatric practice to be more responsive to prevalent psychosocial needs of many children and families.Training pediatricians to address key risk factors for CM, the Safe Environment for Every Kid (SEEK) model aims to support parenting and family functioning, reducing the risk for CM while helping promote children's health, development and safety. We are building upon the existing pediatric primary care system and strengthening 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.

Conditions

Child Maltreatment

Keywords

child abuse prevention; primary care; professional education in primary care

Outcome Measures

Primary Outcomes (1)

• Parent to Child Conflict Tactics Scale

  Initial contact, 6 months & 12 months after start of study participation

Secondary Outcomes (1)

• Department of Human Services, Department of Child Protection records.

  Child's birth through March 2009

Study Arms (2)

Model Care

EXPERIMENTAL

The Model Care approach was implemented in 7 practices, where PCPs were trained to address major risk factors for CM, including maternal depression, alcohol/substance abuse, intimate partner violence, food insecurity, harsh punishment and major stress. We taught how they can be briefly assessed and initially addressed. The initial training consisted of one 4-hour in-person session. Use of the Parent Screening Questionnaire (PSQ) was discussed, as was the importance of applying it universally during regular checkups. PCPs SEEK Parent Handouts on each targeted problem. We held 1-hour booster sessions every 6 months over the subsequent 2.5 years.

Other: Model Care

Standard Care

NO INTERVENTION

PCPs in Standard Care group served as the controls. They continued to practice as usual.

Interventions

Model Care OTHER

The Model Care provided training to pediatric health care providers to assess parental psychosocial risk factors to child maltreatment.

Model Care

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Mother or mother figure accompanying a child under 6 for a regular checkup.
• Fluent english
• Mother agrees to participate
• Health Care provider is provider at involved practice
• Health Care provider agrees to participate

You may not qualify if:

• Mother is already participating through another child
• Mother does not speak english
• Mother declines participation
• Health Care providers practice is not involved in study
• Health Care provider declines

Sponsors & Collaborators

• University of Maryland, Baltimore: lead
• Centers for Disease Control and Prevention: collaborator
• Doris Duke Charitable Foundation: collaborator

Study Sites (1)

University of Maryland, School of Medicine

Baltimore, Maryland, 21201, United States

Location

Study Officials

• Howard Dubowitz, MD MS

  University of Maryland

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 7, 2009
• First Posted: January 9, 2009
• Study Start: May 1, 2006
• Primary Completion: March 1, 2009
• Study Completion: May 1, 2010
• Last Updated: May 8, 2023

Record last verified: 2019-11

Locations

US (1)