Collaborative Care for Infants at Risk

NCT03199326 | Completed

• 1 other identifier: 00098047
• Study Type: interventional
• Target: 468
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluates the feasibility, acceptability, and impact of a collaborative care practice for infants investigated by state Child Protective Services (CPS) for suspected maltreatment. Recognizing the vulnerability of infants referred into CPS in the first year of life, as well as the frequent contact of infants with health care providers in the first year of life, the investigators will conduct a RCT to measure the impact of a collaborative practice model linking CPS caseworkers with primary health care providers during an investigation for suspected infant maltreatment. With this trial, the investigators will ask (3a) Can a collaborative practice model improve parent-reported infant health-related quality of life 6 months following child welfare involvement for suspected infant maltreatment? and (3b) Does a collaborative practice model impact repeat child welfare involvement for suspected child maltreatment over 6 months?

Conditions

Child Abuse; Primary Health Care; Child Welfare

Outcome Measures

Primary Outcomes (1)

• Infant Health Related Quality of Life

  Difference in Change in Infant Health Related Quality of Life based on practice arm

  Change from baseline to 6 months following CPS case closure

Secondary Outcomes (2)

• Parent Perception of Child Welfare and Child Health Care

  at baseline (child welfare) and at 6 months (child health care)

• Repeat Child Welfare Involvement

  6 months after CPS case closure

Other Outcomes (3)

• Engagement of child welfare caseworkers

  baseline

• Acceptance of parents

  baseline

• Recruiting and retention of high-risk longitudinal cohort

  baseline and 6 months

Study Arms (2)

Collaborative Care

EXPERIMENTAL

CPS caseworkers will be randomized to collaborative or comparison practice. For any infant investigated by a caseworker in the collaborative practice, the caseworkers will conduct a standard CPS investigation. Additionally, caseworkers will seek parental permission to contact an identified primary health care provider at two points in the CPS investigation for information sharing related to health needs, social risks, and recommended interventions.

Other: Collaborative Care

Comparison Care

NO INTERVENTION

CPS caseworkers will be randomized to collaborative or comparison practice. For any infant investigated by a caseworker in the comparison practice, the caseworkers will conduct a standard CPS investigation.

Interventions

Collaborative Care OTHER

CPS caseworkers will explain collaborative care to parents, ask parents to allow communication with an infant's primary care provider, and have willing parents sign a release allowing communication with the infant's provider during the investigation. Caseworkers will make at least two attempts to contact identified providers with parental consent. In the first week, caseworkers will contact the provider, identify the infant, and summarize the child maltreatment concerns. The caseworker will ask whether the provider recognizes any additional strengths or vulnerabilities for the infant. Prior to case closure, caseworkers will provide a summary of investigation findings, disposition, and service referrals including placement changes, safety planning, family preservation, and community resources, with a summary letter delivered to the provider after case closure.

Collaborative Care

Eligibility Criteria

• Age: 0 Days - 364 Days
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Less than 12 months of age at referral
• Involved in a child welfare investigation for suspected maltreatment
• Investigation occurring in Utah DCFS Salt Lake Valley or Western regions

You may not qualify if:

• For the primary and selected secondary outcomes,
• Caregiver with primary spoken language other than English or Spanish,
• CPS caseworkers not yet randomized to a practice arm
• Infants in out-of-home placement at the time of referral or case closure,
• Infants suffering fatal maltreatment
• Prior investigation of an infant in a household during study timeframe (e.g., twins, infant siblings, and repeat referrals will be excluded).

Sponsors & Collaborators

• University of Utah: lead
• Robert Wood Johnson Foundation: collaborator

Study Sites (1)

The Center for Safe and Healthy Families, Primary Children's Hospital Eccles Outpatient Building, 81 North Mario Capecchi Dr 4E-200

Salt Lake City, Utah, 84113, United States

Location

Study Officials

• Kristine A Campbell, MD, MSc

  University of Utah

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Surveys will be collected without knowledge of intervention assignment
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor, Pediatrics

Study Record Dates

• First Submitted: June 21, 2017
• First Posted: June 26, 2017
• Study Start: August 15, 2017
• Primary Completion: April 30, 2019
• Study Completion: July 31, 2020
• Last Updated: November 10, 2020

Record last verified: 2020-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)