Collaborative Care for Infants at Risk

Study Overview
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Brief Summary
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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?

Official Title
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Collaborative Care for Infants at Risk

Conditions
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Child Abuse, Primary Health Care, Child Welfare

Intervention / Treatment
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* Other: Collaborative Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 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 Exclusion Criteria: 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). For other secondary outcomes related to CPS outcomes, language exclusion will not be considered.

Ages Eligible for Study
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Minimum Age: 0 Days
Maximum Age: 364 Days

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Collaborative Care<br>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<br>* 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.<br>|
| No Intervention: Comparison Care<br>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. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Parent Perception of Child Welfare and Child Health Care | Difference in parent perceptions of child welfare and child health care based on practice arm | at baseline (child welfare) and at 6 months (child health care) | 
| Repeat Child Welfare Involvement | Repeat Child Welfare Involvement | 6 months after CPS case closure |