A Safe Environment for Every Kid (SEEK) I

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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A Safe Environment for Every Kid (SEEK) I: Preventing Child Maltreatment - A Role for Pediatrics

Conditions
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Child Abuse

Intervention / Treatment
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* Behavioral: Enhanced pediatric primary care
* Behavioral: Standard pediatric primary care


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 1 Month
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Single Group Assignment
Interventional Model Description: Pediatric residents were trained to screen for and help address prevalent psychosocial problems, such as parental depression and substance abuse, that are risk factors for child maltreatment (CM). The SEEK model included a project social worker and use of community resources.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Model Care (SEEK)<br>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. Thus, this group provided enhanced pediatric primary care. | Behavioral: Enhanced pediatric primary care<br>* 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.<br>|
| Active Comparator: Standard pediatric primary care<br>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. Instead, residents in this group provided standard pediatric primary care | Behavioral: Standard pediatric primary care<br>* 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.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reduced child abuse and neglect | Reports to Child Protective Services | 2002 - 2005 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improved resident attitudes and behavior regarding psychosocial problems. | Self-reported thinking and behavior regarding addressing targeted problems | 2002 - 2005 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Child maltreatment, Physician education, Prevention