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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Model Care (SEEK) | Experimental | 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. |
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| Standard pediatric primary care | Active Comparator | 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 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enhanced pediatric primary care | Behavioral | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Reduced child abuse and neglect | Reports to Child Protective Services | 2002 - 2005 |
| Measure | Description | Time Frame |
|---|---|---|
| Improved resident attitudes and behavior regarding psychosocial problems. | Self-reported thinking and behavior regarding addressing targeted problems | 2002 - 2005 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Howard Dubowitz, MD | University of Maryland, Baltimore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Maryland, Baltimore | Baltimore | Maryland | 21201 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17332195 | Result | Dubowitz H, Feigelman S, Lane W, Prescott L, Blackman K, Grube L, Meyer W, Tracy JK. Screening for depression in an urban pediatric primary care clinic. Pediatrics. 2007 Mar;119(3):435-43. doi: 10.1542/peds.2006-2010. | |
| 34057734 | Derived | Kalra N, Hooker L, Reisenhofer S, Di Tanna GL, Garcia-Moreno C. Training healthcare providers to respond to intimate partner violence against women. Cochrane Database Syst Rev. 2021 May 31;5(5):CD012423. doi: 10.1002/14651858.CD012423.pub2. |
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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.
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| Standard pediatric primary care | Behavioral | 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. |
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| 21959095 | Derived | Feigelman S, Dubowitz H, Lane W, Grube L, Kim J. Training pediatric residents in a primary care clinic to help address psychosocial problems and prevent child maltreatment. Acad Pediatr. 2011 Nov-Dec;11(6):474-80. doi: 10.1016/j.acap.2011.07.005. Epub 2011 Sep 29. |