A Safe Environment for Every Kid (SEEK) I (SEEK)

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

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.

Study Overview

• Status: Completed
• Conditions: Child Abuse
• Intervention / Treatment: Behavioral: Enhanced pediatric primary care; Behavioral: Standard pediatric primary care

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Actual): 660
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21201
      • University of Maryland, Baltimore

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 month to 70 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Model Care (SEEK); 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; 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.
Active Comparator: Standard pediatric primary care; 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; 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.

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: University of Maryland, Baltimore
• Investigators: Principal Investigator: Howard Dubowitz, MD, University of Maryland, Baltimore

Publications and helpful links

General Publications

• 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.
• 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.
• 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.

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2002
• Primary Completion (Actual): December 31, 2005
• Study Completion (Actual): December 31, 2006

Study Registration Dates

• First Submitted: July 25, 2007
• First Submitted That Met QC Criteria: July 25, 2007
• First Posted (Estimate): July 26, 2007

Study Record Updates

• Last Update Posted (Actual): April 7, 2022
• Last Update Submitted That Met QC Criteria: March 29, 2022
• Last Verified: November 1, 2019

More Information

Terms related to this study

• Keywords: Prevention; Child maltreatment; Physician education
• Other Study ID Numbers: H-20890