The seek model of pediatric primary care: Can child maltreatment be prevented in a low-risk population?
|dc.description.abstract||Objective: To examine the effectiveness of the Safe Environment for Every Kid (SEEK) model of enhanced pediatric primary care to help reduce child maltreatment in a relatively low-risk population. Methods: A total of 18 pediatric practices were assigned to intervention or control groups, and 1119 mothers of children ages 0 to 5 years were recruited to help evaluate SEEK by completing assessments initially and after 6 and 12 months. Children's medical records and Child Protective Services data were reviewed. The SEEK model included training health professionals to address targeted risk factors (eg, maternal depression), the Parent Screening Questionnaire, parent handouts, and a social worker. Maltreatment was assessed 3 ways: 1) maternal self-report, 2) children's medical records, and 3) Child Protective Services reports. Results: In the initial and 12-month assessments, SEEK mothers reported less Psychological Aggression than controls (initial effect size = -0.16, 95% confidence interval [95% CI] -0.27, -0.05, P =.006; 12-month effect size = -0.12, 95% CI -0.24, -0.002, P =.047). Similarly, SEEK mothers reported fewer Minor Physical Assaults than controls (initial effect size = -0.16, 95% CI -0.29, -0.03, P =.019; 12-month effect size = -0.14, 95% CI -0.28, -0.005, P =.043). There were trends in the same positive direction at 6 months, albeit not statistically significant. There were few instances of maltreatment documented in the medical records and few Child Protective Services reports. Conclusions: The SEEK model was associated with reduced maternal Psychological Aggression and Minor Physical Assaults. Although such experiences may not be reported to protective services, ample evidence indicates their potential harm. SEEK offers a promising and practical enhancement of pediatric primary care. Copyright 2012 by Academic Pediatric Association.||en_US|
|dc.description.sponsorship||We are very grateful to the primary care pediatricians and pediatric nurse practitioners and their office staff, participating mothers, as well as David Bromberg, MD, Nicolette Minas, MS, Ann Pemberton, LCSW-C, and Angela Grodack, MA, for their contributions to this study. Dr. Dubowitz had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. This research was supported by grants from the Centers for Disease Control and Prevention and the Doris Duke Charitable Foundation . National Clinical Trials No: NCT00819702 .||en_US|
|dc.title||The seek model of pediatric primary care: Can child maltreatment be prevented in a low-risk population?||en_US|