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    Training pediatric residents in a primary care clinic to help address psychosocial problems and prevent child maltreatment

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    Author
    Feigelman, S.
    Dubowitz, H.
    Lane, W.
    Grube, L.
    Kim, J.
    Date
    2011
    Journal
    Academic Pediatrics
    Publisher
    Elsevier
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.acap.2011.07.005
    Abstract
    Objective: The objectives of this study were to determine whether 1) residents trained in the SEEK (A Safe Environment for Every Kid) model would report improved attitudes, knowledge, comfort, competence, and practice regarding screening for psychosocial risk factors (parental depression, parental substance abuse, intimate partner violence, stress, corporal punishment, and food insecurity); 2) intervention residents would be more likely to screen for and assess those risk factors; and 3) families seen by intervention residents would report improved satisfaction with their child's doctor compared to families receiving standard care from control residents. Methods: Pediatric residents in a university-based pediatrics continuity clinic were enrolled onto a randomized controlled trial of the SEEK model. The model included resident training about psychosocial risk factors, a Parent Screening Questionnaire, and a study social worker. Outcome measures included: 1) residents' baseline, 6-month, and 18-month posttraining surveys, 2) medical record review, and 3) parents' satisfaction regarding doctor-parent interaction. Results: Ninety-five residents participated. In 4 of 6 risk areas, intervention residents scored higher on the self-assessment compared to control subjects, with sustained improvement at 18 months. Intervention residents were more likely than control subjects to screen and assess parents for targeted risk factors. Parents seen by intervention residents responded favorably regarding interactions with their doctor. Conclusions: The SEEK model helped residents become more comfortable and competent in screening for and addressing psychosocial risk factors. The benefits were sustained. Parents viewed the intervention doctors favorably. The model shows promise as a way of helping address major psychosocial problems in pediatric primary care. Copyright 2011 by Academic Pediatric Association.
    Sponsors
    The study was funded by a grant from the U.S. Department of Health and Human Services, Administration on Children and Families, Office on Child Abuse and Neglect . 90CA1695/01 , Howard Dubowitz, PI. Trial registration, clinicaltrials.gov identifier NCT00507299.
    Keyword
    child maltreatment
    prevention
    psychosocial risk factors
    residency
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-81055140317&doi=10.1016%2fj.acap.2011.07.005&partnerID=40&md5=74c790f59d2104e997e6041f4aa14d44; http://hdl.handle.net/10713/11843
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.acap.2011.07.005
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    Dr. Howard Dubowitz

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