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A Safe Environment for Every Kid (SEEK): A Model for Primary Care (SEEK)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00819702
Recruitment Status : Completed
First Posted : January 9, 2009
Last Update Posted : September 28, 2017
Centers for Disease Control and Prevention
Doris Duke Charitable Foundation
Information provided by (Responsible Party):
Howard Dubowitz, University of Maryland, College Park

Brief Summary:

Our broad goal is to help prevent child maltreatment (CM) by modifying pediatric practice to be more responsive to prevalent psychosocial needs of many children and families.Training pediatricians to address key risk factors for CM, the Safe Environment for Every Kid (SEEK) model aims to support parenting and family functioning, reducing the risk for CM while helping promote children's health, development and safety. We are building upon the existing pediatric primary care system and strengthening the training of pediatricians. The project also builds on our extensive research and clinical expertise in CM and in prevention (Black & Dubowitz, 1999, Dubowitz et al., 1998, 1999, in press; Dubowitz & Guterman, 2005, Gaudin & Dubowitz, 1997).

We have developed and implemented an enhanced model of pediatric primary care, taking advantage of the enormous opportunities of the existing pediatric primary care system, with its regular contact with young children and parents (Dubowitz & Newberger, 1989; Dubowitz, 1989, 1990; Green, 1994). Pediatricians typically devote over half their time to checkups, focusing on prevention. There is increasing recognition that pediatric care must incorporate aspects of parental and family functioning and collaborate with community resources (Academy of Pediatrics, 1998; Green, 1994b). The broad goal of this project is to implement concepts that have been embraced by the field of pediatrics, but have not been applied and tested.

Condition or disease Intervention/treatment Phase
Child Maltreatment Other: Model Care Not Applicable

  Show Detailed Description

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 905 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Prevention
Official Title: Preventing Child Maltreatment: A Role for Community Pediatricians
Study Start Date : May 2006
Actual Primary Completion Date : March 2009
Actual Study Completion Date : May 2010

Arm Intervention/treatment
Experimental: Model Care
The Model Care approach was implemented in 7 practices, where PCPs were trained to address major risk factors for CM, including maternal depression, alcohol/substance abuse, intimate partner violence, food insecurity, harsh punishment and major stress. We taught how they can be briefly assessed and initially addressed. The initial training consisted of one 4-hour in-person session. Use of the Parent Screening Questionnaire (PSQ) was discussed, as was the importance of applying it universally during regular checkups. PCPs SEEK Parent Handouts on each targeted problem. We held 1-hour booster sessions every 6 months over the subsequent 2.5 years.
Other: Model Care
The Model Care provided training to pediatric health care providers to assess parental psychosocial risk factors to child maltreatment.

No Intervention: Standard Care
PCPs in Standard Care group served as the controls. They continued to practice as usual.

Primary Outcome Measures :
  1. Parent to Child Conflict Tactics Scale [ Time Frame: Initial contact, 6 months & 12 months after start of study participation ]

Secondary Outcome Measures :
  1. Department of Human Services, Department of Child Protection records. [ Time Frame: Child's birth through March 2009 ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Mother or mother figure accompanying a child under 6 for a regular checkup.
  • Fluent english
  • Mother agrees to participate
  • Health Care provider is provider at involved practice
  • Health Care provider agrees to participate

Exclusion Criteria:

  • Mother is already participating through another child
  • Mother does not speak english
  • Mother declines participation
  • Health Care providers practice is not involved in study
  • Health Care provider declines

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00819702

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United States, Maryland
University of Maryland, School of Medicine
Baltimore, Maryland, United States, 21201
Sponsors and Collaborators
University of Maryland, College Park
Centers for Disease Control and Prevention
Doris Duke Charitable Foundation
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Principal Investigator: Howard Dubowitz, MD MS University of Maryland, College Park

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Responsible Party: Howard Dubowitz, Professor of Pediatrics, University of Maryland, College Park Identifier: NCT00819702     History of Changes
Other Study ID Numbers: HP-00040157 (H-27327)
1R49CE000588 ( U.S. NIH Grant/Contract )
First Posted: January 9, 2009    Key Record Dates
Last Update Posted: September 28, 2017
Last Verified: September 2017

Keywords provided by Howard Dubowitz, University of Maryland, College Park:
child abuse prevention
primary care
professional education in primary care