Child ProtectionTraining Pediatric Residents in a Primary Care Clinic to Help Address Psychosocial Problems and Prevent Child Maltreatment
Section snippets
Setting
The study took place in the primary care continuity clinics of a medium-sized, inner-city pediatric practice, serving children 0–18 years of age. The clinic had approximately 9,000 registered children, with 14,000 visits per year. Eighty percent of the families received Medicaid insurance.
Sample
The pediatric residency program has approximately 60 residents annually. The study sample consisted of the categorical pediatric and combined medicine-pediatrics residents who provided care in the continuity
Results
The sample consisted of 95 residents (50 intervention and 45 control) (Fig. 2). Three residents did not complete the PQ at baseline, but completed subsequent questionnaires. One resident completed only the pretest. Ninety-one completed questionnaires at 6 months; 84 (88%) did so at 18 months. There were no group differences in baseline characteristics, or in prior experience addressing child maltreatment and IPV (Table 2).
Demographic characteristics of families in the intervention (N = 308) and
Discussion
This study demonstrates that the SEEK model improved residents’ level of comfort, perceived competence, and practice behavior regarding prevalent psychosocial problems that are risk factors for child maltreatment. Indeed, the improvement in the areas of depression, IPV, stress, and food insecurity remained significant even 18 months after the initial training, despite the fact that long-term retention of educational material is difficult to achieve.19 In addition to the training, use of the
Acknowledgment
We thank Leslie Prescott, BA, J. Kathleen Tracy, PhD, Walter Meyer, MA, Joshua N. Semiatin, MS, and members of the research team for their contributions. The participation of the residents was instrumental in this study. We wish to thank the physicians and residents at Children’s Hospital of Philadelphia and University of Oklahoma in piloting the Physician Questionnaire and giving us feedback. Pamela Singer assisted with manuscript preparation.
The study was funded by a grant from the U.S.
References (33)
- et al.
Screening for harsh punishment in a pediatric primary care clinic
Child Abuse Negl
(2009) - et al.
Screening for parental substance abuse in pediatric primary care
Ambul Pediatr
(2007) - et al.
Assessment of the patient-doctor interaction scale for measuring patient satisfaction
Patient Educ Couns
(1992) - et al.
Child protection: a neglected area of pediatric residency training
Child Abuse Negl
(2004) - et al.
Pediatric residency training on domestic violence: a national survey
Ambul Pediatr
(2004) - et al.
Implementing practice guidelines for depression: applying a new framework to an old problem
Gen Hosp Psychiatry
(2002) Preventing child neglect and physical abuse: a role for pediatricians
Pediatr Rev
(2002)- American Academy of Pediatrics. Practicing Safety Program. 2006. Available at: http://www.aap.org/practicingsafety/....
- American Academy of Pediatrics. Bright Futures. 3rd ed, 2008. Available at: http://brightfutures.aap.org. Accessed...
The role of the pediatrician in recognizing and intervening on behalf of abused women
Pediatrics
(1998)
Committee on psychosocial aspects of child and family health. Clinical Report—Incorporating recognition and management of perinatal and postpartum depression into pediatric practice
Pediatrics
Pediatric primary care to help prevent child maltreatment: the Safe Environment for Every Kid (SEEK) model
Pediatrics
Intentional injury management and prevention in pediatric practice: results from 1998 and 2003
Pediatrics
Primary care pediatricians’ roles and perceived responsibilities in the identification and management of maternal depression
Pediatrics
Do pediatricians recognize mothers with depressive symptoms?
Pediatrics
Cited by (57)
Evaluating the Effectiveness of Trauma-Informed Care Frameworks in Provider Education and the Care of Traumatized Patients
2024, Journal of Surgical ResearchPreventing child maltreatment: Key conclusions from a systematic literature review of prevention programs for practitioners
2021, Child Abuse and NeglectCitation Excerpt :This program was designed to enhance participants' knowledge of the Adverse Childhood Experiences (ACEs) studies and incorporate it into their practice. Lastly, three programs specifically targeted the healthcare professionals of pediatricians and family medicine residents (Feigelman et al., 2011; Ferrara et al., 2017; Froula et al., 2017). These programs relayed theoretical knowledge and included group discussions of CM, risk factors, assessment, screening and identification of CM.
Factors related to providers screening children for behavioral health risks in primary care settings
2021, Journal of Pediatric NursingCitation Excerpt :Given study findings that providers reported less screening when they had less confidence and when community resources were perceived as unavailable or inaccessible, training is likely to be an important component for increasing screening compliance and success. There are emerging examples of comprehensive screening and training models that show promise in improving provider confidence (Dubowitz et al., 2009; Feigelman et al., 2011). In a cluster randomized controlled trial, for example, a training offered as part of the Safe Environment for Every Kid (SEEK) model improved provider confidence and comfort in talking about mental health, substance use and intimate partner violence concerns with families (Dubowitz et al., 2011).
The authors have no conflicts of interest to disclose.