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Innovations : seekprogram

Clinical Innovations

Title: SEEK ( Safe Environment for Every Kid) Program

 

Organization: University of Maryland School of Medicine

Innovation Type: Evidence Based Clinical Practice Support   

What They’re Doing: Training health care professionals in pediatric primary care settings to identify and help address problems facing many families (eg, depression, substance abuse).  

Clinical Innovation: Pediatric practices receive training and support to enhance knowledge, skills, and competence related to screening for and addressing important risk factors for child maltreatment. Training consisted of small-group sessions lasting 4 or 8 hours, followed by periodic "booster" sessions. (Although the program is moving towards an online training program.) The Safe Environment for Every Kids ( SEEK ) model has included a brief screening questionnaire given to parents to complete while waiting to be seen, customized handouts for parents and "cheat sheets" for health professionals, and a social worker to support health professionals and parents.  

Evaluation Type: Experimental

Evaluation Plan:   

  • The first randomized trial which ran from June 2002 to November 2005 compared the rate of child maltreatment in high-risk families receiving SEEK model program services to similar families receiving usual pediatric primary care in the same inner-city clinic.  

  • The second randomized trial which ran from June 2006 until January 2009 compared the rate of child maltreatment in 7 suburban private pediatric practices that implemented SEEK to 11 similar practices that did not    

  • Patient Health and Cost Outcomes:

    • Reduces Child Maltreatment: The program significantly reduced rates of child maltreatment among high-risk, inner-city families and led to improvements in less severe parenting problems in lower-risk, suburban families.   

    • Potential to Avert Health System Spending. According to an unpublished analysis of the SEEK model, program-related costs averaged $244 per averted case of child maltreatment, whereas the medical and mental health services required for each child who is the victim of maltreatment cost an estimated $14,520.  

    Other outcomes of interest:     

    • Increases provider confidence: SEEK improved health professionals' self-reported competence and comfort in addressing major risk factors of child maltreatment, as well as their practice behavior. Importantly, these improvements were sustained over several years.   

    Publications:     

    Dubowitz, H., Prescott, L., Feigelman, S., Lane, W., Kim, J. Screening for Intimate Partner Violence in an Urban Pediatric Primary Care Clinic. Pediatrics. 2008: 121 ( 1 ): e85-91.   

    Lane, W., Dubowitz, H., Feigelman, S., Kim, J. Prescott, L., Meyer, W., Tracy, J.K. Screening for Parental Substance Abuse in an Urban Pediatric Primary Care Clinic. Ambulatory Pediatrics, 2007;7:458–462.   

    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; 119 ( 3 ): 435-43   

    Kim J, Dubowitz H., Hudson-Martin E, Lane W. Comparison of 3 data collection methods   for gathering sensitive and less sensitive information. Ambul Pediatr. 2008; 8 ( 4 ): 255-60  

    Dubowitz H, Feigelman S, Lane W, Kim JW. Pediatric Primary Care to Help Prevent Child Maltreatment: The S afe E nvironment for E very K id ( SEEK ) Model. Pediatrics .   2009;123:858-864.   

    Feigelman S, Dubowitz H, Lane W, Kim J.   Screening for Harsh Punishment in a Pediatric Primary Care Clinic.   Child Abuse Neglect.   2009;33(5):269-77.   

    Dubowitz H, Lane W, Semiatin J, Magder L, Venepally M, Jans M. The Safe Environment for Every Kid ( SEEK ) Model: Impact on Pediatric Primary Care Professionals. Pediatrics. 2011;127(4):e962-70. 

    Dubowitz H, Lane W, Semiatin J, Magder L.   The SEEK model of pediatric primary care: Can child maltreatment be prevented in a low-risk population? Under review.   

    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. Academic Pediatrics , 201;11(6):474-80. 

    Target Population: Outpatient pediatric patients and families    

    Date of Implementation: 2002     

    Contact: Howard Dubowitz, MD, MS
    Department of Pediatrics, University of Maryland School of Medicine
    E-mail:
    hdubowitz@peds.umaryland.edu     

    Multimedia: Pending   

    Where to learn more: http://brighfutures.org/

     

     
     

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