Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Jul-Aug;12(4):259-68.
doi: 10.1016/j.acap.2012.03.005. Epub 2012 Jun 2.

The SEEK model of pediatric primary care: can child maltreatment be prevented in a low-risk population?

Howard Dubowitz  1 , Wendy G Lane, Joshua N Semiatin, Laurence S Magder
Affiliations
Randomized Controlled Trial

The SEEK model of pediatric primary care: can child maltreatment be prevented in a low-risk population?

Howard Dubowitz et al. Acad Pediatr. 2012 Jul-Aug.

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Model of the SEEK II Study Design.
Figure 2
Figure 2
Course of study participants.
See this image and copyright information in PMC

Comment in

References

    1. U.S. Department of Health and Human Services. Administration on Children Youth and Families. Washington, DC: U.S. Government Printing Office; 2010. (Child Maltreatment 2009).
    1. Hussey J, Chang J, Kotch J. Child maltreatment in the United States: prevalence, risk factors, and adolescent health consequences. Pediatrics. 2006;118:933–942. - PubMed
    1. Stirling JJ, Amaya-Jackson LA. Understanding the behavioral and emotional consequences of child abuse. Pediatrics. 2008;122:667–673. - PubMed
    1. Dubowitz H, Papas MA, Black MM, et al. Child neglect: outcomes in high-risk urban preschoolers. Pediatrics. 2002;109:1100–1107. - PubMed
    1. Lansford JE, Dodge KA, Pettit GS, et al. A 12-year prospective study of the long-term effects of early child physical maltreatment on psychological, behavioral, and academic problems in adolescence. Arch Pediatr Adolesc Med. 2002;156:824–830. - PMC - PubMed

Publication types