Preventing Child Abuse--Community Pediatrians' Role

预防虐待儿童——社区儿科医生的作用

• 批准号: 7015374
• 负责人: HOWARD DUBOWITZ
• 金额: $ 30万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2008-08-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7015374
• 关键词: attitude; behavioral /social science research tag; child abuse; child health care personnel; clinical research; clinical trials; family structure /dynamics; health care model; health care professional practice; health care referral /consultation; health education; human subject; interview; model design /development; outcomes research; parent offspring interaction; patient care personnel relations; primary care physician; public health; questionnaires; social problems; social psychology; spouse abuse; training; violence prevention

DESCRIPTION (adapted from applicant(s abstract): Child maltreatment (CM) and intimate partner violence (IPV) jeopardize the health and safety of many children and families. Attention has primarily focused on addressing these problems "after the fact." There is a need for rigorously evaluated prevention strategies. This project aims to enhance pediatric primary care to help prevent CM, and to address IPV. Pediatric primary care offers an excellent opportunity: regular "check-ups" aim to prevent injury and disease. It is hypothesized that the Model Care will help pediatricians address risk factors for CM (e.g., IPV, maternal depression), thus diminishing its likelihood, and improving children's health and safety. The proposed project will take place in 20 pediatric private practices in Maryland, involving approximately 80 pediatricians. These practices cover a diverse patient population; approximately one-third are low income, and one-third are minority. The first component involves training pediatricians to identify and assist families at high risk for CM. The second component involves the Model Care, including: 1) screening parents at their preschooler check-ups, 2) assessing problems, 3) initial pediatric and/or social work intervention, and 4) referral to community resources. This model represents a modest but important modification of the existing child health care system. Via random assignment, half will be trained to implement the Model Care. The control group will provide standard care. The investigators will evaluate the impact of training on pediatricians' attitudes, knowledge, comfort, competence, and practice; and also evaluate the effectiveness of the Model Care upon: 1) screening practices, 2) identifying risk factors for CM, 3) whether risk factors are addressed, 4) the prevalence and severity of risk factors, and 5) rates and severity of CM and IPV. This project is innovative and fits with the goals of "Healthy People 2010" and "CDC's Research Agenda". It applies sound theory and clinical experience, attending to common psychosocial problems. It has the potential to make an important contribution to knowledge and practice. If the risk factors are identified, and this leads to the problems being effectively addressed, this will justify replicating the model. The Model Care approach could be replicated with far-reaching implications for the nature of pediatric practice in the U.S.

描述（改编自申请人的摘要）：虐待儿童 (CM) 和亲密伴侣暴力 (IPV) 危害许多儿童和家庭的健康和安全。注意力主要集中在“事后”解决这些问题。该项目旨在加强儿科初级保健以帮助预防 CM，并为解决 IPV 问题提供了一个绝佳的机会：定期“检查”旨在预防伤害和疾病。这Model Care 将帮助儿科医生解决 CM 的风险因素（例如 IPV、产妇抑郁症），从而降低其发生的可能性，并改善儿童的健康和安全。拟议的项目将在马里兰州的 20 个儿科私人诊所进行，涉及约 80 名儿科医生。这些做法涵盖了不同的患者群体；大约三分之一是低收入患者，三分之一是少数族裔。第一个部分涉及培训儿科医生来识别和帮助患有 CM 高风险的家庭。第二个部分涉及示范护理，包括：1）在学龄前儿童检查中筛查家长，2）评估问题，3）初步儿科和/或社会工作干预，以及 4）转介社区资源。该模型代表了对现有儿童医疗保健系统的适度但重要的修改。通过随机分配，一半人将接受培训以实施模型护理。对照组将提供标准护理。研究人员将评估培训对儿科医生的态度、知识、舒适度、能力和实践的影响；并根据以下方面评估模型护理的有效性：1) 筛查实践，2) 识别 CM 的风险因素，3) 风险因素是否得到解决，4) 风险因素的患病率和严重程度，以及 5) CM 的发生率和严重程度和IPV。 该项目具有创新性，符合“健康人民2010”和“CDC研究议程”的目标。它应用合理的理论和临床经验，解决常见的心理社会问题。它有可能对知识和实践做出重要贡献。如果确定了风险因素，并且问题得到了有效解决，那么就证明复制该模型是合理的。模型护理方法可以被复制，对美国儿科实践的性质产生深远的影响。