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Awarded Research Grant to Prevent Violence and Violence-Related Injury

Preventing Child Maltreatment: Community Pediatrians' Role

FOA Number: CE05-012 - Grants for Violence-Related Injury Prevention Research
Project Period: 9/1/05-8/30/08
Application/Grant Number: 5 R49 CE000588-03
Principal Investigator: Howard Dubowitz, MD, MS
University of Maryland Baltimore
Department of Pediatrics
520 W. Lombard Street
Gray Hall, 1st Floor
Baltimore, MD 21201

Phone: 410-706-6144
Fax: 410-706-3017
E-mail: hdubowitz@peds.umaryland.edu

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.

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