A Medical Home-Based Intervention to Prevent Child Neglect in High-Risk Families
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Child Abuse
- Sponsor
- Boston Medical Center
- Enrollment
- 250
- Locations
- 1
- Primary Endpoint
- Adherence to recommended medical care
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
Child maltreatment, particularly neglect, disproportionally affects low-income children with special health care needs (CSHCN) and has serious short and long-term consequences. Currently, few replicable, evidence-based preventive services exist for such families, particularly within the context of the patient-centered medical home. Child Abuse Prevention Problem Solving (CAPPS), a targeted problem solving intervention that addresses key risk and protective factors for child neglect, has the potential to improve key parenting skills and overall wellbeing, ultimately improving outcomes for high-risk children. This study is a multi-center randomized controlled efficacy trial of CAPPS to determine the impact on child neglect, adherence to recommended medical care, and family stressors and strengths.
Detailed Description
Child maltreatment, particularly neglect, disproportionally affects low-income CSHCN and has serious short and long-term consequences. Currently, few replicable, evidence-based preventive services exist for such families, particularly within the context of the patient-centered medical home. CAPPS, a targeted problem solving intervention that addresses key risk and protective factors for child neglect, has the potential to improve key parenting skills and overall wellbeing, ultimately improving outcomes for high-risk children. This is a multi-center randomized controlled efficacy trial of Child Abuse Prevention Problem Solving (CAPPS), a targeted intervention designed to address specific stressors faced by low-income parents of children with special health care needs (CSHCN) and to enhance family strengths previously been shown to reduce the risk of maltreatment. The study will enroll 250 parents of CSHCN who receive primary care in a network of urban patient-centered medical homes. The specific research aims are to 1: Decrease referrals to child protective services for neglect and increase adherence to recommended medical care; and 2: Decrease perceived social isolation, difficulty navigating complex services, and caregiver burden and enhance family strengths, including parental resilience, social connections, access to support in times of need, and knowledge of parenting and child development.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Primary caregiver of a child under age 7 with a physical, emotional, or behavioral health condition
- •Child on Medicaid
- •Fluent in English or Spanish
Exclusion Criteria
- •Prior history of substantiated child maltreatment
- •Prior history of report to child protective services for suspected child maltreatment
- •Parent cognitively limited
Outcomes
Primary Outcomes
Adherence to recommended medical care
Time Frame: Up to 12 months after enrollment in study
Adherence will be evaluated by chart review to determine a composite measure that includes numbers of medical visits attended, hospitalizations, missed appointments, delayed or missed prescriptions fills, and receiving recommended immunizations.
Referral to Child Protective Services for neglect
Time Frame: Up to 12 months after enrollment in study
This will be determined using chart review and parent report.
Secondary Outcomes
- Parental resilience and social connections - RSES(Up to 12 months after enrollment in study)
- Parental resilience and social connections - PM(Up to 12 months after enrollment in study)
- Parental resilience and social connections - PSI(Up to 12 months after enrollment in study)
- Access to concrete support(Up to 12 months after enrollment in study)
- Knowledge of parenting skills, child development - PS(Up to 12 months after enrollment in study)
- Parental resilience and social connections - CHIP(Up to 12 months after enrollment in study)
- Parental resilience and social connections - SAS-SR(Up to 12 months after enrollment in study)
- Parental resilience and social connections - PSS(Up to 12 months after enrollment in study)
- Knowledge of parenting skills, child development - CTSPC(Up to 12 months after enrollment in study)
- Parental resilience and social connections - MOS-SS(Up to 12 months after enrollment in study)