Protocol for comparing two training approaches for primary care professionals implementing the Safe Environment for Every Kid (SEEK) model.
Protocol for comparing two training approaches for primary care professionals implementing the Safe Environment for Every Kid (SEEK) model.
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DOI：
10.1186/s43058-020-00059-9
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发表时间：
2020
影响因子：
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通讯作者：
Nwosu US
中科院分区：
文献类型：
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作者：
Dubowitz H;Saldana L;Magder LA;Palinkas LA;Landsverk JA;Belanger RL;Nwosu US
虐待儿童（CM）是一个重大的公共卫生问题，在短期和长期内影响着许多人的生命，并给个人、家庭和社会带来了高昂的代价。需要广泛实施基于证据的预防干预措施，例如为儿科初级保健开发的“每个孩子的安全环境”(SEEK) 模型。初级保健提供了一个绝佳的机会来帮助解决作为 CM 危险因素的普遍心理社会问题（例如父母抑郁症）。通过解决此类问题，SEEK 可以加强家庭并支持父母；促进儿童的健康、发展和安全；帮助预防CM；并有利于美国人民的健康。本研究将探讨优化 SEEK 的采用、实施和维持的干预策略，及其预防 CM 的有效性。尽管两项联邦资助的随机对照试验提供了强有力的证据，但 SEEK 尚未得到广泛采用。本研究的目标是检查技术驱动的实施策略，以扩大儿科和家庭医学初级保健机构中的 SEEK。目的是 (1) 评估在初级保健实践中实施 SEEK 的培训策略的有效性，(2) 评估成功实施和维持 SEEK 的障碍和促进因素，以及 (3) 检查该模型在预防 CM 方面的有效性以及实施 SEEK 的经济成本。这种随机 III 型混合方法设计将研究医疗培训的进步如何促进 SEEK 在美国不同地区的儿科和家庭医学实践中的采用和实施。这些是独立的在线培训和通过质量改进项目进行的深入结构化培训，并得到美国儿科和家庭医学委员会的批准。我们还将评估 SEEKonline（帮助初级保健从业者实施该模型的软件）以及“传统”纸笔策略对实施的影响。该研究使用 EPIS 框架和通用实施完成阶段、定量测量、定性访谈以及从电子健康记录中提取的数据。所获得的知识应该改善儿科初级保健，以更好地解决普遍存在的健康社会决定因素，使许多儿童和家庭受益。结果应加强实施科学领域并指导初级保健的未来干预措施。 NCT03642327，临床试验，2018 年 8 月 21 日注册。
Child maltreatment (CM) is a major public health problem, affecting many lives, in the short and long term, and costing individuals, families, and society dearly. There is a need for broad implementation of evidence-based preventive interventions, such as the Safe Environment for Every Kid (SEEK) model, developed for pediatric primary care. Primary care offers an excellent opportunity to help address prevalent psychosocial problems (e.g., parental depression) that are risk factors for CM. By addressing such problems, SEEK can strengthen families and support parents; promote children’s health, development, and safety; help prevent CM; and benefit the health of the US population. This study will examine intervention strategies for optimizing SEEK’s adoption, implementation, and sustainment, and its effectiveness in preventing CM. Despite strong evidence from two federally funded randomized controlled trials, SEEK has not been widely adopted. The goal of this study is to examine technology-driven implementation strategies to scale-up SEEK—in pediatric and family medicine primary care settings. The aims are to (1) evaluate the effectiveness of training strategies on SEEK’s implementation in primary care practices, (2) evaluate barriers and facilitators to successful implementation and sustainment of SEEK, and (3) examine the model’s effectiveness in preventing CM and the economic costs of implementing SEEK. This randomized type III hybrid mixed methods design will examine how advances in medical training can bolster SEEK’s adoption and implementation in pediatric and family medicine practices in different regions of the USA. These are independent online training and in-depth structured training via a quality improvement project, approved by the American Boards of Pediatrics and of Family Medicine. We will also evaluate SEEKonline, software that assists primary care practitioners implement the model, and a “Traditional” paper and pencil strategy for their impact on implementation. The study uses the EPIS framework and the Universal Stages of Implementation Completion, quantitative measures, qualitative interviews, and data abstracted from electronic health records. The knowledge gained should improve pediatric primary care to better address prevalent social determinants of health, benefiting many children and families. The outcomes should enhance the field of implementation science and guide future interventions in primary care. NCT03642327, Clinical Trials, registered August 21, 2018.