Child Abuse, Child Welfare, Primary Health Care
Conditions
Brief summary
This study evaluates the feasibility, acceptability, and impact of a collaborative care practice for infants investigated by state Child Protective Services (CPS) for suspected maltreatment. Recognizing the vulnerability of infants referred into CPS in the first year of life, as well as the frequent contact of infants with health care providers in the first year of life, the investigators will conduct a RCT to measure the impact of a collaborative practice model linking CPS caseworkers with primary health care providers during an investigation for suspected infant maltreatment. With this trial, the investigators will ask (3a) Can a collaborative practice model improve parent-reported infant health-related quality of life 6 months following child welfare involvement for suspected infant maltreatment? and (3b) Does a collaborative practice model impact repeat child welfare involvement for suspected child maltreatment over 6 months?
Interventions
OTHERCollaborative Care
CPS caseworkers will explain collaborative care to parents, ask parents to allow communication with an infant's primary care provider, and have willing parents sign a release allowing communication with the infant's provider during the investigation. Caseworkers will make at least two attempts to contact identified providers with parental consent. In the first week, caseworkers will contact the provider, identify the infant, and summarize the child maltreatment concerns. The caseworker will ask whether the provider recognizes any additional strengths or vulnerabilities for the infant. Prior to case closure, caseworkers will provide a summary of investigation findings, disposition, and service referrals including placement changes, safety planning, family preservation, and community resources, with a summary letter delivered to the provider after case closure.
Sponsors
Robert Wood Johnson Foundation
University of Utah
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
Surveys will be collected without knowledge of intervention assignment
Eligibility
Sex/Gender
ALL
Age
0 Days to 364 Days
Healthy volunteers
No
Inclusion criteria
* Less than 12 months of age at referral * Involved in a child welfare investigation for suspected maltreatment * Investigation occurring in Utah DCFS Salt Lake Valley or Western regions
Exclusion criteria
For the primary and selected secondary outcomes, * Caregiver with primary spoken language other than English or Spanish, * CPS caseworkers not yet randomized to a practice arm * Infants in out-of-home placement at the time of referral or case closure, * Infants suffering fatal maltreatment * Prior investigation of an infant in a household during study timeframe (e.g., twins, infant siblings, and repeat referrals will be excluded). For other secondary outcomes related to CPS outcomes, language exclusion will not be considered.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Infant Health Related Quality of Life | Change from baseline to 6 months following CPS case closure | Difference in Change in Infant Health Related Quality of Life based on practice arm |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Parent Perception of Child Welfare and Child Health Care | at baseline (child welfare) and at 6 months (child health care) | Difference in parent perceptions of child welfare and child health care based on practice arm |
| Repeat Child Welfare Involvement | 6 months after CPS case closure | Repeat Child Welfare Involvement |
Other
| Measure | Time frame | Description |
|---|---|---|
| Engagement of child welfare caseworkers | baseline | Proportion of eligible cases investigated that were offered collaborative practice |
| Acceptance of parents | baseline | Proportion of cases offered collaborative practice in which parents allowed practice |
| Recruiting and retention of high-risk longitudinal cohort | baseline and 6 months | Proportion of eligible cases willing to enroll in and follow-up with researchers |
Countries
United States
Outcome results
None listed