Advertisement

The Identification of Psychosocial Risk Factors Associated With Child Neglect Using the WE-CARE Screening Tool in a High-Risk Population

Published:February 08, 2017DOI:https://doi.org/10.1016/j.pedhc.2016.12.005

      Abstract

      Introduction

      Neglect accounts for over 70% of child maltreatment and carries significant sequelae. Identification of psychosocial determinants of health may allow pediatric providers to ameliorate precursors of child neglect.

      Methods

      Data were collected 1 month before and after implementation of the Well-Child Care Visit, Evaluation, Community Resources, Advocacy, Referral, Education (i.e., WE-CARE) screen at all well-child visits. Social workers recorded number and types of referrals, and providers completed surveys.

      Results

      Analysis of 602 completed screens (75% capture rate) showed 377 families (63%) with at least one need and 198 (33% overall, 53% of those with positive results) indicating a desire to discuss. Of families requesting assistance, 122 (62%) connected with a social worker, and total referrals increased after implementation. Provider surveys supported an increased frequency of and comfort with assessing families for certain risk factors, and screening was not perceived to interrupt clinic flow.

      Conclusion

      Standardized screening identifies families at risk for neglect, improves provider comfort, and minimally affects flow. Identification of psychosocial needs should be part of routine preventive care.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Pediatric Health Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Berkowitz C.D.
        Child abuse recognition and reporting: Supports and resources for changing the paradigm.
        Pediatrics. 2008; 122: 10-12
        • Carter B.
        Developing and implementing an appreciative “quality of care” approach to child neglect practice.
        Child Abuse Review. 2012; 21: 81-98
        • Centers for Disease Control and Prevention
        Child abuse and neglect prevention.
        Author, Atlanta, GA2016 (Retrieved from)
        • Centers for Disease Control and Prevention
        Burden of tobacco use in the U.S..
        Author, Atlanta, GA2016 (Retrieved from)
        • Dubowitz H.
        Tackling child neglect: A role for pediatricians.
        Pediatric Clinics of North America. 2009; 56: 363-378
        • Fang X.
        • Brown D.S.
        • Florence C.S.
        • Mercy J.A.
        The economic burden of child maltreatment in the United States and implications for practice.
        Child Abuse and Neglect. 2010; 36: 156-165
        • Fraser J.A.
        • Mathews B.
        • Walsh K.
        • Chen L.
        • Dunne M.
        Factors influencing child abuse and neglect recognition and reporting by nurses: A multivariate analysis.
        International Journal of Nursing Studies. 2010; 47: 146-153
        • Garg A.
        • Butz A.M.
        • Dworkin P.H.
        • Lewis R.A.
        • Serwint J.R.
        Screening for basic social needs at a medical home for low-income children.
        Clinical Pediatrics. 2009; 48: 32-36
        • Garg A.
        • Butz A.M.
        • Dworkin P.H.
        • Lewis R.A.
        • Thompson R.E.
        • Serwint J.R.
        Improving the management of family psychosocial problems at low-income children's well-child care visits: The WE-CARE project.
        Pediatrics. 2007; 120: 547-558
        • Garg A.
        • Dworkin P.H.
        Surveillance and screening for social determinants of health: The medical home and beyond.
        JAMA Pediatrics. 2016; 170: 189-190
        • Raman S.
        • Holdgate A.
        • Torrens R.
        Are our frontline clinicians equipped with the ability and confidence to address child abuse and neglect?.
        Child Abuse Review. 2012; 21: 114-130
        • Schickedanz A.
        • Coker T.R.
        Surveillance and screening for social determinants of health-where do we start and where are we headed?.
        Current Problems in Pediatric and Adolescent Health Care. 2016; 46: 154-156

      Biography

      Stephanie Zielinski, Pediatric Nurse Practitioner, University of Rochester Medical Center and School of Nursing, Rochester, NY.

      Biography

      Heather A. Paradis, Medical Director of Community Services at Children's Hospital of Wisconsin, Milwaukee, WI.

      Biography

      Pamela Herendeen, Professor of Clinical Nursing, Senior Pediatric Nurse Practitioner, University of Rochester Medical Center, NY.

      Biography

      Paula Barbel, Assistant Professor of Nursing, The College at Brockport, State University of New York, Brockport, NY.

      Linked Article

      • Erratum
        Journal of Pediatric Health CareVol. 32Issue 2
        • Preview
          Erratum to “The Identification of Psychosocial Risk Factors Associated With Child Neglect Using the WE-CARE Screening Tool in a High-Risk Population” [Journal of Pediatric Health Care, (31) 2017 470-475]
        • Full-Text
        • PDF