Collaborative Care for Infants at Risk

Overview

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?

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Supportive Care
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: December 31, 2019

Interventions

  • Other: Collaborative 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.

Arms, Groups and Cohorts

  • Experimental: Collaborative Care
    • CPS caseworkers will be randomized to collaborative or comparison practice. For any infant investigated by a caseworker in the collaborative practice, the caseworkers will conduct a standard CPS investigation. Additionally, caseworkers will seek parental permission to contact an identified primary health care provider at two points in the CPS investigation for information sharing related to health needs, social risks, and recommended interventions.
  • No Intervention: Comparison Care
    • CPS caseworkers will be randomized to collaborative or comparison practice. For any infant investigated by a caseworker in the comparison practice, the caseworkers will conduct a standard CPS investigation.

Clinical Trial Outcome Measures

Primary Measures

  • Infant Health Related Quality of Life
    • Time Frame: 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 Measures

  • Parent Perception of Child Welfare and Child Health Care
    • Time Frame: 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
    • Time Frame: 6 months after CPS case closure
    • Repeat Child Welfare Involvement

Participating in This Clinical Trial

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.

Gender Eligibility: All

Minimum Age: N/A

Maximum Age: 364 Days

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Utah
  • Collaborator
    • Robert Wood Johnson Foundation
  • Provider of Information About this Clinical Study
    • Principal Investigator: Kristine Campbell, Associate Professor, Pediatrics – University of Utah

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