Safe Environment for Every Kid (SEEK™)
Safe Environment for Every Kid (SEEK™) aims to assess and address psychosocial problems to strengthen families, support parents, and promote children’s healthy development in their first 5 years. Parents complete a brief Parent Questionnaire before selected well-child visits. The questionnaire is used to identify parenting and family risk factors for child maltreatment such as depression, substance use, parental stress, intimate partner violence, food insecurity, and harsh punishment. SEEK is delivered by primary care professionals (PCPs) who use motivational interviewing techniques to engage parents as partners. Then, PCPs and parents develop a plan utilizing the families’ strengths to address identified risk factors and barriers to engagement. At the end of the well-child visit, parents receive handouts for each identified risk factor. The handouts provide basic information and resources in a user-friendly way to reinforce what was covered during the visit. PCPs then refer consenting families to community resources, as needed, often with the help of clinical social workers and mental health professionals.
Safe Environment for Every Kid (SEEK) does not currently meet criteria to receive a rating because no studies of the program that achieved a rating of moderate or high on design and execution demonstrated a favorable effect on a target outcome.
Date Research Evidence Last Reviewed: Oct 2021
Sources
The program or service description, target population, and program or service delivery and implementation information was informed by the following sources: the program or service manual, the program or service developer’s website, and the California Evidence Based Clearinghouse for Child Welfare.
This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the download the Handbook of Standards and Procedures, Version 1.0
Target Population
SEEK is designed for families with children 5 years and younger.
Dosage
SEEK is typically delivered at selected well-child visits (i.e., 2-month, 9-month, 15-month, 2-year, 3-year, 4-year, and 5-year) until the child is 5 years old.
Location/Delivery Setting
Recommended Locations/Delivery Settings
SEEK is delivered in pediatric and family medicine primary care settings.
Education, Certifications and Training
SEEK is delivered by licensed medical professionals including pediatricians, family medicine physicians, physician assistants, nurse practitioners, and residents in pediatric and family medicine primary care settings. Providers must complete a free online self-paced training. The training consists of nine 15-minute modules on the SEEK model, risk factors for child maltreatment, relationship building, motivational interviewing, and approaches for addressing barriers to engagement.
A program license and copyright agreement are required to deliver the intervention. The license allows healthcare practices to implement the program and use SEEK materials. Licensed healthcare practices are required to provide implementation feedback every 6 months.
Program or Service Documentation
Book/Manual/Available documentation used for review
The SEEK Online Training Modules video is implemented in conjunction with the Algorithms and Responses to Barriers infographics.
Dubowitz, H., & Lane, W. (2013). SEEK online training modules [Video]. Department of Pediatrics, University of Maryland School of Medicine. https://seekwellbeing.org/introduction-to-training-videos/
Safe Environment for Every Kid (SEEK). (2020). Algorithms and responses to barriers [Infographic]. Department of Pediatrics, University of Maryland School of Medicine. https://seekwellbeing.org/seek-materials/
Available languages
The materials for SEEK are available in English. The Parent Questionnaire (PQ-R) is available in English, Spanish, Italian, and Mandarin Chinese. Parent resources are available in English and Spanish.
Other supporting materials
For More Information
Website: https://seekwellbeing.org/
Phone: (410) 706-1703
Contact form: https://seekwellbeing.org/contact-us/
Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.
| Results of Search and Review | Number of Studies Identified and Reviewed for Safe Environment for Every Kid (SEEK™) |
|---|---|
| Identified in Search | 9 |
| Eligible for Review | 2 |
| Rated High | 0 |
| Rated Moderate | 1 |
| Rated Low | 1 |
| Reviewed Only for Risk of Harm | 0 |
| Outcome | Effect Size
 and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
|---|---|---|---|---|
| Child safety: Child welfare administrative reports |
0.28
11 |
1 (1) | 558 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group.
| Outcome | Effect Size
and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
Months after treatment when outcome measured
|
|---|---|---|---|---|---|
| Child safety: Child welfare administrative reports |
0.28
11 |
1 (1) | 558 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
- |
| Study 11664 - SEEK vs. Standard Pediatric Care (Dubowitz, 2009) | |||||
| Child Protective Services Reports |
0.28
11 |
- | 558 | - | 0 |
*p <.05
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications.
Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.
Full citations for the studies shown in the table are available in the "Studies Reviewed" section.
The participant characteristics display is an initial version. We encourage those interested in providing feedback to send suggestions to preventionservices@abtglobal.com.
The table below displays locations, the year, and participant demographics for studies that received moderate or high ratings on design and execution and that reported the information. Participant characteristics for studies with more than one intervention versus comparison group pair that received moderate or high ratings are shown separately in the table. Please note, the information presented here uses terminology directly from the study documents, when available. Studies that received moderate or high ratings on design and execution that did not include relevant participant demographic information would not be represented in this table.
For more information on how Clearinghouse reviewers record the information in the table, please see our Resource Guide on Study Participant Characteristics and Settings.
| Characteristics of the Participants in the Studies with Moderate or High Ratings | ||||||
|---|---|---|---|---|---|---|
|
Study Location
|
Study Year
|
Age or Grade-level
|
Race, Ethnicity, Nationality
|
Gender
|
Populations of Interest*
|
Household Socioeconomic Status
|
| Study 11664 - SEEK vs. Standard Pediatric Care | ||||||
| Characteristics of the Children and Youth | ||||||
| Baltimore, MD, USA | 2002 | Median age: 6 months; Age range: 0–5 years | 93% Black | 48% Female | -- | -- |
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| Baltimore, MD, USA | 2002 | Average age: 25 years | -- | -- |
Caregiver relationship: 93% Mother, 5% Father, 2% Other; Average number of children in home: 2 children; 12% Families with at least one CPS report from January 1989 to June 2002 |
32% Employed |
“--” indicates information not reported in the study.
* The information about disabilities is based on initial coding. For more information on how the Clearinghouse recorded disability information for the initial release, please see our Resource Guide on Study Participant Characteristics and Settings. The Clearinghouse is currently seeking consultation from experts, including those with lived experience, and input from the public to enhance and improve the display.
Note: Citations for the documents associated with each 5-digit study number shown in the table can be found in the “Studies Reviewed” section below. Study settings and participant demographics are recorded for all studies that received moderate or high ratings on design and execution and that reported the information. Studies that did not report any information about setting or participant demographics are not displayed. For more information on how participant characteristics are recorded, please see our Resource Guide on Study Participant Characteristics and Settings.
Studies Rated Moderate
Study 11664Lane, W., Dubowitz, H., Feigelman, S., & Poole, G. (2014) The effectiveness of food insecurity screening in pediatric primary care. International Journal of Child Health and Nutrition, 3(3), 130-138. https://doi.org/10.6000/1929-4247.2014.03.03.3
Dubowitz, H., Feigelman, S., Lane, W., & Kim, J. (2009). Pediatric primary care to help prevent child maltreatment: The Safe Environment for Every Kid (SEEK) Model. Pediatrics, 123(3), 858-864. https://doi.org/10.1542/peds.2008-1376
Feigelman, S., Dubowitz, H., Lane, W., Grube, L., & Kim, J. (2011). Training pediatric residents in a primary care clinic to help address psychosocial problems and prevent child maltreatment. Academic Pediatrics, 11(6), 474-480. https://doi.org/10.1016/j.acap.2011.07.005
This study was conducted in a usual care or practice setting (Handbook Section 6.2.2)Studies Rated Low
Study 11666Lane, W. G., Dubowitz, H., Frick, K. D., Semiatin, J., & Magder, L. (2021). Cost effectiveness of SEEK: A primary care-based child maltreatment prevention model. Child Abuse & Neglect, 111, Article 104809. https://doi.org/10.1016/j.chiabu.2020.104809
Dubowitz, H., Lane, W. G., Semiatin, J. N., & Magder, L. S. (2012). The SEEK model of pediatric primary care: Can child maltreatment be prevented in a low-risk population? Academic Pediatrics, 12(4), 259-268. https://doi.org/10.1016/j.acap.2012.03.005
Dubowitz, H., Lane, W. G., Semiatin, J. N., Magder, L. S., Venepally, M., & Jans, M. (2011). The Safe Environment for Every Kid model: Impact on pediatric primary care professionals. Pediatrics, 127(4), e962-e970. https://doi.org/10.1542/peds.2010-1845
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Studies Not Eligible for Review
Study 11665
Dubowitz, H., Lane, W. G., Semiatin, J. N., Magder, L. S., Venepally, M., & Jans, M. (2011). The Safe Environment for Every Kid model: Impact on pediatric primary care professionals. Pediatrics, 127(4), e962-e970. https://doi.org/10.1542/peds.2010-1845
This study is ineligible for review because it does not report program or service impacts on an eligible target outcome (Study Eligibility Criterion 4.1.5).
Study 11667
Dubowitz, H. (2013). The Safe Environment for Every Kid (SEEK) model: Promoting children's health, development and safety. Zero to Three.
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).
Study 11668
Dubowitz, H., Saldana, L., Magder, L. A., Palinkas, L. A., Landsverk, J. A., Belanger, R. L., & Nwosu, U. S. (2020). Protocol for comparing two training approaches for primary care professionals implementing the Safe Environment for Every Kid (SEEK) model. Implementation Science Communications, 1, Article 78. https://doi.org/10.1186/s43058-020-00059-9
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).
Study 11669
Dubowitz, H. (2014). The Safe Environment for Every Kid model: Promotion of children's health, development, and safety, and prevention of child neglect. Pediatric Annals, 43(11), e271-e277. https://doi.org/10.3928/00904481-20141022-11
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).
Study 11670
Dubowitz, H. (2014). The Safe Environment for Every Kid (SEEK) model: Helping promote children’s health, development and safety: SEEK offers a practical model for enhancing pediatric primary care. Child Abuse and Neglect, 38(11), 1725-1733. https://doi.org/10.1016/j.chiabu.2014.07.011
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).
Study 11671
Eismann, E. A., Theuerling, J., Maguire, S., Hente, E. A., & Shapiro, R. A. (2019). Integration of the Safe Environment for Every Kid (SEEK) model across primary care settings. Clinical Pediatrics, 58(2), 166-176. https://doi.org/10.1177/0009922818809481
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).
Study 11672
Feigelman, S., Dubowitz, H., Lane, W., Grube, L., & Kim, J. (2011). Training pediatric residents in a primary care clinic to help address psychosocial problems and prevent child maltreatment. Academic Pediatrics, 11(6), 474-480. https://doi.org/10.1016/j.acap.2011.07.005
This study is ineligible for review because it does not report program or service impacts on an eligible target outcome (Study Eligibility Criterion 4.1.5).