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aftERcare.


- candidate number14551
- NTR NumberNTR3913
- ISRCTNISRCTN wordt niet meer aangevraagd.
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR20-mrt-2013
- Secondary IDsNL40541.018.12 CCMO
- Public TitleaftERcare.
- Scientific TitleAmsterdam follow-up of troubling ER-visitors children: Assessment and referral to external help.
- ACRONYMaftERcare
- hypothesisChild maltreatment is a major social problem with many adverse consequences. A substantial number of maltreated children is not identified by health care professionals. To improve identification of maltreated children in hospitals, a new hospital-based policy is developed. In this policy, all adults who present at the emergency department because of domestic violence, substance abuse and/or a suicide attempt are asked whether they have children in their care. If so, parents are coerced to visit the outpatient pediatric department together with all their children. During this visit, problems are evaluated and voluntary support can be arranged. We hypothesize that the children who are identified in the Amsterdam policy experience serious psychosocial problems and can benefit from supportive care, either for themselves or for their parents. Furthermore, we hypothesize that in the Amsterdam policy, the majority of children and parents are compliant with supportive care on a voluntary basis.
- Healt Condition(s) or Problem(s) studiedChildren, Domestic Violence, Substance abuse, Suicide attempt, Maltreatment
- Inclusion criteriaWe intend to include all children aged 0-17 years old, who are referred to the outpatient pediatric department of any of the 6 hospitals in Amsterdam, the UMCG or the Maasstad ziekenhuis because of a presentation at the emergency department of their parent(s) because of one or more of the following indications: domestic violence, substance abuse and/or a suicide attempt between August 1st 2012 and April 30th 2014.
- Exclusion criteriaOnly for cohort study:
1. No informed consent;
2. Insufficient knowledge of Dutch language.

There are no exclusion criteria for the registry study.
- mec approval receivedyes
- multicenter trialyes
- randomisedno
- groupParallel
- TypeSingle arm
- Studytypeobservational
- planned startdate 1-aug-2012
- planned closingdate30-apr-2015
- Target number of participants200
- InterventionsOnly usual care. Questionnaires will be administred at baseline and 1 year follow-up, to children >7 years, parents and health care providers.
- Primary outcomeThe primary outcomes of the registry study is: The proportion of the children identified as being maltreated.
The primary outcome of the cohort study are the psychosocial outcomes of children.
- Secondary outcomeRegistry study: The compliance of identified families with different types of involved care, and the proportion of identified families reported to CPS.

Cohort study: Social problems of parents and parents' and health care professionals' opinion and acceptance of the Amsterdam policy.
- TimepointsBaseline and 1 year follow-up.
- Trial web siteN/A
- statusopen: patient inclusion
- CONTACT FOR PUBLIC QUERIES Eva Hoytema van Konijnenburg
- CONTACT for SCIENTIFIC QUERIES Eva Hoytema van Konijnenburg
- Sponsor/Initiator Academic Medical Center (AMC, Amsterdam)
- Funding
(Source(s) of Monetary or Material Support)
Stichting Kinderpostzegels Nederland, Gemeente Amsterdam
- PublicationsHoytema van Konijnenburg, E. M. M., Sieswerda-Hoogendoorn, T., Brilleslijper-Kater, S. N., van der Lee, J. H., Teeuw, A. H. New hospital-based policy for children whose parents present at the ER due to domestic violence, substance abuse and/or a suicide attempt. European Journal of Pediatrics 2013 Feb;172(2):207-214
- Brief summaryEvaluation of a hospital-based guidance policy for children whose parents present at the emergency department because of domestic violence, substance abuse and/or a suicide attempt: Study protocol.

Background:
Child maltreatment is a major social problem with many adverse consequences. A substantial number of maltreated children is not identified by health care professionals. To improve identification of maltreated children in hospitals, a new hospital-based policy is developed. In this policy, all adults who present at the emergency department because of domestic violence, substance abuse and/or a suicide attempt are asked whether they have children in their care. If so, parents are coerced to visit the outpatient pediatric department together with all their children. During this visit, problems are evaluated and voluntary support can be arranged. The aim of this study is to assess: 1) psychosocial outcomes of the children and 2) supportive care pathways that are initiated as a result of this policy.

Methods:
We will conduct a prospective registry study including all children 0-17 years who are referred according to the Amsterdam policy during one year. Information about care pathways will be provided by different health care organizations. Furthermore, all children and parents that give informed consent are included in a multi-center, prospective cohort study, involving questionnaires on psychosocial complaints. Outcomes will be assessed at baseline and 1-year follow-up. Primary outcome measures are: psychosocial outcomes in children and the type of and compliance with supportive care pathways for children and parents.

Discussion:
This is the first study to evaluate this hospital-based guidance policy. The most important strength of this study is the use of multiple measures and informants, combined with follow-up. The most important limitation is the expected selection of patients that are willing to participate in the prospective cohort study. The registry part of the study will provide information about a non-selective group. Results of this study will be used to improve the current policies.
- Main changes (audit trail)
- RECORD20-mrt-2013 - 1-apr-2013


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