Comparing Two Training Approaches to Scaling Up the Safe Environment for Every Kid (SEEK) Approach.

Area of Science:

• Continuing Medical Education
• Healthcare Quality Improvement
• Implementation Science

Background:

• Scaling up evidence-based practices in primary care is crucial for improving child safety.
• Continuing Medical Education (CME) modalities vary in their effectiveness for practice change.
• The Safe Environment for Every Kid (SEEK) approach aims to enhance child safety within primary care settings.

Purpose of the Study:

• To compare the impact of independent online (IND) and Maintenance of Certification-4 (MOC) training on the adoption, implementation, and sustainment of the SEEK approach.
• To evaluate the role of primary care practice characteristics in the scaling up of the SEEK approach.

Main Methods:

• A longitudinal, multisite study involving 44 primary care practices across the United States.
• Practices were randomized to either IND or MOC training modalities.
• Data on training completion, practice characteristics, and SEEK implementation (startup, fidelity, sustainment) were collected over two years.

Main Results:

• Few differences were observed between IND and MOC training modalities regarding SEEK adoption and sustainment.
• Higher training completion (dose) was associated with greater fidelity, particularly in IND practices.
• Practices with greater baseline commitment and self-efficacy were more likely to initiate and implement SEEK with fidelity.

Conclusions:

• The simpler IND training modality appears effective for scaling up evidence-based practices like SEEK.
• Enhancing PCP commitment and self-efficacy through preparation is vital for successful implementation.
• Further strategies are needed to improve PCP engagement and completion rates for CME training.