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

J Pediatr Health Care. 2017 Jul-Aug;31(4):470-475. doi: 10.1016/j.pedhc.2016.12.005. Epub 2017 Feb 8.


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.

Keywords: Child neglect; determinants of health; pediatrics; psychosocial screening.

MeSH terms

  • Adult
  • Child
  • Child Abuse / diagnosis*
  • Child Abuse / psychology
  • Child Abuse / statistics & numerical data
  • Child Welfare*
  • Female
  • Follow-Up Studies
  • Health Services Research
  • Humans
  • Male
  • Mass Screening
  • Parents / psychology*
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Public Assistance / organization & administration
  • Referral and Consultation / organization & administration*
  • Risk Factors
  • Social Class
  • Social Determinants of Health
  • Social Work* / organization & administration
  • United States / epidemiology
  • Vulnerable Populations / psychology*