Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health

Lutheran Settlement House

Name of Innovative Program: 
Children and Mom Project
Sponsoring Organization
Lutheran Settlement House
Name of Innovative Program Lead: 
Erika Tapp
E-mail Address of Innovative Program Lead: 
etapp@lutheransettlement.org
Project Description: 
 Domestic violence victims are more likely to seek medical attention for their children than for themselves (American Academy of Pediatrics). As few as 14% of women will self-identify as victims (Klap, et. al. Journal of General Internal Medicine, 2007). So how do you reach these women? LSH’s pioneering Children and Mom Project (CAMP) is making this happen by instituting universal screening as a standard of care in pediatric medical settings.  The program includes an onsite DV Medical Advocate, who provides both immediate interventions, training to hospital staff, and ensures long-term sustainability by developing hospital staff ‘CAMP champions’. Published studies reviewing patient files have shown that screening rates have increased. More women are seeking DV services. Debuting in 2005, CAMP has been replicated in three pediatric units and two more hospitals are looking to do the same. CAMP is reaching women in need, and making a difference every day.
Creativity and Innovation: 
 CAMP is the nation’s first on-site domestic violence program in a pediatric setting. CAMP is an effective, cost-efficient way to promote DV awareness and intervention. CAMP’s goal is to ensure that screening for Intimate Partner Violence (IPV) becomes a standard of care throughout the hospitals. It trains clinical and non-clinical staff, as well as medical school faculty and students, on domestic violence issues, tools to detect and document abuse, and appropriate care, referrals and follow-up. Pediatricians and medical staff refer appropriate patients to an onsite DV Medical Advocate. Medical Advocates conduct crisis intervention and more in-depth counseling, focus on increasing safety for both mothers and children, provide on-going support for mothers, increase the mothers’ awareness of the impact of witnessing domestic on their children, and connecting children to counseling services when appropriate. CAMP has been implemented at St. Christopher's Hospital for Children, Einstein Medical Center, and CHOP.  
Leadership: 
 In the past year, a total of 861 clinical and non-clinical staff at CHOP, St. Christopher’s Hospital, and Einstein Medical Center were trained by the DV Medical Advocates on domestic violence, RADAR (the screening tool), and how to respond to positive screens. Participants in trainings included:  nurses; new employees; 2nd year medical students; nursing students, residents.Having a designated staff champion is an important component to a successful CAMP program.  A CAMP champion is a designated staff person who works with the IPV counselor to promote IPV screening and support for coworkers who may have additional questions about screening.  Champions receive an additional 8 hours of training on intimate partner violence. Champions word with and educate their co-workers year-round. The IPV counselor provides champions with current research information, videos and handouts. A champion can be a social worker, nurse, resident or attending who has a special interest in IPV.    
Sustainability: 
 Currently, CAMP is funded through a variety of sources - the Pennsylvania Coalition Against Domestic Violence (PCADV), the Curaterra Foundation, and varying amounts from the hospitals themselves. PCADV has long-supported CAMP, and will continue its support. Levels of support from the hospitals has varied as they themselves struggle with the increased need for services and decreased funding. LSH is working with the hospitals to move to a model whereby the hospital pays for half of the cost of a an advocate, and LSH provides the other half. LSH strongly believes that building a diversified funding model will be the best way to ensure the future of CAMP. This insistence has already acted as a catalyst to CHOP which has committed to fund half the cost of the DV Medical Advocate, and the First Hospital Foundation recently committed funding for the other half. 
Replicability: 
 Making IPV-screening a universal standard of care is the broad goal of CAMP, and can be replicated in every pediatric hospital in the country. Training medical staff in how to screen for intimate partner violence is one of the chief activities of DV Medical Advocate on site at these hospitals. These trainings have been done with groups small and large. LSH is currently in discussions with two additional regional hospitals about expanding the program into their facilities. The PCADV has made our state the national leader in finding innovative ways to identify and prevent domestic violence; CAMP has proven to be a highly effective model for reaching more vulnerable families. 
Results/Outcomes: 
 In 2010, Dr. Mario Cruz, LSH’s collaborator at St. Chris, published “Results of a multifaceted Intimate Partner Violence training program for pediatric residents,” in Child Abuse and Neglect; this study established that the CAMP program improved resident knowledge in: IPV screening questions, referral sources, and the relationship between child abuse and IPV. Screening for IPV went from less than 1% to 33.1% in the first 8 months.Dr. Cruz’s most recent study, submitted to Academic Pediatrics in July of 2012, reviewed case records from IPC victims referred to DV Medical Advocate, and established that CAMP has been successful in identifying IPV victims and connecting victims to the services they most want. It determined that IPV victims who sought assistance generally were primarily seeking supportive counseling (63%) and safety planning (22%) during counseling sessions (as opposed to relocation assistance, support groups, hotline information, or the other services).  
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