PROJECT SUMMARY Intimate partner violence (IPV) among caregivers is an important risk factor for the physical abuse of children. IPV affects 1 in 4 American women, with children present during almost half of the episodes of IPV. IPV may serve as a “sentinel” event and can provide an opportunity for both early detection and secondary prevention of abuse in a child who lives in an affected household. Physical abuse affects about 120,000 children annually in the US, with the youngest children (<3 years old), who are usually unable to provide a history, at the highest risk. Physical child abuse occurs in 30-60% of homes with IPV. We have shown that occult or inapparent injuries are often detected by x-rays when young children living with IPV undergo evaluation for abuse. Yet, most children who live with recognized IPV are not evaluated, perhaps because the care of abused children and adults is separated into different, often competing care systems. Family-Centered Care (FCC), a process in which the needs of children and caregivers are considered together, may improve caregiver engagement with the evaluation of children for physical abuse and with IPV-related services. The objective of the proposed research is to develop and evaluate an FCC model to improve evaluations for physical abuse of IPV-exposed children and to engage the IPV victim in attending to her own needs. First, we will conduct qualitative interviews of local stakeholders (including victims of IPV) and national leaders and will observe the current process of evaluating IPV-exposed children by child protective services and by medical providers to identify barriers to and facilitators of these evaluations. Using these data, we will use a systematic decision- making process to develop an FCC model to improve the medical evaluation of IPV-exposed children and an implementation strategy to enhance its use. A successful FCC model might link the child’s medical visit with providing an advocate to connect the abused caregiver with IPV services based on preliminary data. Finally, we will conduct a pilot trial in which we will compare our model of FCC with usual care for its acceptability and the feasibility of subsequent studies of its efficacy. Our central hypothesis is that an FCC model that simultaneously addresses the needs of children and caregivers will improve caregiver engagement, improve recognition of child abuse, and reduce the risk of subsequent IPV. I will also pursue formal training to acquire advanced skills and knowledge in community-engaged research, the practical application of implementation science, the conduct and evaluation of clinical trials, and the development of independent research grants. My mentors are experts in clinical and community-engaged research, child abuse pediatrics, familyviolence, and implementation science with extensive experience mentoring junior faculty. In addition to guidance on career development, they will provide hands-on mentorship for the propo...