Pediatric Academic Societies Abstracts for 2001

SAFETY CHECK VIOLENCE PREVENTION PILOT STUDY S Barkin, MD, MSHS, AE Baker, MS, EJ Slora, PhD, and RC Wasserman, MD, MPH. Wake Forest University School of Medicine, Winston-Salem, NC; Pediatric Research in Office Settings (PROS), American Academy of Pediatrics, Elk Grove Village, IL; and Pediatric Research in Office Settings (PROS), American Academy of Pediatrics, Burlington, VT. Accepted for a platform presentation at the 2001 Pediatric Academic Societies? Annual Meeting.

BACKGROUND: Major health organizations have issued guidelines for incorporating violence prevention into routine primary care for children, but only limited tools are available and no empirical evidence exists for this approach.

OBJECTIVE: To pilot-test a pediatric provider's violence prevention intervention administered during routine well child checks.

DESIGN/METHODS: Four community-based PROS practices in diverse geographic locations, serving both English and Spanish speaking families, participated, with two practices assigned to an intervention group and two assigned to a comparison group. The intervention consisted of four components: 1) a community violence prevention resource worksheet; 2) a knowledge, attitude, and behavior survey; 3) a topic-specific provider recommendation guide; and 4) tangible tools (eg, gun trigger lock) to assist patients in adhering to providers' recommendations. Data were gathered at baseline and four weeks later on parent knowledge and attitudes (for both groups), and behaviors (intervention only). Paired t-tests were computed for before and after comparison of behaviors (intervention group). Baseline and follow-up comparison of knowledge and attitudes were conducted using method pre- and post-t tests (intervention versus comparison group).

RESULTS: Intervention group respondents (n=34) reported improved behavior in the domains of media use (p=. 01) and anger management (p=. 03), with an effect size of 8-18%. There was no significant change with regard to discipline techniques. A small sample size of gun-owning families precluded analysis of data on firearm safety. Change scores computed to compare families' knowledge and attitudes at baseline and four weeks later indicate that intervention families (n= 34) improved with regard to media use (p=.005), discipline techniques (p=. 02) and anger management (p<. 02), whereas comparison families (n=20) exhibited no change over time.

CONCLUSIONS: This pilot indicates that a provider's office-based intervention can modify patient families' violence prevention knowledge, attitudes and behaviors- especially in the areas of media use and anger management. This information will guide and enhance a national randomized controlled trial.