ABSTRACT
Presented at the Pediatric Academic Societies annual meeting, May 2004
PEDIATRICIANS’
PERCEPTIONS OF THEIR LEVEL OF CONFIDENCE AND EFFECTIVENESS IN VIOLENCE PREVENTION
COUNSELING: A NATIONAL SURVEY
Stacia A Finch1, Alison B Bocian1, Victoria
Weiley1, Shari Barkin2. 1Pediatric Research in
Office Settings (PROS), Dept of Practice & Research; Center for Child
Health Research, American Academy of Pediatrics, Elk Grove Village, IL; and 2Dept
of Pediatrics, Wake Forest University School of Medicine, Winston-Salem,
NC.
BACKGROUND: The majority of pediatricians
indicate that violence prevention (VP) topics should be included as part of
health supervision (HS), yet studies indicate this doesn't occur regularly.
OBJECTIVE: Measure pediatricians' current
practices and attitudes regarding VP topics during HS for children ages 2-11.
DESIGN/METHODS: In 2003, a Periodic Survey was mailed to a random sample of 1,603
AAP members (response rate=53%). Analyses were limited to pediatricians (excluding
residents) who provided HS for children ages 2-11 (n=486); mean age was 43
years and 60% were female. Differences in current practice, confidence in
addressing topics, and self-perceived effectiveness at changing behaviors were
assessed by gender, practice location, and age (<45 and ≥45) using
Chi-square analyses.
RESULTS: Most pediatricians (64%) reported spending too little time
addressing VP issues during HS, with younger pediatricians more likely to
report this sentiment (p<.01). Most pediatricians do not routinely discuss
VP topics during HS:
|
|
Gun storage |
Gun removal |
Discipline techniques |
Exposure to media violence |
|
% discussed with 75-100% of patients: |
|
|
|
|
|
2-5 yrs |
23% |
16% |
41% |
27% |
|
6-11 yrs |
24% |
17% |
33% |
34% |
Females were more likely than males to discuss: 1) limiting exposure to media violence with both age groups (p<.05) and 2) discipline techniques during visits for ages 2-5 (p=.05); no differences were found by age or location. While most pediatricians felt confident in discussing discipline techniques (91%) and limiting exposure to violent media (89%), they were less so for safe firearm storage (54%) and removal of guns from home (51%). Pediatricians' self-perceived effectiveness at changing patients' VP-related behaviors also varied: discipline techniques (76%), limiting exposure to violent media (50%), safe firearm storage (35%), and removal of guns from home (17%). Suburban pediatricians felt more effective at changing patients' behaviors regarding discipline techniques (p<.01) and limiting exposure to violent media (p=.01). There were no differences in confidence or self-perceived effectiveness by gender or age.
CONCLUSIONS: Pediatricians report spending insufficient time addressing VP and
varying levels of confidence and self-perceived effectiveness by VP topic.
Increasing pediatricians’ skills in VP-related counseling must be made a
priority if HS visits are to be used to address VP.