Violence Prevention in the Primary Care Setting: A Program for Pediatric Residents

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Abstract

Objective

To measure the effect of a violence prevention program on pediatric residents' violence prevention guidance during well-child visits.

Design

Prospective study of an educational intervention.

Setting

Inner-city tertiary care hospital and satellite site.

Participants

Pediatric residents.

Interventions

A 21/2-hour violence prevention program, consisting of an introductory talk, role playing, a printed resident guide, and supplemental reading materials.

Main Outcome Measures

Parent or guardian report of violence prevention guidance offered during the well-child visit, using a postvisit survey.

Results

Three hundred eight patient encounters were included in the survey: 93 prior to the program, 106 just afterward, and 109 after 6 months. Before the program, guns or violence was discussed at 9.7% of visits; this increased to 19.1% of visits after the program (odds ratio, 2.20; 95% confidence interval, 1.02-4.74). The improvement was sustained 6 months after the program. More than 80% of residents felt the program increased their fund of knowledge and taught them skills, and 93% stated that they would use these skills in the future.

Conclusion

This one-time educational intervention significantly increased the amount of violence prevention guidance provided by pediatric residents to their patients and families. The effect was sustained after 6 months. Residents regarded the program as a successful method of providing the skills and knowledge needed to address the issue of interpersonal violence in their primary care encounters.

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