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Implementation of a Program to Teach Pediatric Residents and Faculty About Domestic Violence
Rachel P. Berger, MD, MPH;
Debra Bogen, MD;
Tina Dulani;
Elsie Broussard, MD, DrPH
Arch Pediatr Adolesc Med. 2002;156:804-810.
Objectives To obtain information about pediatric resident and staff knowledge,
attitudes, and screening practices related to domestic violence (DV), to implement
a domestic violence education program, and to evaluate whether the program
resulted in changes in these 3 domains.
Design Interventional with before and after survey evaluation.
Setting A hospital-based, pediatric residency continuity clinic that serves
families in Pittsburgh, Pa.
Participants Pediatric residents (n = 51), medicine-pediatric residents (n = 6),
continuity clinic faculty (n = 22), and certified-registered nurse practitioners
(n = 5).
Results Prior to implementation of the DV education program, respondents correctly
answered questions about the prevalence of DV (74 participants [90%]), the
racial distribution of DV victims (66 participants [80%]), and the significant
overlap between child abuse and DV (75 participants [91%]). Seventy-nine participants
(96%) believed that screening for the presence of DV was part of their role
as pediatric health care providers. At baseline, 17 (21%) of the 82 participants
reported that they were routinely screening for signs of DV during well-child
care visits compared with 39 (46%) after attending the education program (P = .005).Among participants who attended both educational
session 25% (9/36) were routinely screening for the presence of DV prior to
the intervention, compared with 46% (16/35) after the intervention (P = .008). At baseline, 33 (40%) of the 82 participants
had identified at least 1 case of DV in the prior 6 months compared with 45
(53%) after training. Prior to training, 18 participants (22%) were aware
of resources for DV victims compared with 45 (53%) after training (P<.001).
Conclusions To our knowledge, this is one of the first pediatric studies to demonstrate
that using a short, multifaceted educational module, it is possible to change
DV screening practices and to increase identification of DV victims among
pediatric residents, continuity clinic faculty, and certified-registered nurse
practitioners at a pediatric teaching hospital.
From the Departments of Pediatrics, Pittsburgh Child Advocacy Center
(Dr Berger) and General Academic Pediatrics (Dr Bogen), Children's Hospital
of Pittsburgh, Pittsburgh, Pa; Mount Holyoke College, South Hadley, Mass (Ms
Dulani); and Department of Health Services Administration, Graduate School
of Public Health, Department of Psychiatry, University of Pittsburgh School
of Medicine (Dr Broussard), Pittsburgh, Pa.
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