Violence prevention in the primary care setting - A program for pediatric residents

Objective: To measure the effect of a violence prevention program on pediat ric 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 in troductory talk, role playing, a printed resident guide, and supplemental r eading materials. Main Outcome Measures: Parent or guardian report of violence prevention gui dance 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. Befo re the program, guns or violence was discussed at 9.7% of visits; this incr eased to 19.1% of visits after the program (odds ratio, 2.20; 95% confidenc e interval, 1.02-4.74). The improvement was sustained 6 months after the pr ogram. 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. Re sidents regarded the program as a successful method of providing the skills and knowledge needed to address the issue of interpersonal violence in the ir primary care encounters.