Adolescent violence prevention practices among California pediatricians

Objectives: To examine pediatricians' provision of violence prevention serv ices to their adolescent patients and to identify factors associated with p ediatricians' implementation of these services. Design: A cross-sectional sample of California pediatricians completed a se lf-report questionnaire. The "Precede/Proceed" theoretical model guided the questionnaire in identification of factors associated with pediatricians' screening and intervening practices in preventing adolescent violence. Results: Two hundred twenty pediatricians (54% female, 66% white, 24% Asian , 5% Latino, and 5% other) participated in the study. On average, participa nts screened their patients for violence-related risk factors 31% of the ti me for fighting, 39% of the time for violence in the home, and 29% of the t ime for weapon carrying. Participants provided their at-risk patients with violence-related interventions less than 50% of the time (on average) imple menting the following interventions: written materials, follow-up appointme nts, discipline counseling, or referral to a community organization, Child Protective Services, or a specialized adolescent clinic. Factors associated with violence prevention screening practices included the following: posit ive attitudes and beliefs regarding screening for violence, familiarity wit h violence prevention guidelines, use of prompts in medical records, percep tions of greater skills, and positive reinforcement from patients and colle agues for providing violence prevention services (R-2=0.44; P<.001). Factor s associated with violence prevention intervention practices included: posi tive attitudes and beliefs in screening for violence, availability of resou rces, and positive reinforcement from patients and colleagues for providing violence prevention services (R-2=0.37; P<.001). Conclusions: California pediatricians are not widely screening their adoles cent patients for risk factors associated with adolescent violence, nor are they providing interventions to their adolescent patients who may be at ri sk for violence. The factors associated with pediatricians' implementation of violence prevention services may assist in the development of effective interventions designed to enhance their delivery of these services to their adolescent patients.