The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61629

Anu Partap, MD, MPH¹, Dean Coonrod, MD, MPH², Michelle Watkins², and Dena Salter, MBA². (1) Department of Pediatrics, Maricopa Medical Center, 2601 East Roosevelt, Phoenix, AZ 85008, 602-344-5579, anu.partap@hcs.maricopa.gov, (2) Department of OB-GYN, Maricopa Integrated Health System/MedPro, 2601 East Roosevelt, Phoenix, AZ 85008

The American Academy of Pediatrics and multiple health organizations recommend screening for violence between parents during child health care visits. Screening has a secondary prevention role in identifying children who are at risk for adverse health, safety, and behavioral health outcomes. The Child Abuse and Domestic Violence Prevention and Early Intervention Project (CADVP) implemented a pilot program in January 2002 in Women’s Clinic and Children’s Health Center, serving low-income Hispanic families. The pediatric pilot program was evaluated on the impact of clinic-based advocates, stamped triggers on well visit forms, and monthly provider trainings on compliance with universal screening recommendations. All well-child visit forms from March 2002 through November 2002 were reviewed. Of 3,743 patients, 38% of parents were screened (n=1434); 34% of charts were left blank; 28% of parents were not screened because of privacy constraints. Over time, screening behaviors improved, increasing to 41%, however, 60% continued to miss screening opportunities. Among those who were screened, disclosures occurred in 2%. This rate is far below national rates and the 17% disclosure rate in the linked Women’s Clinic. On-site advocates, monthly trainings, and chart-based triggers are important, but not sufficient, factors in standardizing DV screenings in pediatric clinics. The low disclosure rate may be an indicator of the quality of the screening, privacy constraints, or maternal, cultural, or provider characteristics. Public health officials and practitioners must consider these limitations and the balance of resource investment when designing a program to screen for domestic violence in the context of pediatric care.

Learning Objectives:

At the consclusion of the session, the participant (learner) in this session will be able to:
• Describe the impact of a domestic violence program on pediatric screening practices.
• Describe factors that lead to missed opportunities for secondary prevention in child health care.
• Apply the program findings and evaluation design components to his/her own program development and evaluation design.

Keywords: Domestic Violence, Child Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Center for Health Care Against Family Violence
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Grant from Value Options, contracted with MedPro and Maricopa Integrated Health System, which founded the Center for Health Care Against Family Violence