GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care
Abstract Introduction Child abuse is a significant problem in the US; approximately 700,000 children per year are victims of child maltreatment. Risk factors for child abuse are well defined and multifactorial and include those that are parent-related, child-related, and environmental. Pediatricians...
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| Format: | Article |
| Language: | English |
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Association of American Medical Colleges
2013-05-01
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| Series: | MedEdPORTAL |
| Subjects: | |
| Online Access: | http://www.mededportal.org/doi/10.15766/mep_2374-8265.9429 |
| _version_ | 1818942446531248128 |
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| author | Rachel Boykan Leslie Quinn Catherine Messina |
| author_facet | Rachel Boykan Leslie Quinn Catherine Messina |
| author_sort | Rachel Boykan |
| collection | DOAJ |
| description | Abstract Introduction Child abuse is a significant problem in the US; approximately 700,000 children per year are victims of child maltreatment. Risk factors for child abuse are well defined and multifactorial and include those that are parent-related, child-related, and environmental. Pediatricians do not commonly screen for these risk factors in the primary care setting. This may be due to a perceived lack of time, discomfort in speaking about sensitive issues, and mistrust of the system, among other reasons. While several interventions to address risk for child abuse have been developed and published, most are systems-focused, involving social workers, nurses, physicians, and other health care workers. The GUIDES method educates pediatric residents on known risk factors for child abuse and establishes an easy-to-use method for addressing these risk factors in the clinical setting, specifically at well-child visits of children from birth to age 10. Methods Similar to the HEADS mnemonic, GUIDES is a mnemonic that stands for Growth, Underlying medical history, Injury/prevention, Development, Economics, and Social/family history. Using this mnemonic, one may structure questions to maximize obtaining information regarding well-established risk factors for childhood harm/injury. In a 1-hour self-directed PowerPoint tutorial, the learner is educated on risk factors for child maltreatment and an easy-to-learn method for screening for these risk factors in the primary care setting. It is expected that the learner will apply this method in his/her primary care setting. Repeated application of the material can serve to reinforce knowledge and skills. Results In an initial pilot study, residents' self-assessments and use of this tool in their continuity care clinics were tracked for a period of 6 months by telephone survey of parents of children seen for well-child care visits. A comparison of residents' pre/post surveys (n = 24) using the McNemar test revealed a trend towards improvement in addressing questions in domains such as growth, behavior, and development. Residents asked about discipline more frequently postintervention. However, in other areas of questioning (economic and psychosocial), residents showed no improvement. Discussion Based on these preliminary data, we conclude that this brief intervention may improve residents' ability to address known risk factors for childhood harm. The lack of improvement in residents' self-report in more sensitive domains (economic and psychosocial) may reflect the need for more in-depth intervention and/or longitudinal practice. |
| first_indexed | 2024-12-20T07:11:34Z |
| format | Article |
| id | doaj.art-669022c5dd5349ec81a11ed25b3fe0be |
| institution | Directory Open Access Journal |
| issn | 2374-8265 |
| language | English |
| last_indexed | 2024-12-20T07:11:34Z |
| publishDate | 2013-05-01 |
| publisher | Association of American Medical Colleges |
| record_format | Article |
| series | MedEdPORTAL |
| spelling | doaj.art-669022c5dd5349ec81a11ed25b3fe0be2022-12-21T19:48:53ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652013-05-01910.15766/mep_2374-8265.9429GUIDES: Assessment for Prevention of Child Maltreatment in Primary CareRachel Boykan0Leslie Quinn1Catherine Messina21 Stony Brook University School of Medicine2 Stony Brook University School of Medicine3 Stony Brook UniversityAbstract Introduction Child abuse is a significant problem in the US; approximately 700,000 children per year are victims of child maltreatment. Risk factors for child abuse are well defined and multifactorial and include those that are parent-related, child-related, and environmental. Pediatricians do not commonly screen for these risk factors in the primary care setting. This may be due to a perceived lack of time, discomfort in speaking about sensitive issues, and mistrust of the system, among other reasons. While several interventions to address risk for child abuse have been developed and published, most are systems-focused, involving social workers, nurses, physicians, and other health care workers. The GUIDES method educates pediatric residents on known risk factors for child abuse and establishes an easy-to-use method for addressing these risk factors in the clinical setting, specifically at well-child visits of children from birth to age 10. Methods Similar to the HEADS mnemonic, GUIDES is a mnemonic that stands for Growth, Underlying medical history, Injury/prevention, Development, Economics, and Social/family history. Using this mnemonic, one may structure questions to maximize obtaining information regarding well-established risk factors for childhood harm/injury. In a 1-hour self-directed PowerPoint tutorial, the learner is educated on risk factors for child maltreatment and an easy-to-learn method for screening for these risk factors in the primary care setting. It is expected that the learner will apply this method in his/her primary care setting. Repeated application of the material can serve to reinforce knowledge and skills. Results In an initial pilot study, residents' self-assessments and use of this tool in their continuity care clinics were tracked for a period of 6 months by telephone survey of parents of children seen for well-child care visits. A comparison of residents' pre/post surveys (n = 24) using the McNemar test revealed a trend towards improvement in addressing questions in domains such as growth, behavior, and development. Residents asked about discipline more frequently postintervention. However, in other areas of questioning (economic and psychosocial), residents showed no improvement. Discussion Based on these preliminary data, we conclude that this brief intervention may improve residents' ability to address known risk factors for childhood harm. The lack of improvement in residents' self-report in more sensitive domains (economic and psychosocial) may reflect the need for more in-depth intervention and/or longitudinal practice.http://www.mededportal.org/doi/10.15766/mep_2374-8265.9429Risk FactorsChild MaltreatmentGUIDES |
| spellingShingle | Rachel Boykan Leslie Quinn Catherine Messina GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care MedEdPORTAL Risk Factors Child Maltreatment GUIDES |
| title | GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care |
| title_full | GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care |
| title_fullStr | GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care |
| title_full_unstemmed | GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care |
| title_short | GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care |
| title_sort | guides assessment for prevention of child maltreatment in primary care |
| topic | Risk Factors Child Maltreatment GUIDES |
| url | http://www.mededportal.org/doi/10.15766/mep_2374-8265.9429 |
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