Pediatricians Can Help Prevent Violence

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Pediatricians can help prevent future violent behaviors in their patients with a brief, one-time office intervention during a routine exam, according to a new study published in the July issue of Pediatrics.

The study involved 5,000 families with children ages 2 to 11 and more than 200 providers at 137 practices associated with the American Academy of Pediatrics’ (AAP) Pediatric Research in Office Settings (PROS) network.

It is the largest study to date showing that pediatricians can reduce violent behaviors, according to Shari Barkin, M.D., director of the Division of General Pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt.

"This concept of anticipatory guidance—that pediatricians can have a public health impact through a brief, one-time office intervention—is key,” said Barkin, who designed and implemented the study with co-authors while working at Wake Forest University School of Medicine.

The research was based on changing factors previously shown to impact the risk of future violent behavior, such as: excessive media time (computer games and television often depicting violence), access to unsafely stored firearms and corporal punishment.

“This study provides important new evidence demonstrating the value of strategies that can be used in pediatricians’ offices to reduce the risk of violence for children,” says Steering Committee chair Stephen Pearson, M.D., FAAP, of the American Academy of Pediatrics PROS Network.

One group of parents received specific violence-prevention intervention, including timers for monitoring media use and time-outs, cable locks for safe storage of guns, and office referrals for childhood aggression; the other group received only printed literature on literacy promotion and no information related to violence prevention.

After six months, there was a significant increase in the number of caregivers limiting their children’s media time to fewer than two hours per day, with intervention group families watching, on average, 45 minutes less of media per day.

Additionally, firearm owners exposed to the intervention in the study were twice as likely to store their firearms more safely. Use of time-outs was not significantly affected, but there was a decrease in families who reported corporal punishment, more in the intervention group than the control group.

“We showed that this type of dialogue between the pediatrician and the family, which only lasts three to four minutes, can motivate change,” Barkin said.

“We hope this will become an intervention that all pediatricians adopt as a part of their regular practice for families. Reducing violence is a pediatric and public health imperative.”

Source: Vanderbilt University Medical Center

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