Impact Of Pediatricians’ Perceived Self-Efficacy and Confidence on Violence Prevention Counseling: A National Study

Abstract

Objective-To measure impact of pediatricians' perceived self-efficacy and confidence on current practices and attitudes regarding four violence prevention (VP) topics (gun storage, gun removal, limiting exposure to media violence, discipline techniques) during health supervision for children ages 2-11.Methods-Random sample survey of American Academy of Pediatrics Fellows (n = 486; 53% response rate) providing health supervision for children ages 2-11. Participants surveyed about VP issues regarding: (1) current counseling practices for 2-5 and 6-11 year olds; (2) amount of time spent addressing; (3) confidence in addressing; and (4) perceived self-efficacy at changing patients' behaviors. Multivariate analyses explored relationships between pediatricians' perceived self-efficacy and confidence versus VP counseling frequency.Results-VP topics were not routinely discussed during health supervision. Most pediatricians (64%) reported spending too little time addressing these topics. Although most pediatricians felt confident discussing and effective at changing behaviors regarding limiting exposure to media violence (89% vs. 50%) and discipline techniques (91% vs. 76%), they were less so for safe gun storage (54% vs. 35%) and gun removal (51% vs. 17%). Perceived self-efficacy was the mediating factor on self-reported VP counseling frequencies for all topics. Author Manuscript confident discussing than effective at changing behaviors. Since pediatricians' self-efficacy was related to counseling practices, boosting self-efficacy could ultimately improve counseling frequencies. Further research is needed to identify methods to build providers' perceived selfefficacy regarding these VP areas. Conclusions-Pediatricians HHS Public Access

Pediatrician attitudes, knowledge, and practice behavior regarding teen driving safety

“…Second, our response rate was 41%. While this rate compares favorably with the response rate in a domestic violence screening survey (Parsons, Zaccaro, Wells, & Stoval, 1995) of obstetrician-gynecologists (15%), it is somewhat lower than our own mail survey (Lapidus et al, 2002) on the same topic (49%) and among a national sample of pediatricians (53%) regarding violence prevention counseling (Finch et al, 2008). A third limitation of our study is self-selection.…”

“…In one study, time and lack of specific training were barriers to discussing violence prevention topics (Sege, Hatmaker, De-Vos, Levin, & Spivak, 2006). In another study of AAP fellows, most pediatricians did not routinely discuss violence prevention issues during health supervision visits with parents and their 2-5 and 6-11 year olds (Finch et al, 2008). In this national study, pediatricians' self-efficacy was related to counseling practices and the authors concluded that boosting self-efficacy could improve counseling frequencies.…”

“…Survey questions were developed from the AAP policy statement on teen drivers and adapted from a previous national AAP study of pediatricians on violence prevention counseling (Committee on Injury and Poison Prevention, Committee on Adolescence, 2006;Finch, Weiley, Ip, & Barkin, 2008). We assessed item construction, comprehension, and ease of completion using six physicians from the CT AAP Chapter executive committee.…”

Continuing Medical Education and Firearm Violence Counseling

“…A survey of 573 internists revealed that 58 percent had never asked patients about gun ownership, and 77 percent had never counseled patients on risks of firearm-related injury or death [20]. Similarly, less than half of surveyed pediatricians reported regularly providing firearm safety screening or counseling [18,[25][26][27]. At the medical student level, 66 percent of 1,469 seniors across 16 schools reported counseling patients about firearm safety "never" or "rarely,", with only 4 percent reporting doing so "usually" or "always" [16].…”

Development and Psychometric Properties of a Violence Screening Tool for Primary Care

“…Diagnosis of either current violence involvement (perpetration or victimization), or risk for future violence perpetration or injury is rarely made. Pediatricians do not feel comfortable dealing with violence issues with their patients [3,4]. The rate of diagnoses of assault injury and violence perpetration in 10 -21 year olds in the primary care setting was reported to be only .3% and .84%, respectively, much lower than expected compared with national youth self report [5].…”