P3A291: A Part Of, Not Apart From: Creating a Violence Prevention Training for Pediatricians by Building a Partnership Between a Community-based Organization and a Pediatric Primary Care Clinic

Background: Firearm related injury is the leading cause of death in youth aged 1-24, and disproportionately impacts Black males and other historically marginalized groups. Despite this, there are barriers to screening for and addressing violence prevention in the pediatric primary care setting. Myriad factors contribute to this, not the least of which are historical misgivings, where providers express concern about how their patients will perceive them asking about violence, with the concern being further alienation.

Methods: With support of an AAP Community Access to Child Health grant, we engaged with a community-based organization with violence prevention expertise. The goal was to develop curriculum that was responsive to the needs of pediatric providers while also appropriately reflecting the values of the patients that comprised the community.

Over a 6-month period, intentional partnership building took place, using established, practices of building and sustaining relationships with community-based organizations. This led to an iterative process of creating a workshop that used community expertise to approach violence, with special focus on the educational needs and anticipated discomfort of pediatric providers. The workshop incorporated tenets of nonviolence, content about morbidity and mortality related to youth violence, and, ultimately, case-based scenarios to simulate interacting with a violence-impacted young person, that centered around community trust and rapport building.

The three-hour workshop was offered on two dates and was promoted to pediatric attendings (both hospital and community-based) and residents who worked in primary care throughout the state. The workshops were facilitated by the community-based organization. Pre-workshop surveys assessed how often pediatricians screen for violence and to identify what are their barriers to doing such. Post-workshop data evaluated the efficacy of the training, and changes in attitudes, knowledge, and beliefs.

Results: A total of 26 participants enrolled in the workshops (nine in the first, 17 in the second), 18 residents and eight attendings. Pre-workshop surveys indicated that 85% (n=22) never had formalized violence prevention training, and 35% (n = 10) reported having not asked about violence because of concern how their patients might perceive them (Figure 1). Post-workshop surveys demonstrated that 92% of the participants found the workshop effective or highly effective. Qualitative comments highlighted the model’s strength in providing techniques for rapport building, personal reflection, and engagement, while also expressing a need for more information about resources (Table 1).

Conclusion: Pediatricians in primary care can play a pivotal role in youth violence prevention. Partnering with a community-based organization to train pediatricians about violence prevention can be a useful way of educating pediatricians. Whereas more focus could be brought to resources, this training model has the potential to shift attitudes concerning pediatrician’s connection to the community, which may in turn increase their sense of self-efficacy with respect to screening for violence.