Abstract
BackgroundChildhood physical abuse is a major public health issue with negative consequences to health and well-being manifested in childhood and adolescence, and persisting into adulthood. Yet much childhood physical abuse is not identified when it occurs and little is known about how to screen for it. MethodsTo address this gap, the effectiveness of 4 modes of administration of screens to identify childhood physical abuse were compared in a sample of 506 adolescents and young adults aged 12-24 years seeking general health services at a primary care clinic. Comparisons were made between paper and pencil screen, audio computer-assisted self-interview screen, face-to-face structured screen (all 3 using the same measure), and face-to-face unstructured interview. FindingsOverall, 44.5% of the sample disclosed that they had been physically abused. Compared to paper and pencil screen, the odds of reporting physical abuse were 1.5 (95% confidence interval [CI]: 0.92, 2.58) and 4.3 (95% CI: 2.49, 7.43) higher among participants using face-to-face structured screen and face-to-face unstructured interview methods, respectively. The face-to-face unstructured interview identified significantly more reports than the paper and pencil screen. ConclusionsAlthough the unstructured interview was the most effective mode for screening for childhood physical abuse, additional research is needed to confirm whether this holds true in other health care settings. Further research should examine how a health provider's training, experience, and comfort level might influence the identification of physical abuse disclosure in primary care settings using face-to-face unstructured interview.
Highlights
Childhood physical abuse is a major public health issue with tremendous emotional and financial burden.[1]
Most victims do not spontaneously disclose a history of childhood physical abuse, they are likely to disclose if asked in a medical setting as part of a comprehensive health history.[12,13,14]
Our aim was to compare the effectiveness of 4 modes of administration of screens—paper and pencil screen, audio computer-assisted self-interview (ACASI) screen, face-to-face structured screen, and face-to-face unstructured interview—to identify a history of childhood physical abuse during a clinical visit
Summary
Childhood physical abuse is a major public health issue with tremendous emotional and financial burden.[1] Though much abuse goes unreported,[2] the number of reported cases among children and adolescents nationally is high: In 2013 there were 3.5 million reports of child maltreatment involving 6.4 million children, of which 18% were for physical abuse.[3]. Childhood physical abuse has both short- and longterm negative consequences that affect all aspects of functioning throughout the victim’s life course.[2,4,5] In adolescents the problems associated with abuse include teen pregnancy,[6] high stress, poor self-esteem, cigarette smoking, drug and alcohol abuse,[7,8] and depression and suicidality.[9] These negative effects can be diminished through treatment interventions if the abuse is identified by a health care provider.[1,2,10,11] most victims do not spontaneously disclose a history of childhood physical abuse, they are likely to disclose if asked in a medical setting as part of a comprehensive health history.[12,13,14] most. Much childhood physical abuse is not identified when it occurs and little is known about how to screen for it
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