GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care

Abstract

OPEN ACCESSMay 23, 2013GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care Rachel Boykan, MD, Leslie Quinn, MD, Catherine Messina Rachel Boykan, MD Stony Brook University School of Medicine Google Scholar More articles by this author , Leslie Quinn, MD Stony Brook University School of Medicine Google Scholar More articles by this author , Catherine Messina Stony Brook University Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9429 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail 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. Educational Objectives By the end of this tutorial, learners will be able to: Utilize the GUIDES mnemonic to structure questions and define strategies for addressing risk factors for childhood harm/injury in the primary care setting.Identify well-established risk factors for childhood harm/injury.Understand how to utilize GUIDES in the primary care setting. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: GUIDES Instructor's Guide.doc GUIDES- card (front and back).pptx GUIDES.pptx PEDIATRIC RESIDENT QUESTIONNAIRE for GUIDES follow-up.doc PEDIATRIC RESIDENT QUESTIONNAIRE for GUIDES pre-module.doc To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationBoykan R, Quinn L, Messina C. GUIDES: Assessment for Prevention of Child Maltreatment in Primary Care. MedEdPORTAL. 2013;9:9429. https://doi.org/10.15766/mep_2374-8265.9429 Copyright & Permissions© 2013 Boykan et al. This is an open-access article publication under the terms of the Creative Commons Attribution-No Derivatives license.KeywordsGUIDESChild MaltreatmentRisk Factors Disclosures None to report. Funding/Support None to report. Loading ...