The Abuse of Women is a Pediatric Issue Terri L' Weaver, Ph'D', Patrice L' Pye, Ph'D', Heidi M' Sall

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The Abuse of Women is a Pediatric Issue Terri L.
Weaver, Ph.D., Patrice L. Pye, Ph.D., Heidi M.
Sallee, MD, Melissa L. Maglione, M.S, Anita
Bazile, Ph.D., Sharonda Ayers, B.S., Aida
Cajdric, M. S., Lesley S. Kuras, B.S., and
Princess Osei-Bonsu, M.S. Saint Louis University

• Abstract
• In 1998, the American Academy of Pediatrics (AAP)
  developed a policy statement highlighting the
  importance of assessing and intervening in
  intimate partner violence (IPV). This study
  reports findings from an interdisciplinary
  project, Pediatric-Psychology Partnership for
  Abuse Prevention. Clinical psychology trainees
  and pediatric residents served as an integrated
  health team seeing female caregivers and their
  children within an urban, ambulatory pediatric
  clinic. Lifetime (and current) exposure to IPV,
  and child health/behavior and parent focused
  concerns were assessed with 318 female
  caregivers. Twenty-seven percent of the sample
  reported life time exposure to IPV while nearly
  six percent reported current exposure to IPV.
  There was a significant relationship between
  current and lifetime exposure. Women who
  experienced any exposure to IPV, current or
  lifetime (n 86), were significantly more likely
  to report having at least one child concern and
  parent or adult focused concern at the pediatric
  appointment. Specific concerns expressed at
  significantly greater rates by the any IPV group
  of female caregivers included difficulty with
  discipline, financial difficulties, and
  relationship conflict. A mediational model,
  constructed to explore the inter-relationships
  among variables and found that financial concerns
  mediated the association between any exposure to
  IPV and a composite variable of parenting
  concerns. These findings suggest that lifetime
  and current IPV exposure may have important
  implications for current pediatric care
  particularly by way of parenting and parenting
  resources.
• Intimate Partner Violence (IPV)
• Implications for Parenting and Parental Resources
• Disparities are seen in the incidence,
  prevalence, and burden of IPV among specific
  population groups
• African American women and their children
  experience disproportionate risk for IPV
• Social and environmental risk factors include
  being young, divorced or separated, earning lower
  incomes, and living in an urban area
• In spite of the magnitude of the problem, IPV is
  underreported, underidentified and at risk
  populations are underserved
• The current project focuses on reducing issues of
  health disparity in IPV by eliminating barriers
  to care for underserved African American women
  and their children.
• Ambulatory Pediatric Site
• University Pediatrics is an ambulatory primary
  care setting training physicians, medical
  students, interns, and pediatric residents at
  Saint Louis University School of Medicine.
• University Pediatrics is located in St. Louis
  City, a medically underserved community.
• University Pediatrics serves
• -Average of 6000 patients per year -80 African
  American
• -Generally low SES (80 Medicaid) -Substantial
  percentage of single and teenage mothers
• -Clinical presentations include poor nutrition,
  failure to thrive, prematurity,asthma, behavioral
  and school-related problems.
• Methods
• Female caregivers attending sick and well child
  visits at University Pediatrics (N 318)
  completed feedback surveys regarding their
  healthcare visit and were asked about any
  additional concerns they had for themselves or
  their children.

Results

• Conclusions and Future Directions
• The pediatric visit presents a window of
  opportunity for assessing for current and
  lifetime IPV and for linking exposure to IPV with
  other maternal and child health issues
• The majority of mothers indicated that screening
  for IPV is a relevant and appropriate part of
  their childrens health care visit
• Future research needs to focus on the impact of
  IPV screening on mothers safety practices with
  themselves and their children and maternal and
  child health and wellbeing.