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

Table 1. Demographics Women Surveyed

(N = 304) PercentagesCaregiver’s Age

18-20 27 8.9%21-29 125 41.1%30-39 79 26.0%40-49 44 14.5%50-59 10 3.3%60-69 3 1.0%

70+ 1 0.3%No Answer 15 4.9%

Child’s Age0-2 wks 20 6.5%

2 wks-3 mos 31 10.2%3-6 mos 16 5.4%

6 mos-1 yr 29 9.5%1-1.5 yrs 21 6.9%1.5-2 yrs 21 6.9%

2-4 yrs 23 7.6%over 4 yrs 131 43.1%

No Answer 12 3.9%Ethnic BreakdownWhite, Not Hispanic 48 15.8%Black, Not Hispanic 229 75.3%

Hispanic 3 1.0%Asian 2 0.7%

American Indian 2 0.7%Other 5 1.6%

Not Sure 1 0.3%No Answer 14 4.6%

Well Child VisitSick 76 25.0%Well 217 71.4%

No Answer 11 3.6%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

Responses to "I am concerned about my child's" (N = 199)

Weight IssuesEating HabitsAnger/FightingSleep HabitsSad/Anxious MoodAcademic DifficultiesSmoking CigarettesOther

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

Responses to "I am concerned about my" (N = 199)

Financial Strains

Difficulties with Discipline

Smoking Cigarettes

Eating Habits

Parenting

Relationship Conflict

Other

AbstractIn 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. • Female caregivers were screened to assess current and lifetime IPV, as well as concerns for others. All respondents were given resource cards with safety planning information and community resource phone numbers.

Results

Table 2. IPV-Related Safety ConcernsCurrent (N=236) Past (N=139) For Someone Else (N=139)Yes 9.3%Yes 30.9%Yes 20.1%No 90.3%No 66.2%No 79.9%No Answer 0.4%No Answer 2.9% If yes, who: friend 53.7%

If yes, who: husband 18.2% If yes, who: husband 9.3% sister 17.8%ex-husband 13.6% ex-husband 18.6% cousin 3.5%

boyfriend 45.5% boyfriend 58.1% other 25%stranger 0.0% stranger 4.7%

other 22.7% other 9.3%

Conclusions and Future DirectionsThe 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 children’s health care visit;

Future research needs to focus on the impact of IPV screening on mother’s safety practices with themselves and their children and maternal and child health and wellbeing.

Table 3. Put REGRESSION HERE

N=100 Somewhat to Completely Agree

Asking about personal safety should done as part of the pediatric visit 87%

A mother's safety significantly affects the well-being of the child 99%

I have learned information that was helpful during the screening 88%