Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 May-Jun;19(4):438-445.
doi: 10.1016/j.acap.2019.01.006. Epub 2019 Jan 29.

A Qualitative Study Examining Stakeholder Perspectives of a Local Child Abuse Program in Community Emergency Departments

Gunjan Tiyyagura  1 , Paula Schaeffer  2 , Marcie Gawel  2 , John M Leventhal  2 , Marc Auerbach  2 , Andrea G Asnes  2
Affiliations

A Qualitative Study Examining Stakeholder Perspectives of a Local Child Abuse Program in Community Emergency Departments

Gunjan Tiyyagura et al. Acad Pediatr. 2019 May-Jun.

Abstract

Objective: Emergency department (ED) providers may fail to recognize or report child abuse and/or neglect (CAN). To improve recognition and reporting, we designed the Community ED CAN Program, in which teams of local clinicians (nurses, physicians, physician assistants) received training in CAN and 1) disseminated evidence-based education; 2) provided consultation, case follow-up, and access to specialists; and 3) facilitated multidisciplinary case review. The aims of this study were to understand the Program's strengths andchallenges and to explore factors that influenced implementation.

Methods: We used a qualitative research design with semistructured, one-on-one interviews to understand key stakeholders' perspectives of the Community ED CAN Program. We interviewed 27 stakeholders at 3 community hospitals and 1 academic medical center. Researchers analyzed transcribed data using constant comparative method of grounded theory and developed themes.

Results: Program strengths included 1) comfort in seeking help from local champions, 2) access to CAN experts, 3) increased CAN education/awareness, and 4) improved networks and communication. Facilitators of implementation included: 1) leadership support, 2) engaged local champions and external change agents (eg, CAN experts), 3) positive attributes of the champions, and 4) implementation flexibility. Program challenges/barriers to implementation included 1) variability of institutional support for the champions and 2) variability in awareness about the program.

Conclusions: A Community ED CAN Program has the potential to improve recognition and reporting of CAN. Key steps to facilitate implementation include the identification of committed local champions, strong leadership support, connections to experts, program publicity, and support of the champions' time.

Keywords: champions; child abuse; community of practice; emergency department.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest:

The authors have no conflicts of interest to disclose.

Figures

Figure 1:
Figure 1:
Program Components
Figure 2:
Figure 2:
Interview guide
Figure 3:
Figure 3:
Strategy for program implementation
See this image and copyright information in PMC

References

    1. Pless IB, Sibald AD, Smith MA, Russell MD. A reappraisal of the frequency of child abuse seen in pediatric emergency rooms. Child Abuse Negl 1987;11:193–200. - PubMed
    1. Keshavarz R, Kawashima R, Low C. Child abuse and neglect presentations to a pediatric emergency department. J Emerg Med 2002;23:341–5. - PubMed
    1. King AJ, Farst KJ, Jaeger MW, Onukwube JI, Robbins JM. Maltreatment-Related Emergency Department Visits Among Children 0 to 3 Years Old in the United States. Child Maltreat 2015;20:151–61. - PMC - PubMed
    1. Palazzi S, de Girolamo G, Liverani T, IchilMa. Observational study of suspected maltreatment in Italian paediatric emergency departments. Arch Dis Child 2005;90:406–10. - PMC - PubMed
    1. King WK, Kiesel EL, Simon HK. Child abuse fatalities: are we missing opportunities for intervention? Pediatr Emerg Care 2006;22:211–4. - PubMed

Publication types