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. 2023 Aug;23(6):1151-1158.
doi: 10.1016/j.acap.2022.12.005. Epub 2022 Dec 27.

Adolescent Relationship Abuse Prevention in Pediatric Primary Care: Provider, Adolescent, and Parent Perspectives

Sarah Tiffany-Appleton  1 , Erin Mickievicz  2 , Yanet Ortiz  2 , Olivia Migliori  2 , Kimberly A Randell  3 , Emily F Rothman  4 , Diego Chaves-Gnecco  2 , Daniel Rosen  5 , Elizabeth Miller  6 , Maya I Ragavan  7
Affiliations

Adolescent Relationship Abuse Prevention in Pediatric Primary Care: Provider, Adolescent, and Parent Perspectives

Sarah Tiffany-Appleton et al. Acad Pediatr. 2023 Aug.

Abstract

Objective: Adolescent relationship abuse (ARA) is associated with myriad negative health outcomes. Pediatric primary care presents an opportunity to engage adolescents and parents, who can be protective against ARA, in ARA prevention; however, no family-focused, health care-based ARA interventions exist. The purpose of this study is to explore the perspectives of adolescents, parents, and health care providers (HCPs) on incorporating ARA prevention into primary care, including 1) current discussions around ARA, 2) how to best include ARA prevention education, and 3) how to address implementation barriers.

Methods: We conducted individual, semi-structured interviews with HCPs, adolescents ages 11 to 15, and parents recruited through convenience sampling. Transcripts were individually coded by 4 study team members (with every third transcript co-coded to assess discrepancies) and analyzed via thematic analysis.

Results: Participants identified a need for pediatric HCPs to involve younger adolescents and parents in universal, inclusive ARA prevention and noted that HCPs require training, techniques, and resources around ARA. Participants acknowledged multilevel barriers to implementing primary care-based ARA prevention. They suggested that ARA education be intentionally integrated into HCP and clinic workflows and recommended strategies to garner adolescent and parent buy-in to facilitate ARA-focused conversations.

Conclusions: Pediatric primary care is a promising environment to involve parents and adolescents in universal ARA-prevention. Future research should contextualize these results with larger samples across multiple practice settings and integrate relevant partners in the development and evaluation of evidenced-based ARA prevention for pediatric primary care.

Keywords: adolescent relationship abuse; anticipatory guidance; parents; pediatric primary care; semi-structured interviews.

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Conflict of interest statement

Conflict of Interest Disclosures: E. Miller receives royalties for writing content for UptoDate, Wolter Kluwers Inc. The authors have no other conflicts of interest relevant to this article to disclose.

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