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Study shows that Pediatricians Play Crucial Role in Violence Prevention

Researchers at Wake Forest University Baptist Medical Center say physicians and other health care providers play valuable roles in violence prevention in their communities.

A study published in the March issue of Injury Prevention states that physicians have a great deal of influence on families and often form unique bonds with them as they mature.

The study identified six potential ways clinicians could help curb violent behavior during a routine well-child examination. The six areas of intervention included: educating the family about youth violence, counseling the child directly, using the unique bond formed between doctor and patient, advocating gun safety to either the parent or the patient, referring patients and families to community programs, and educating patients through impersonal means, such as brochures or posters.

"Violence prevention is not just about guns; that''s only part of it," said Shari Barkin, M.D. assistant professor of pediatrics and public health sciences at Wake Forest University Baptist Medical Center and the principal investigator of the study. "During well-child examinations, pediatricians must provide education to parents regarding discipline and TV viewing.

"Corporal punishment is a very personal issue for most parents," Barkin said. "Discipline needs to be respectful but firm. However, corporal punishment sends a negative message to your children. It is saying, ''I have a conflict with you so I am going to strike you.'' It teaches children to resolve conflicts in aggressive ways."

Viewing TV for extended amounts of time and watching violent programming can also negatively affect children.

"Children should watch a maximum of two hours of TV a day," she said. "And programs should be selected to decrease violent TV shows watched by children. Young children can''t separate fantasy from reality, so they imitate TV and make it reality."

The study also reinforces that health care providers, while influential, don''t work in a vacuum, Barkin said.

"Physicians reinforce positive messages that children get elsewhere," Barkin said. "The role of the physician must be supported by community leaders and parents."

The study reports that physicians need to become familiar with the resources in their communities and help children plug into programs that can benefit them.

The qualitative study was conducted by interviewing pediatricians, community leaders, and parents living or working in Los Angeles, Calif. Participants were asked if they felt clinicians had a role in violence primary prevention, which was defined as preventing violent injury in children younger than 18 years of age. Barkin worked with Gery Ryan with the University of Missouri and Lillian Gelberg with the UCLA Division of Family Medicine.

"The study showed that while the physician cannot solve the problem of youth violence alone, findings suggest that they should address this issue with their patients and should work in tandem with existing community resources to further a solution to this growing epidemic," Barkin said.

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