376 - Addressing Adolescent Relationship Abuse in a Pediatric Emergency Department: Intervention Mapping Using Community Collaborators

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 376
Publication Number: 376.212

Lenore R. Jarvis, Children's National Hospital, Washington, DC, United States; Elizabeth .. Miller, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States; Eden Efrem, Children's National Hospital, Silver Spring, MD, United States; Summer Khalefa, Children's Hospital, Fairfax Station, VA, United States; James Chamberlain, Children's National Health System, Washington, DC, United States; Monika Goyal, Children's National Medical Center, Washington, DC, United States; Pam Hinds, Children's National Health System, Washington, DC, United States

Presenting Author(s)

Lenore R. Jarvis, MD, MEd (she/her/hers)

Assistant Professor of Pediatrics
Children's National Hospital
Washington, District of Columbia, United States

Background: Adolescent relationship abuse (ARA) affects millions of adolescents annually and is associated with negative mental and physical health outcomes. The pediatric emergency department (ED) can serve as a strategic venue for healthy relationship promotion and intervention for adolescents experiencing ARA. However, evidence-based interventions in this setting are currently lacking.

Objective: To adapt existing evidence-based ARA interventions for the pediatric ED setting using community collaborative input.

Design/Methods: Two groups, one comprised of adolescents and another with adults, were recruited between March and May 2022 for six, iterative sessions using intervention mapping methodology. A social-ecological framework was used by the moderators to contextualize ARA. Enrolled participants were also asked questions about ARA needs assessment and healthy relationship promotion and ARA intervention programmatic development. Data were analyzed using consensus coding.

Results: Participants included two groups of individuals: adolescent (n=12) and adult (caregivers of adolescents, clinicians, social workers, and ARA community partners) (n=9). Overall, participants believed that ARA is normalized and intergenerational. Groups provided reflections for the context of ARA and several ARA programmatic recommendations (see Tables 1 and 2). Both groups recommended universal ARA education about healthy and unhealthy relationships and available resources, potentially followed by universal ARA screening. Neither group recommended universal brief motivational interviewing to address ARA but believed that adolescents would benefit from an opt-in approach to speaking to an ARA advocate or social worker. Groups stated that it is important for adolescents to understand ARA confidentiality and mandatory reporting requirements and discussions surrounding ARA should occur without parents in the room. Electronic methods and technology solutions were preferred over paper or verbal solutions.

Conclusion(s):

Adolescent and adult community collaborators recommend universal ARA education and available resources using electronic methods within a pediatric ED.