Utilizing an Urban Healthcare Setting to Prevent Adolescent Dating Violence: Evaluation of Outcomes from Clinicians and Adolescents

Ten year prevalence estimates suggest that teen dating violence (TDV) remains a persistent public health problem. Despite its prevalence and harms, many healthcare clinicians do not screen for TDV. This gap in screening represents a missed opportunity for intervention and support. In previous research, adolescents endorse the need for healthcare clinicians to screen all adolescents for TDV exposure, and indicate a belief that screening by a healthcare clinician is necessary. However, to date, no evidenced based intervention has been developed with healthcare clinicians as the catalyst for preventing TDV.

A national nonprofit organization provided a two-hour training on dating violence to 16 health care clinicians at an urban adolescent health clinic. Components of the training included epidemiology, suggested screening questions, and strategies for responding to positive screens. Health care clinicians’ self-efficacy, outcome expectancies, knowledge, and behavioral capabilities were examined pre and post training in addition to a 6-month follow-up. 45 adolescent patients (M = 18.3, SD=1.9) were also surveyed at follow-up to assess their openness to discussing dating abuse with their clinicians.

ANOVA tests show significant differences in clinician knowledge, behavioral capability, outcome expectations, and outcome expectancies post training and at the 6-month follow-up. Specifically, significant increases were observed in clinicians’ ability identify warning signs of dating abuse (F(2,41) = 11.31, p < 0.01), knowledge about how to respond to youth experiencing data abuse (F(2,41) = 9.76, p < 0.01), behavioral capability to talk with patients about TDV (F(2,41) = 3.68, p = 0.03), perceived importance of talking to patients about ADV (F(2,41) = 3.41, p = 0.04) and belief that discussing TDV with their patients will reduce their involvement in TDV (F(2,41) = 3.71, p = 0.03).

Preliminary analysis of adolescent survey data shows that about half of the youth participants (51.1%) feel confident in their ability to identify signs of an unhealthy/abusive relationship. The majority of youth participants (66.7%) also reported that they talk about healthy relationships with their doctor and they are comfortable discussing this topic with their doctor (88.9%). Finally, almost half of participants strongly agree that they would share with their doctor if they were in an abusive relationship (48.9%) and think their doctor would help them (46.7%).

This pilot training intervention successfully improved adolescent healthcare clinician self-efficacy, outcome expectancies, knowledge, and behavioral capability regarding TDV.  Future research is needed to evaluate health behavioral risk outcomes resulting from the intervention with health care clinicians.