Prevention of peer and community violence: the pediatrician's role

Pediatric practitioners can play a pivotal preventative role in helping their young patients to lower their risk of becoming involved in peer and community violence by developing a sound program and implementing specific preventative treatments. The recommendations presented here are derived from the integration of two sources: (1) research evidence on children's involvement with peer violence as aggressors, victims, bystanders who support violence, nonviolent problem-solvers, gender-role-related participants, or witnesses to community violence; and (2) the practical experience of developing a pediatric violence prevention program in a neighborhood health center over the last 12 years. To develop a sound violence prevention program, it is recommended that pediatricians (1) define violence as a major health problem that can be prevented, (2) develop a thorough knowledge of both the factors underlying violence and the misleading popular myths regarding violence, (3) adopt a clear strategy by which to organize and focus these findings in the service of creating behavioral change, and (4) build collaborative partnerships with community leaders and violence prevention researchers to enhance the value of their clinical interventions. To implement specific treatments to reduce children's risk of involvement with violence, it is recommended that pediatricians (1) take a thorough history of children's involvement with violence as an aggressor, a victim, a bystander, a nonviolent problem-solver, a participant in gender-role-related violence, and a witness to violence in the community; (2) educate children and their parents about the ways of reducing their risks by helping them to develop habits of thought and behavior patterns that lead to effective and nonviolent problem solving; (3) provide follow-up support for the changes children and their parents make to help prevent violence; and (4) engage in community outreach activities designed to change community norms about violence.(ABSTRACT TRUNCATED AT 250 WORDS)