Competency

Performance Indicators

Engage in activities to prevent family violence

1. Promote activities to increase public awareness of family violence.

2. Promote activities to address populations at risk.

3. Participate in health policy activities to address family violence.

4. Promote community action to establish and enhance programs to support victims and family members and for perpetrator interventions, especially at early stages.

5. Understand the impact of services (such as home visitation nurses) on the prevention of physical abuse and neglect.

6. Understand the principles of prevention of family violence (including sexual abuse of children).

professionals in nursing, social work, nutrition, and psychology. In 1994, adolescent medicine achieved the formal status of a subspecialty and became a 3-year program. In 1997, the Residency Review Committee for Pediatrics began requiring that pediatric residents complete a 1-month block rotation in adolescent medicine. Because of these requirements, 96 percent of programs report having an adolescent medicine block rotation, 90 percent of which are required (Emans et al., 1998). However, only 39 percent of programs felt that the number of adolescent faculty was adequate for teaching residents, and while many topics are believed to be adequately covered (e.g., sexually transmitted diseases, confidentiality, puberty, contraception, and menstrual problems), many others continue to be inadequately covered (e.g., psychological testing, violence in relationships, violence and weapon-carrying, and sports medicine) (Emans et al., 1998).

The development of such training programs demonstrates an approach to the advanced-level training necessary in family violence, but it also reveals the challenges. The programs became possible only with the increase in attention to and research on adolescent health needs and the subsequent availability of funds. Research indicated that adolescents have unique health care needs and a high rate of health problems (Athey et al., 2000). With funding from the Maternal and Child Health Bureau, support from the American Academy of Pediatrics, and the creation of the Society for Adolescent Medicine, appropriate training content was identified and training programs were implemented. Growth in the evidence base, increased support, and the availability of funding for research and training development appear to be critical factors for the evolution of such an advanced-level training program. Such a foundation does not yet appear to exist in family violence. For example, recent petitions to the American Board of Pediatrics to establish a subboard on child abuse and neglect (to be called Child Abuse and Forensic Pediatrics) have been deferred to allow time to document the scientific



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