The Pediatrician's Guide to Community Collaboration on Sexual Violence Prevention
Though work in your practice is comprehensive and individualized, it provides a limited amount of time for anticipatory guidance and reaches a small number of families, typically only annually. Working with community organizations allows you to reach a large number of families and children and make environmental and social changes that can benefit the community for many years.
The American Academy of Pediatrics, in its policy statement “The Pediatrician’s Role in Community Pediatrics” (Pediatrics. 2005;115:1092–1094), recognizes the importance of community pediatrics, defined as
- A perspective that enlarges the pediatrician’s focus from one child to all children in the community
- A recognition that family, educational, social, cultural, spiritual, economic, environmental, and political forces act favorably or unfavorably, but always significantly, on the health and functioning of children
- A synthesis of clinical practice and public health principles directed toward providing health care to a given child and promoting the health of all children within the context of the family, school, and community
- A commitment to use a community’s resources in collaboration with other professionals, agencies, and parents to achieve optimal accessibility, appropriateness, and quality of services for all children and to advocate especially for those who lack access to care because of social, cultural, geographic, or economic conditions or special health care needs
- An integral part of the professional role and duty of the pediatrician
General Tips for Enhancing Community Connections
- Many clinicians are afraid of asking questions that could open a Pandora’s box of issues they feel they may be unable to handle. Lack of time, payment, confidence, comfort, and self-efficacy all contribute to this fear. Clinicians would like quick solutions they know will work. Of course, such magic potions rarely exist, but strong connections with community resources will increase your chances for successfully addressing sexual violence prevention. Get to know local programs such as parenting classes and domestic violence shelters. When a family in need is identified, you will be able to refer them to a resource, confident that the family’s needs will be met. A few hours a month from you and your staff to form and maintain linkages with community-based resources will be very beneficial.
- Because parents may not feel comfortable openly discussing sensitive issues during a visit, place information and resources in a private place for individuals to take for future use. For example, a parent who is a victim of domestic violence might not be able to admit it if her abuser or child is present. However, when she uses the restroom, she could take a card with the number of a domestic violence hotline and hide it in her shoe or purse.
- Resources may not exist in some communities. If you identify a gap, become an activist. Reach out to the local school district or health department to help meet the need. Be an advocate for your patients by encouraging your community to provide important resources.
- Sometimes, strengthening an individual family is not enough; even the most resilient child faces obstacles to healthy development if the community is not healthy. This can create a sense of hopelessness about your ability to make a difference with patients. However, outside the examination room, you can be an advocate not just for individual patients, but also for the community. Get involved in community coalitions that provide children with positive after-school activities or prevent child sexual abuse. Speak to the parent-teacher association (PTA)/parent-teacher organization (PTO) or the local media. Work to spread the belief that all children deserve to grow up safe, strong, and secure.
How to Get Started Working With Community Organizations and Schools
- Be clear in your mind about your motivation to work with community organizations. There are many ways to make a difference. Choose an activity or a focus that aligns with your practice and personal interests. Perhaps you want to improve one aspect of all children’s health. Or do you want to support your own child who is in the school system? Do you feel an obligation to contribute to public health arenas where you can have a large effect? Do you want to improve the environment in your patients’ communities? Any of these, and many others, can lead to effective ways to contribute.
- Estimate how much energy and time you plan to have to promote community health. Even small contributions from pediatricians can make powerful changes. Pediatricians who contribute in small ways over long periods and those who apportion a large chunk of time to community health may have a larger effect. In any circumstance, it’s useful to be realistic initially about what you can afford to do. This can determine the types of activities and goals to pursue.
- Become educated on how community organizations work. To be optimally effective, you must first understand the community service system. Many doctors are correct to dismiss outside advocates of the health care system as naïve or misinformed. Similarly, health care professionals must be respectful of the community service system’s complexities and recognize that there often are established ways to change the status quo that will help you have an effect.
- Join with others if their message and style are similar. Often, other organizations or individuals in your community have already begun to work on sexual violence prevention.
- Become educated on what has worked for others. Volumes of literature on how others have prevented sexual violence already exist. There is also more than one way to introduce or implement a community-based program. Sexual violence prevention is a vast field of study, but it does not take very long to learn a few basic outcomes of others’ experiences with programs and interventions.
- Don’t be turned off by jargon. Just as non-health professionals are easily lost in medical jargon when sitting in on medical meetings, doctors can become lost in jargon when involved with community organizations. Speak up and ask for explanations of acronyms and unfamiliar shorthand phrases.
Potential Collaborators (Organizations With Local Chapters or Sites)