title: Impact of pediatricians' perceived self-efficacy and confidence on violence prevention counseling: a national study.
abstract: OBJECTIVE
  To measure impact of pediatricians' perceived self-efficacy and confidence on current practices and attitudes regarding four violence prevention (VP) topics (gun storage, gun removal, limiting exposure to media violence, discipline techniques) during health supervision for children ages 2-11.
  
  
  METHODS
  Random sample survey of American Academy of Pediatrics Fellows (n = 486; 53% response rate) providing health supervision for children ages 2-11. Participants surveyed about VP issues regarding: (1) current counseling practices for 2-5 and 6-11 year olds; (2) amount of time spent addressing; (3) confidence in addressing; and (4) perceived self-efficacy at changing patients' behaviors. Multivariate analyses explored relationships between pediatricians' perceived self-efficacy and confidence versus VP counseling frequency.
  
  
  RESULTS
  VP topics were not routinely discussed during health supervision. Most pediatricians (64%) reported spending too little time addressing these topics. Although most pediatricians felt confident discussing and effective at changing behaviors regarding limiting exposure to media violence (89% vs. 50%) and discipline techniques (91% vs. 76%), they were less so for safe gun storage (54% vs. 35%) and gun removal (51% vs. 17%). Perceived self-efficacy was the mediating factor on self-reported VP counseling frequencies for all topics.
  
  
  CONCLUSIONS
  Pediatricians reported spending insufficient time on VP counseling. Confidence and perceived self-efficacy levels varied by VP topic, but for all topics pediatricians felt more confident discussing than effective at changing behaviors. Since pediatricians' self-efficacy was related to counseling practices, boosting self-efficacy could ultimately improve counseling frequencies. Further research is needed to identify methods to build providers' perceived self-efficacy regarding these VP areas.
authors.affiliation: Pediatric Research in Office Settings (PROS), Department of Research, American Academy of Pediatrics, 141 Northwest Point Blvd., Elk Grove Village, IL, 60007, USA. sfinch@aap.org
authors.forename: Stacia A
authors.initials: SA
authors.lastname: Finch
authors.forename: Victoria
authors.initials: V
authors.lastname: Weiley
authors.forename: Edward H
authors.initials: EH
authors.lastname: Ip
authors.forename: Shari
authors.initials: S
authors.lastname: Barkin
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003376:Counseling; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010372:Pediatrics; D010820:Physicians; D020377:Self Efficacy; D014754:Violence / Q000517:prevention & control*