Can a youth violence screening tool be used in a Pediatric Emergency Department setting?

Youth violence is a significant public health concern. Many children and adolescents are treated in emergency departments (EDs), which may be a location to identify at-risk youth for interventions by administering a screening instrument. A prospective convenience study of youth (ages 8-17 years) presenting to the ED was conducted to evaluate a second-generation violence questionnaire. The 14 items of the Violence Prevention Emergency Tool 2 (VPET 2) was developed from a previously described tool (VPET 1). VPET 2 asked the frequency of physical or verbal violence events witnessed or experienced by the subject and was administered in the ED by research assistants. Of the 211 youths, 200 were enrolled (95% participation rate); 3 were ineligible, and 8 declined (<4%). The youths had a mean age 13.3 years, 52.5% males, 39% Hispanic, and 17% black. Seventy-six percent of the legal guardians were mothers, 62.5% had at least a high school education, and 55% were working full time. Sixty-six percent of the subjects reported seeing a person slap another person "really hard;" 8.5% were threatened by someone with a weapon; 28% were physically harmed by another person; 10% reported drug/alcohol use; 32.5% had failed a class in the past year. Adolescents (13-17 years) compared with preadolescents (8-12 years) were more likely to report being threatened and/or physically harmed (p < 0.05). No significant sex differences were identified. VPET 2 was administered in an ED with a high rate of enrollment and completion. This may be a feasible screening tool for use in the ED for determining which youth have the highest levels of violence exposure. A brief validated version of VPET 2 could be a valuable tool in ensuring that youth most at-risk are identified and provided appropriate referrals and services. Diagnostic study, level IV.