Characterizing the teachable moment: Is an emergency department visit a teachable moment for intervention among assault-injured youth and their parents?

OBJECTIVES: Injury interventions often invoke the teachable moment (TM); however, there is scant empirical research examining this construct with violent injuries. We sought to operationalize the TM construct and to determine whether an emergency department (ED) visit was a TM for intervention among assault-injured adolescents and their parents. SETTING AND PARTICIPANTS: One hundred sixty-eight youth (age, 10-15 years) and their parents presenting to the ED with interpersonal assault injuries at 2 urban medical centers. METHODS AND ANALYSIS: Data were collected using ED record abstraction and interviews. Interview questions assessed perceived injury severity, perceived susceptibility, and preventability/ability to avoid future conflict. Data were examined by age, sex, weapon involvement, and time elapsed between injury and interview. Factor analysis was used to identify the components of the TM construct, and a TM index was created for youth and parents. RESULTS: Youth and parents found their trip to the ED moderately stressful, although parents perceived more stress than youth. Older youth (13-15 years old) and the parents of younger youth (10-12 years old) were most likely to see their injuries as preventable. The parent TM index was positively correlated with parent-reported aggression (r = 0.16, P < 0.03); the youth's TM index scores were associated with the time elapsed since the event (r = -0.16, P = 0.03). CONCLUSIONS: This study provides preliminary support for the TM after assault injuries. The TM index may be a first step toward an assessment that can differentiate individuals who are amenable to violence prevention intervention from those who are not.