508 - Youth Perspectives on Caregiver Notification after Disclosure of Adolescent Relationship Abuse

Poster Number: 508
Publication Number: 508.100

Kimberly A. Randell, Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; Melissa Miller, Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; Megha Ramaswamy, University of Kansas School of Medicine, Kansas City, KS, United States; Maya I. Ragavan, University of Pittsburgh, Wexford, PA, United States; Ann M. Davis, Center for Children's Healthy Lifestyles & Nutrition/ KU Medical Center, Kansas City, MO, United States; Romina Barral, University of Missouri-Kansas City School of Medicine, University of Kansas, Kansas City, MO, United States; Neha Potta, University of Missouri-Kansas City School of Medicine, Ballwin, MO, United States; Carlos M. Guzman, University of Kansas School of Medicine, Overland Park, KS, United States; Kendra R. Sibert, Children's Mercy Hospitals and Clinics, Grain Valley, MO, United States; Elizabeth Miller, UPMC Childrens Hospital of Pittsburgh, Pittsburgh, PA, United States

Background: Trusted adults are important supports for youth experiencing adolescent relationship abuse (ARA). Understanding youth preferences around notification of a trusted adult after ARA disclosure may facilitate connecting youth to this critical support.

Objective: To explore youth perspectives on trusted adult notification after ARA disclosure in healthcare settings.

Design/Methods: We conducted individual interviews with youth aged 14-19 (n=20 each females/males) at the time of an adolescent primary care or adolescent specialty clinic appointment. We used a thematic analysis approach to code interview transcripts then consolidate codes into themes.

Results: Among 45 participants, mean age was 17.2 (SD 1.4); 53% were female (Table 1). Participants generally felt that a trusted adult should be notified after disclosure of any type of ARA. Youth recognized that all forms of abuse, not only physical or sexual, are harmful. Youth shared benefits of involving a trusted adult, including ongoing support and harm prevention. However, youth noted that adult notification may have negative consequences for youth, including being kicked out of their home, escalating violence from their abusive partner, and not being believed by family. Youth recommended shared decision-making around notification of a trusted adult after ARA disclosure. This should involve talking to the patient to learn further about the abuse, how the patient plans to address the abusive relationship, who the patient considers a trusted adult, and what the consequences of telling an adult about the ARA might be. Youth recommended that physicians respect adolescent autonomy around decisions to notify a trusted adult about ARA but recognized the physician might need to involve other adults regardless of the youth’s perspective if there are safety concerns. Youth shared ways that physicians can provide support through the process of adult notification including informing the youth about what will happen, allowing the youth to be part of talking to the trusted adult, and ensuring it will be safe for the youth to return home after ARA disclosure. See Table 2 for illustrative quotes.Conclusion(s): Youth recognize the benefits of sharing ARA disclosure with a trusted adult but noted potential negative outcomes and emphasized the importance of shared decision making. Findings support a youth-centered approach that integrates safety and shared decision making around adult notification after ARA disclosure.
Table 1: Participant demographics
Table 2: Illustrative participant quotes