Development and psychometric properties of a violence screening tool for primary care

Abstract

Purpose: The aim of this study was to develop and validate a screening tool to detect youth at risk for future violence perpetration for primary care.

Methods: Youth (n = 165) aged 11-17 years enrolled during a primary care appointment. Two clinics served as study sites. Youth filled out questionnaires confidentially at baseline and at 1-year follow-up. Primary outcome was violent behavior during the preceding year. At baseline, youth answered 18 risk and protective factor questions that predicted future violence involvement. Additional violence scales were asked for a total of 47 questions. Item analysis determined which combination best predicted future violence involvement. Psychometric properties, including internal consistency, test-retest reliability, convergent validity, and predictive validity, were analyzed.

Results: A total of 101 youth (61%) completed 1-year follow-up: 16% reported violent behavior with no difference between gender or race/ethnicity. Twenty-five baseline questions correlated with violence involvement 1 year later. After item analysis, 14 questions demonstrated the strongest psychometric functioning with Cronbach's α = .77. External validity was strong, with the 14 item violence injury protection and risk screen correlating with the aggression (.74) and victimization (.54) scales, the Strength and Difficulties Questionnaire (.39), and current violence involvement (.78). For youth aged 14-17 years, predictive validity was strongly correlated (.78) with future violence perpetration. A score of 5.0 for males and 6.0 for females revealed a sensitivity of 77%, a specificity of 98%, and a positive predictive value of 91%. Seventeen percent of youth aged 14-17 screened positive using these cutpoints.

Conclusion: A brief, 14-item questionnaire demonstrated strong psychometric functioning and performed well as a screening tool to predict future violence perpetration for youth aged 14-17.