Appendix Table A-5. CCRM Atlas Measure 2: Parental interest in following up on the local agency referral (Safety Check Parental/Guardian Post-Visit Survey)
| Domain: | Readiness for behavior change | Element/ relationship: |
Patient |
| Instrument: | Safety Check Parental/Guardian Post-Visit Survey | ||
| Purpose: | Clinicians in the Pediatric Research in Office Settings program were trained on providing violence prevention-related community referrals. This measures the parent's level of interest in following up on the local agency referral. | ||
| Format/data source: | Patient/Individual Survey | ||
| Measure type: | Process | Date: | 2006 |
| Preventive service/ USPSTF: | Other – Mental Health* | ||
| Clinical practice: | Primary care – Pediatrics | ||
| Denominator: | Number of respondents to parent/guardian post-visit survey (Q3) | ||
| Numerator: | Number of respondents who selected “Interested” or “Very interested” in following up on the local agency referral (Q3d) | ||
| Development & testing: | |||
| Past or validated application: | |||
| Citation(s): | Barkin, S., Ip, E. H., Finch, S., et al. Clinician practice patterns: linking to community resources for childhood aggression. Clinical Pediatrics (2006) 45:750-756. | ||
| Notes: | Please be aware that this measure is using only a selected section of an entire survey instrument. Therefore, this individual measure may need to undergo further reliability and validation testing to ensure that it can be applied in a clinical-community relationship setting. | ||
* This is a measure that was originally applied in a mental health setting, but it could be adapted for a primary care setting.
