31. Pediatricians’ Perceptions about Discussing Police Encounters with Black Adolescent Male Patients and Their Caregivers

Previous research has shown Black men aged 15-34 (∼2% of the US population) comprise more than 15% of killings of individuals by law enforcement officers. Intrusive encounters with police officers – more likely to occur in Black populations – are linked to symptoms of anxiety and post-traumatic stress disorder. Conversations to prepare young Black men to safely navigate police are colloquially known as ‘The Talk.’ Physicians' potential role in this conversation has been acknowledged. However, taking on that role is potentially daunting for medical providers. There are no formal guidelines for how to best engage patients and caregivers in ‘The Talk.’ We performed focus groups of a convenient sample of pediatric residents and attending physicians from three urban, academic pediatric primary care centers in Philadelphia. Additional targeted outreach was done to those from racial/ethnic groups underrepresented in medicine to ensure diversity of opinion. The focus group guide was informed by Bandura’s self-efficacy theory. Study data, including demographic characteristics and consent forms, were managed using REDCap (Research Electronic Data Capture). Focus groups were conducted separately for resident and attending physicians, with each focus group containing between 3 and 8 participants. Focus group moderators included 2 white women physicians and 1 Latinx woman physician; there were no Black moderators in order to limit social desirability bias. Interviews were recorded, transcribed, and coded in NVivo12 by two coders; discrepancies in coding were resolved by consensus. Thematic saturation was reached in 6 focus groups. Participants included 19 attending physicians (median age 45) and 13 resident physicians (median age 29). Four themes emerged: (1) Creating a comfortable experience for the patient/caregiver is critical to any attempt to discuss the content of ‘The Talk.’ Participants noted that time with and consistency in seeing patients are barriers. (2) Talking with patients about racism is seen as valuable but challenging, especially if the interaction is racially non-concordant. Training was viewed as a necessary component of having the conversation. (3) Talking about police brutality can be facilitated by parents/guardians and needs operational supports. Participants suggested embedding questions about police brutality within existing questionnaires to facilitate having these conversations with patients. Additionally, providers expressed desires for more resources to give to patients, such as legal aid or education on their legal rights if interacting with police. (4) Racial anxiety can complicate discussions and resources are welcome. Physician support in the form of a conversation script was the most suggested resource by participants to incorporate conversations on racism and police brutality into practice. Physicians recognize that discussions on racism and safely navigating police encounters are important in their clinical practice. Important facilitators to having a discussion on safely navigating police interactions are comfortable and consistent physician-patient relationships, formal educational trainings, including a scripted discussion guide, caregiver facilitation of the conversation, and external prompting to discuss this topic, such as patient questionnaires.