Research In Practice Blog
Intro
As they are about to enter the room for an adolescent well visit, a busy pediatrician notes their patient answered “yes” to a question about having negative encounters with police or school support officers. They take a deep breath, and enter the room…
Vs.
During his 17-year-old well visit, Jalen shares about recently getting pulled over by police multiple times since starting to drive. His mother looks upset. The pediatrician pauses, unsure of how to proceed…
For many Black families, "The Talk" is a foundational part of growing up. It is a conversation about safety and survival--navigating a world where systemic racism and racial violence can create distinct risks for Black youth during police interactions. Pediatricians have acknowledged barriers and facilitators to engaging in what is seen as valuable anticipatory guidance about safely navigating police encounters, but patient/family perspectives regarding the physician’s role in such conversations has not been documented. Our interviews with Black male youth and their caregivers elevate the voices of these key collaborators in understanding the perceived role of pediatricians in discussing police encounters and provide insights for how pediatricians can proceed when faced with scenarios like Jalen’s.
Our Findings
A Welcomed Conversation, Regardless of Race
Families encouraged pediatrician engagement on this topic, regardless of the physician's race. Racial discordance has been noted by pediatricians as a barrier to physicians having this conversation. Interview participants emphasized that, while racial concordance can certainly build initial trust, compassion and understanding were the most important factors. As one caregiver noted, "I just want someone to understand ... have a little bit of compassion, it doesn't matter what race".
The Primary Goal: Safety and Reducing Fear
At the heart of these conversations is safety. Caregivers want their children to be empowered by an understanding of the potentially high-risk nature of police encounters and best practices to minimize adverse outcomes. They expect the same of pediatricians and emphasize focusing the conversation on reducing fear. Caregivers reflected that fear may lead to escalation. Through cultivating expectations and practices that reduce fear and maintain poise during police interactions, pediatricians can help foster a sense of confidence to safely navigate police encounters.
Partnering with Parents: It is paramount that caregivers are involved in these discussions. The pediatrician’s guidance must align with the values and strategies already being nurtured at home. Moreover, pediatricians must "level-set" with the caregiver to ensure the messaging is congruent and tailored to the youth's specific social and cognitive development.
Participants’ Suggested Strategies to Enhance Reception
- Timing is key: aim to introduce these conversations between ages 12 and 15, or when youth begin to spend more time unsupervised from caregivers, such as commuting to school.
- Trusted relationships can help families prefer these discussions happen with providers whom they have an established relationship.
- It’s not necessarily a one-time conversation: consider revisiting the discussion on safely navigating police encounters annually during well-child visits.
- Take a complementary approach: align with and build on the family’s conversations to-date; the conversation may occur 1-on-1 between youth and the pediatrician (pending caregiver receptivity), to foster attention and foster the relationship between youth and pediatrician.
- Utilize supplementary resources: youth are hungry for practical advice. They want to know their legal rights and understand what police are looking for in certain situations. Provide families with resources from credible organizations (e.g., ACLU and NAACP).
How can this work inform action?
Clinical Practice: Our study demonstrates Black youth and caregivers’ openness to conversations on navigating police encounters with pediatricians. However, not all pediatricians will feel ready to engage in these conversations, and that’s okay. The medical mandate "first, do no harm" remains paramount--if one doesn't feel equipped, consider sharing the research with a colleague for discussion to build your capacity; seek out resources to help address specific concerns (e.g., knowledge about practical supports in your area); or, in the moment, humbly acknowledge and validate the concerns about negative or harmful police encounters, and ask families how to best be supportive.
Education: Translating these findings into generalizable curricula with reliable outcomes is a worthy undertaking that falls squarely in the American Board of Pediatrics’ goal of ensuring pediatricians can be entrusted to use “population health strategies and quality improvement methods to promote health and address racism, discrimination, and other contributors to inequities among pediatric population.” Educators are invited to take on the iterative process of incorporating exciting resources with medical pedagogy to inform professional development for medical professionals. Similar to this research, a collaborative approach should include youth and caregivers in co-development of resources.
Research: The potential to change clinical practice is optimized by a saturation of evidence and an accurate understanding of diverse experiences. While this study focused on Black male youth, further research is needed to understand the perspectives of Black non-male youth and other populations disproportionately impacted by police violence.
Conclusion
By elevating the lived experiences of Black youth and their families, we can ground our interventions in reality and provide guidance that truly supports their holistic safety and well-being. As pediatricians, we are more than just medical providers; we are advocates for our patients' futures. Joining "The Talk" is a meaningful opportunity to fulfill that role.
Additional Information and Resources:
Clinical Futures Research in Practice Blog Post: Enhancing Anticipatory Guidance: Pediatricians Address Police Encounters in Care for Black Youth and Families
KPFA’s Law & Disorder Podcast: The Public Health Risk of Police Violence and Pediatric Responsibility; Plus Resistance in Residence Artist Lisa Marie Rollins