Factors affecting pediatricians' reporting of suspected child maltreatment

Objective.-To identify factors associated with pediatricians' decision not to report suspected child maltreatment. Design.-A survey was distributed to a random sample of pediatricians in a single state. Participants were asked if they had ever suspected child abuse or neglect but did not report. In addition, all were asked to list all the considerations that pediatricians incorporate into their decisions not to report. Results.-One hundred ninety-five pediatricians completed the survey (56% of those eligible). Twenty-eight percent of respondents stated that they had considered reporting an incident of suspected child maltreatment but had chosen not to. Providers who had chosen not to report were more likely to be men (P = .006), to have been in practice longer (P = .001), to have reported more cases (P = .001), to have been deposed (P = .001) or to have testified (P = .01) in child maltreatment cases, and to have been threatened with lawsuit (P = .02) than were pediatricians who had never declined to report. Multivariate logistic regression demonstrated that male gender (odds ratio [OR] 2.18; 95% confidence interval [CI] 1.05-4.49), years in practice (OR 1.23; 95% CI 1.05-1.44). and experience reporting (OR 1.28; 95% CI 1.02-1.60) were all independently associated with decisions not to report. Respondents who had declined to report were more likely to cite lack of knowledge about reporting laws and process (P = .05) and poor experiences with child service agencies (P = .03) as reasons for not reporting than were their counterparts who had never declined to report suspected maltreatment. Conclusions. -Many barriers exist to reporting suspected maltreatment. Specific educational interventions may be helpful in eliminating barriers to reporting.