Paeds · adolescent-and-young-adult-medicine
Youth violence, risky behaviour and injury prevention
Also known as Youth violence prevention · Adolescent injury prevention · Teen risky behaviour and safety · Public-health approach to youth violence · Lethal means counselling in adolescents · Positive youth development
A fellowship, public-health approach to preventing youth violence, risky behaviour and injury in adolescence: how to recognise the young person at risk, screen privately across violence, road, self-harm and weapon domains, stratify by prevention tier, and deliver evidence-based prevention from graduated driver licensing and safe firearm storage to positive youth development and lethal-means counselling across ANZ, UK, US and Canada.
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Target exams
Red flags
- Active suicidal plan or intent, especially with access to firearms or other lethal means
- Weapon injury or disclosure of weapon-carrying with intent to harm
- Disclosure of assault, intimate-partner violence, sexual coercion, exploitation or trafficking
- Medical instability from overdose, self-harm or violence-related injury
- Acute psychosis or inability to keep safe
- Escalating violence with fear for the young person's or others' safety
Life stages
Care settings
Clinical exam formats
Board mappings
- General and Community Paediatrics
- Adolescent health, injury and violence prevention
- Current 2026 PREP curriculum — Learning Objective 1.2.1: Communicate with a child or young person in a way which is appropriate to the position of that child within their own culture
- Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment – essential general paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 6: Clinical management – essential general paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 15: Essential general paediatrics
- Clinical Applications
- Adolescent medicine, injury and violence prevention
- Long Cases
- Short Cases
- Communication stations
- 2. Professional skills and knowledge: Communication
- 4. Professional skills and knowledge: Patient management
- 5. Health promotion and illness prevention
- 11. Adolescent health
- General Paediatrics: Applies a public-health approach to youth violence, risky behaviour and injury prevention
- Foundation of Practice (FOP)
- Applied Knowledge in Practice (AKP)
- Adolescent health, safeguarding and injury prevention
- History
- Communication
- Clinical
- General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
- General Pediatrics Content Outline — Domain 11: Adolescent Medicine and Gynecology
- General Pediatrics Content Outline — Domain 15: Safety, Injury Prevention, and Violence
- General Pediatrics EPA 4: Providing preventive counselling and injury/violence-risk reduction for adolescents
- Patient Care 5: Patient Management
- Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
- Systems-Based Practice 3: System Navigation for Patient Centered Care – Coordination of Care
- Professionalism 1: Professional Behavior and Ethical Principles
- Communicator
- Health Advocate
- Professional
- Pediatrics: Foundations EPA — Applying injury- and violence-prevention counselling for adolescents
- Pediatrics: Core EPA — Providing preventive care and safety counselling
Overview & Definition
A 15-year-old comes in for a sports check. You ask about seatbelts because that is easy. You do not ask about weapons, because that feels awkward. A year later the same teenager is shot dead in a friend's home by an unsecured firearm. The missed work was not a rare diagnosis. It was a five-minute question nobody asked, in the domain that kills more adolescents than any disease. [3] [6]
Injury is the dominant cause of death and disability in adolescence across high-income countries. Road crashes, violence, self-harm and overdose sit at the top of the list. These are not random acts of bad luck. They cluster in predictable patterns, they follow developmental and social risk, and they respond to prevention. [1] [4]
Youth violence is the intentional use of physical force or power by or against a young person that threatens or causes harm — bullying, fighting, weapon-carrying, assault, gang involvement, and teen dating violence all sit inside this frame. Unintentional injury is the same harm arriving without intent — road crashes, drowning, poisoning, and sport and recreation injury. The two are linked because they share risk drivers: impulsivity, intoxication, peer influence, access to means, and the developmental biology of adolescence. [1] [2]
The clinical skill is to treat violence and injury as a health problem you can act on, not a character problem you can only judge. The World Health Organization frames this as a four-step public-health model: define the problem, identify its causes, design and evaluate interventions, then scale up what works. Your consultation sits inside that fourth step. [1] [3]
The prevention encounter in sequence
- 1
Engage
Greet young person first, time alone, conditional confidentiality, non-judgemental stance.
- 2
Screen
Weave violence, road, self-harm, weapon and means questions into HEeADSSS.
- 3
Stratify
Sort into universal, selective or indicated prevention tier.
- 4
Prevent
Match the tier to evidence: GDL, safe storage, SEL/PYD, targeted programs, brief advice.
- 5
Safety plan
Lethal-means restriction, written plan, who to call tonight.
- 6
Follow-up
Timed review, low-threshold way back in, close referral loops.
References13ShowHide
- [1]Krug EG, Mercy JA, Dahlberg LL, et al. The world report on violence and health. Lancet, 2002.PMID 12384003
- [2]Dahlberg LL Youth violence. Developmental pathways and prevention challenges. American Journal of Preventive Medicine, 2001.PMID 11146255
- [3]Duke NN Youth Violence Prevention and Safety: Opportunities for Health Care Providers. Pediatric Clinics of North America, 2015.PMID 26318944
- [4]Santaella-Tenorio J, Tarantola D Youth Violence: Prevention and Control. American Journal of Public Health, 2021.PMID 34038157
- [5]Williams AF Graduated driver licensing (GDL) in the United States in 2016: A literature review and commentary. Journal of Safety Research, 2017.PMID 29203021
- [6]Gastineau KAB, McKay S Firearm Injury Prevention. Pediatric Clinics of North America, 2023.PMID 37865435
- [7]Krass P Lethal Means Counseling in Emergency Care: A Critical Opportunity for Adolescent Suicide Prevention. Journal of Adolescent Health, 2026.PMID 42331501
- [8]Taylor RD, Oberle E, Durlak JA, Weissberg RP Promoting Positive Youth Development Through School-Based Social and Emotional Learning Interventions: A Meta-Analysis of Follow-Up Effects. Child Development, 2017.PMID 28685826
- [9]Cohen E, Mackenzie RG, Yates GL HEADSS, a psychosocial risk assessment instrument: implications for designing effective intervention programs for runaway youth. Journal of Adolescent Health, 1991.PMID 1772892
- [10]Steinberg L A Social Neuroscience Perspective on Adolescent Risk-Taking. Developmental Review, 2008.PMID 18509515
- [11]Tozzo P, Cuman O, Moratto E, et al. Family and Educational Strategies for Cyberbullying Prevention: A Systematic Review. International Journal of Environmental Research and Public Health, 2022.PMID 36012084
- [12]Schwebel DC, Gaines J Pediatric unintentional injury: behavioral risk factors and implications for prevention. Journal of Developmental and Behavioral Pediatrics, 2007.PMID 17565295
- [13]Vivolo-Kantor AM, Niolon PH, Estefan LF, et al. Middle School Effects of the Dating Matters Comprehensive Teen Dating Violence Prevention Model on Physical Violence, Bullying, and Sexual Harassment: A Cluster-Randomized Controlled Trial. Prevention Science, 2021.PMID 31833020