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Pereira S, Azeredo YN, Schraiber LB, Aguiar JMD, Kalichman BD, Gralia CGV, Reis MSD, Lima NP, Bacchus LJ, Colombini M, Feder G, d'Oliveira AFPL. Evaluation of an intervention to improve Primary Health Care's response to cases of domestic violence against women - São Paulo, Brazil. CIENCIA & SAUDE COLETIVA 2024; 29:e02982024. [PMID: 39194102 DOI: 10.1590/1413-81232024299.02982024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/08/2024] [Indexed: 08/29/2024] Open
Abstract
The aim was to analyse and improve the Primary Health Care (PHC) response to domestic violence against women (DVAW) by developing, implementing and evaluating an intervention. A pilot study evaluating the before and after of intervention implementation, using mixed methods and carried out in three phases - formative, intervention and evaluation - between August 2017 and March 2019 in two Basic Health Units (UBS) in the city of São Paulo. In this paper, we present the details and evaluation of the intervention, carried out six to twelve months after its implementation. The intervention was developed based on the findings of the formative phase and in line with the health policy that establishes the Violence Prevention Nucleus (NPV) and consisted of stablishing a care pathway; general training for all workers and specific training for the NPV; drawing up educational material and monthly case discussions over 6 months. The evaluation showed acceptability among the workers, increased identification and repertoire for caring for cases of DVAW, strengthening internal referral and the intersectoral network. We identified obstacles to the full implementation and sustainability of the intervention.
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Affiliation(s)
- Stephanie Pereira
- Grupo de Pesquisa e Intervenção Violência e Gênero nas Práticas de Saúde, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. Av. Dr Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Yuri Nishijima Azeredo
- Grupo de Pesquisa e Intervenção Violência e Gênero nas Práticas de Saúde, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. Av. Dr Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Lilia Blima Schraiber
- Grupo de Pesquisa e Intervenção Violência e Gênero nas Práticas de Saúde, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. Av. Dr Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Janaína Marques de Aguiar
- Grupo de Pesquisa e Intervenção Violência e Gênero nas Práticas de Saúde, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. Av. Dr Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Beatriz Diniz Kalichman
- Grupo de Pesquisa e Intervenção Violência e Gênero nas Práticas de Saúde, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. Av. Dr Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Cecilia Guida Vieira Gralia
- Grupo de Pesquisa e Intervenção Violência e Gênero nas Práticas de Saúde, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. Av. Dr Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Marina Silva Dos Reis
- Grupo de Pesquisa e Intervenção Violência e Gênero nas Práticas de Saúde, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. Av. Dr Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Nayara Portilho Lima
- Grupo de Pesquisa e Intervenção Violência e Gênero nas Práticas de Saúde, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. Av. Dr Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | - Loraine J Bacchus
- London School of Hygiene and Tropical Medicine. London England United Kingdom
| | - Manuela Colombini
- London School of Hygiene and Tropical Medicine. London England United Kingdom
| | - Gene Feder
- University of Bristol. Bristol England United Kingdom
| | - Ana Flávia Pires Lucas d'Oliveira
- Grupo de Pesquisa e Intervenção Violência e Gênero nas Práticas de Saúde, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. Av. Dr Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
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Zemlak JL, Alexander KA, Wilson D, Singer R, Williams JS, Sherman SG. Sex Workers' Experiences of Screening for Intimate Partner Violence. J Obstet Gynecol Neonatal Nurs 2024; 53:397-405. [PMID: 38490264 PMCID: PMC11246806 DOI: 10.1016/j.jogn.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE To examine experiences of intimate partner violence (IPV) screening among women who sell sex. DESIGN A qualitative descriptive study. SETTING Telephone interviews during the COVID-19 pandemic (June 2020 to October 2020). PARTICIPANTS Women aged 18 to 49 years who sold or traded sex for food, drugs, money, or shelter at least three times during the past 3 months before recruitment (N = 22). METHODS We used individual, semistructured telephone interviews to collect data about participants' experiences with IPV and IPV screening during health care encounters. We used reflexive thematic analysis to examine these data. RESULTS We identified two overarching themes related to IPV screening experiences: Preferences for IPV Screening and Barriers to Disclosure of IPV Experiences. Participants described a preference for IPV screening done face-to-face with providers who show a genuine interest in their responses. Stigma was a barrier of IPV disclosure. CONCLUSION Health care providers are a trusted safety net for disclosure of IPV experiences. Providing screening in a trauma-informed, nonstigmatizing manner may facilitate disclosure of IPV by women who sell sex. Future research among marginalized populations is needed to examine ways to address IPV in clinical settings with a harm reduction empowerment lens.
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Sutherland MA, Hutchinson MK, Si B, Ding Y, Liebermann E, Connolly SL, Saint-Eloi Cadely H, Hayes JF, Mueller SD. Health screenings in college health centers: Variations in practice. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-8. [PMID: 38905516 DOI: 10.1080/07448481.2024.2361307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 05/19/2024] [Indexed: 06/23/2024]
Abstract
Objective: The purpose of this study was to examine the routine screening of female students in college health centers for six priority health-related behaviors and experiences (tobacco use, alcohol use, eating disorders [EDs], obesity, anxiety and depression, intimate partner violence/sexual violence [IPV/SV]), and to identify variations in practice. Participants: A nationally representative sample of 1,221 healthcare providers (HCPs), including nurse practitioners, physicians, and physician assistants, from 471 U.S. college health centers. Methods: HCPs completed surveys (on-line or paper) and reported on routine screening of female college students. Results: HCPs reported consistently high rates (75-85%) of screening for tobacco use, alcohol use, and anxiety/depression. Rates of screening for IPV/SV, obesity and EDs were much lower. Nurse practitioners reported the highest IPV/SV screening rates. Conclusions: College health centers present unique opportunities for screening, case-finding and intervening to reduce long-term sequelae. Providers are well-positioned to lead initiatives to improve screening practices.
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Affiliation(s)
| | | | - Bing Si
- Systems Science and Industrial Engineering, Binghamton University, Binghamton, New York, USA
| | - Yu Ding
- Systems Science and Industrial Engineering, Binghamton University, Binghamton, New York, USA
| | - Erica Liebermann
- College of Nursing, University of Rhode Island, Kingston, Rhode Island, USA
| | - Somatra L Connolly
- University of Rhode Island College of Nursing, RINEC, Providence, Rhode Island, USA
| | - Hans Saint-Eloi Cadely
- Developmental Science Graduate Program Director, Department of Human Development and Family Science, University of Rhode Island, Kingston, Rhode Island, USA
| | - Jacqueline F Hayes
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Brown Medical School, Providence, Rhode Island, USA
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Jarnecke AM, Saraiya TC. Identifying best practices for substance-related intimate partner violence screening and referral: a narrative review. Front Psychiatry 2024; 15:1380102. [PMID: 38957738 PMCID: PMC11217329 DOI: 10.3389/fpsyt.2024.1380102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/29/2024] [Indexed: 07/04/2024] Open
Abstract
Introduction Substance use is strongly associated with intimate partner violence (IPV) and is a modifiable risk factor for IPV. However, lack of comprehensive screening and referral for co-occurring IPV and substance use, along with their psychiatric sequalae, limits the identification and implementation of effective interventions for substance-related IPV. This narrative review (1) investigates the literature on screening and referral practices for IPV, and if these include screening for substance use or other psychiatric comorbidities, (2) provides recommendations for current best practices, and (3) suggests future directions for research and practice aimed at identifying and reducing substance-related IPV. Methods A narrative literature review examined studies investigating IPV screening and referral programs in clinics. Selected studies were reviewed for: (1) effectiveness, (2) barriers to implementation and sustainability, and (3) responsivity to psychiatric comorbidity, including substance use and substance use disorders (SUD). Results Findings suggest that effective IPV screening and referral programs have been developed, but disparities in IPV screening exist and many programs only screen for IPV victimization. Barriers to the implementation and sustainability of IPV screening programs include lack of ongoing provider training, funding or institutional support, and direct connection to referral services. Further, many IPV screening programs lack assessment of and referral for comorbid psychiatric conditions, including substance use, and tend not to be routinely implemented in SUD clinics. Discussion Additional systematic work is needed to develop universal and comprehensive screening and referral programs for substance-related IPV and address issues of long-term sustainability, particularly within SUD treatment settings.
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Affiliation(s)
- Amber M. Jarnecke
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Tanya C. Saraiya
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Center of Alcohol & Substance Use Studies, Rutgers University-New Brunswick, Piscataway, NJ, United States
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Micklitz HM, Glass CM, Bengel J, Sander LB. Efficacy of Psychosocial Interventions for Survivors of Intimate Partner Violence: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1000-1017. [PMID: 37148270 DOI: 10.1177/15248380231169481] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Survivors of intimate partner violence (IPV) face serious health-related, social and economic consequences. Prior meta-analyses indicate efficacy of psychosocial interventions for support of IPV survivors, but their results are affected by methodological limitations. Extensive subgroup analyses on the moderating effects of intervention and study characteristics are lacking. To address these limitations in an up-to-date and comprehensive meta-analytic review, four literature databases (PsycInfo, Medline, Embase, and CENTRAL, March 23, 2022) were searched for randomized-controlled trials examining the efficacy of psychosocial interventions compared to control groups in improving safety-related, mental health, and psychosocial outcomes in IPV survivors. Weighted effects on IPV, depression, posttraumatic stress disorder (PTSD), and psychosocial outcomes were calculated under random-effects assumption. Subgroup analyses were performed to investigate moderating effects of predefined intervention and study characteristics. Study quality was rated. In all, 80 studies were included in qualitative synthesis, and 40 studies in meta-analyses. Psychosocial interventions significantly reduced symptoms of depression (SMD: -0.15 [95% confidence interval, CI [-0.25, -0.04]; p = .006], I2 = 54%) and PTSD (SMD: -0.15 [95% CI [-0.29, -0.01]; p = .04], I2 = 52%), but not IPV reexperience (SMD: -0.02 [95% CI [ -0.09, 0.06]; p = .70], I2 = 21%) compared to control conditions at post. High-intensive and integrative interventions, combining advocacy-based and psychological components, were favorable subgroups. Yielded effects were modest and not maintained long term. The quality of evidence was low and potential harms remain unclear. Future research should adopt higher standards of research conduct and reporting and must account for the complexity and diversity of IPV experiences.
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Affiliation(s)
- Hannah M Micklitz
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carla M Glass
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Jürgen Bengel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Lasse B Sander
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Wei X, Wang W, Law YW, Zhang H. The Impacts of Intimate Partner Violence on Postpartum Depression: An Updated Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1531-1550. [PMID: 37480328 DOI: 10.1177/15248380231188068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
The associations between intimate partner violence (IPV) and postpartum depression (PPD) have been well established in previous reviews. However, none has explored potential differences between IPV subtypes or exposure times, which could help healthcare providers recognize the adverse impacts of various IPV subtypes and conduct comprehensive IPV screening. This study aimed to estimate the impacts of overall IPV and its subtypes (physical, psychological, and sexual) on PPD using an updated meta-analysis and to examine the potential role of IPV exposure time and regional income levels. Four English databases (Medline, PsycINFO, PubMed, and Web of Science) and two Chinese databases (China National Knowledge Infrastructure [CNKI] and Wanfang Database) were systematically searched. We included 76 studies with 388,966 samples. Random-effects models were used to pool the odds ratios (ORs) across studies. Overall, IPV and its subtypes had statistically significant impacts on PPD (overall: OR = 2.50, physical: OR = 2.31, psychological: OR = 2.22, sexual: OR = 1.75). A higher impact of IPV on PPD was observed in middle- and low-income regions (OR = 3.01) than in high-income regions (OR = 1.92). IPV during pregnancy (OR = 2.73) had a greater impact on PPD than lifetime IPV (OR = 2.24). This study provides updated evidence for the significant impact of IPV and its subtypes and exposure time on PPD. Women at risk of exposure to physical IPV, especially during pregnancy, are in urgent need of support to reduce the risk of PPD.
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Affiliation(s)
- Xinyi Wei
- The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Yik Wa Law
- The University of Hong Kong, Pokfulam, Hong Kong
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7
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Sales JM, Anderson KM, Livingston MD, Garbarino S, Hadera S, Rose ES, Carlson MS, Kalokhe AS. Experiences of childhood, intimate partner, non-partner, and hate crime-related violence among a sample of people living with HIV in the epicenter of the U.S. HIV epidemic. Front Public Health 2024; 12:1331855. [PMID: 38384880 PMCID: PMC10879432 DOI: 10.3389/fpubh.2024.1331855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/09/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction Experiences of violence among people living with HIV (PLWH) are thought to be highly prevalent but remain inadequately captured. As a first step toward acceptable, trauma informed practices that improve engagement and retention in care for PLWH, we must acquire more comprehensive understanding of violence experiences. We examined experiences of various forms of lifetime violence: adverse childhood experiences (ACES), intimate partner violence (IPV), non-partner violence (NPV), and hate crimes among diverse sample of PLWH in Atlanta, Georgia. Methods Cross sectional data collected from in- and out-of-care PLWH (N = 285) receiving care/support from Ryan White Clinics (RWCs), AIDS Service Organizations (ASOs), or large safety-net hospital, February 2021-December 2022. As part of larger study, participants completed interviewer-administered survey and reported on experiences of violence, both lifetime and past year. Participant characteristics and select HIV-related variables were collected to further describe the sample. Univariate and bivariate analyses assessed participant characteristics across types of violence. Results High prevalence of past violence experiences across all types (ACES: 100%, IPV: 88.7%, NPV: 97.5%, lifetime hate crimes 93.2%). People assigned male at birth who identified as men experienced more violence than women, with exception of non-partner forced sex. Participants identifying as gay men were more likely to have experienced violence. Conclusion Among our sample of PLWH at the epicenter of the United States HIV epidemic, histories of interpersonal and community violence are common. Findings emphasize need for RWCs, ASOs, and hospital systems to be universally trained in trauma-informed approaches and have integrated onsite mental health and social support services.
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Affiliation(s)
- Jessica M. Sales
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Katherine M. Anderson
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Melvin D. Livingston
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Sophia Garbarino
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Selaem Hadera
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Eve S. Rose
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Madelyn S. Carlson
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Ameeta S. Kalokhe
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, United States
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Rahrig H, Ma L, Brown KW, Martelli AM, West SJ, Lasko EN, Chester DS. Inside the mindful moment: The effects of brief mindfulness practice on large-scale network organization and intimate partner aggression. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:1581-1597. [PMID: 37880570 PMCID: PMC10842035 DOI: 10.3758/s13415-023-01136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/27/2023]
Abstract
Mindfulness can produce neuroplastic changes that support adaptive cognitive and emotional functioning. Recently interest in single-exercise mindfulness instruction has grown considerably because of the advent of mobile health technology. Accordingly, the current study sought to extend neural models of mindfulness by investigating transient states of mindfulness during single-dose exposure to focused attention meditation. Specifically, we examined the ability of a brief mindfulness induction to attenuate intimate partner aggression via adaptive changes to intrinsic functional brain networks. We employed a dual-regression approach to examine a large-scale functional network organization in 50 intimate partner dyads (total n = 100) while they received either mindfulness (n = 50) or relaxation (n = 50) instruction. Mindfulness instruction reduced coherence within the Default Mode Network and increased functional connectivity within the Frontoparietal Control and Salience Networks. Additionally, mindfulness decoupled primary visual and attention-linked networks. Yet, this induction was unable to elicit changes in subsequent intimate partner aggression, and such aggression was broadly unassociated with any of our network indices. These findings suggest that minimal doses of focused attention-based mindfulness can promote transient changes in large-scale brain networks that have uncertain implications for aggressive behavior.
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Affiliation(s)
- Hadley Rahrig
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA.
| | - Liangsuo Ma
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kirk Warren Brown
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Carnegie Mellon University, Pittsburgh, PA, USA
| | | | | | - Emily N Lasko
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - David S Chester
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Dams-O'Connor K, Seifert AC, Crary JF, Delman BN, Del Bigio MR, Kovacs GG, Lee EB, Nolan AL, Pruyser A, Selmanovic E, Stewart W, Woodoff-Leith E, Folkerth RD. The neuropathology of intimate partner violence. Acta Neuropathol 2023; 146:803-815. [PMID: 37897548 PMCID: PMC10627910 DOI: 10.1007/s00401-023-02646-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/14/2023] [Accepted: 10/14/2023] [Indexed: 10/30/2023]
Abstract
Lifelong brain health consequences of traumatic brain injury (TBI) include the risk of neurodegenerative disease. Up to one-third of women experience intimate partner violence (IPV) in their lifetime, often with TBI, yet remarkably little is known about the range of autopsy neuropathologies encountered in IPV. We report a prospectively accrued case series from a single institution, the New York City Office of Chief Medical Examiner, evaluated in partnership with the Brain Injury Research Center of Mount Sinai, using a multimodal protocol comprising clinical history review, ex vivo imaging in a small subset, and comprehensive neuropathological assessment by established consensus protocols. Fourteen brains were obtained over 2 years from women with documented IPV (aged 3rd-8th decade; median, 4th) and complex histories including prior TBI in 6, nonfatal strangulation in 4, cerebrovascular, neurological, and/or psychiatric conditions in 13, and epilepsy in 7. At autopsy, all had TBI stigmata (old and/or recent). In addition, white matter regions vulnerable to diffuse axonal injury showed perivascular and parenchymal iron deposition and microgliosis in some subjects. Six cases had evidence of cerebrovascular disease (lacunes and/or chronic infarcts). Regarding neurodegenerative disease pathologies, Alzheimer disease neuropathologic change was present in a single case (8th decade), with no chronic traumatic encephalopathy neuropathologic change (CTE-NC) identified in any. Findings from this initial series then prompted similar exploration in an expanded case series of 70 archival IPV cases (aged 2nd-9th decade; median, 4th) accrued from multiple international institutions. In this secondary case series, we again found evidence of vascular and white matter pathologies. However, only limited neurodegenerative proteinopathies were encountered in the oldest subjects, none meeting consensus criteria for CTE-NC. These observations from this descriptive exploratory study reinforce a need to consider broad co-morbid and neuropathological substrates contributing to brain health outcomes in the context of IPV, some of which may be potentially modifiable.
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Affiliation(s)
- Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan C Seifert
- Department of Diagnostic, Molecular and Interventional Radiology, Biomedical Engineering and Imaging Institute, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - John F Crary
- Department of Pathology, Molecular, and Cell Based Medicine, Ronald M. Loeb Center for Alzheimer's Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, and Artificial Intelligence & Human Health, Ronald M. Loeb Center for Alzheimer's Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Neuropathology Brain Bank & Research CoRE, Mount Sinai Hospital, New York, NY, USA
| | - Bradley N Delman
- Department of Diagnostic, Molecular and Interventional Radiology, Biomedical Engineering and Imaging Institute, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Marc R Del Bigio
- Department of Pathology, Rady Faculty of Health Sciences, University of Manitoba, Room 401 Brodie Centre, 727 McDermot Avenue, Winnipeg, MB, Canada
- Diagnostic Services - Pathology, Shared Health Manitoba, Winnipeg, MB, Canada
| | - Gabor G Kovacs
- Tanz Centre for Research in Neurodegenerative Disease (CRND) and Department of Laboratory Medicine and Pathobiology, Krembil Discovery Tower, University of Toronto, 60 Leonard Ave, Toronto, ON, Canada
- Laboratory Medicine Program and Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | - Edward B Lee
- Translational Neuropathology Research Laboratory, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber L Nolan
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Ariel Pruyser
- Department of Rehabilitation and Human Performance, Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Enna Selmanovic
- Department of Rehabilitation and Human Performance, Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William Stewart
- Department of Neuropathology, Elizabeth University Hospital, Glasgow, G514TF, Queen, UK
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, G128QQ, UK
| | - Emma Woodoff-Leith
- Department of Pathology, Molecular, and Cell Based Medicine, Ronald M. Loeb Center for Alzheimer's Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, and Artificial Intelligence & Human Health, Ronald M. Loeb Center for Alzheimer's Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Neuropathology Brain Bank & Research CoRE, Mount Sinai Hospital, New York, NY, USA
| | - Rebecca D Folkerth
- Office of Chief Medical Examiner, 520 First Avenue, New York, NY, 10116, USA.
- Department of Forensic Medicine, New York University Grossman School of Medicine, New York, NY, USA.
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Akande M, Del Farno A, Adrian H, Fogwell NT, Johnson DM, Zlotnick C, Operario D. 'Sometimes, we don't know if we're getting abused': discussions of intimate partner violence and HIV risk among transgender women. CULTURE, HEALTH & SEXUALITY 2023; 25:1101-1115. [PMID: 36309824 PMCID: PMC10148920 DOI: 10.1080/13691058.2022.2134929] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/07/2022] [Indexed: 05/03/2023]
Abstract
Transgender women are among the populations at highest risk for HIV in the USA and have elevated risk for intimate partner violence (IPV). There is an urgent need for integrated HIV-IPV prevention interventions for transgender women. Using qualitative methods, we explored transgender women's lived experiences of IPV and the relationship between IPV and HIV risk. Using thematic analysis, we identified four key concepts that warrant inclusion in the development of models for IPV and HIV interventions: (1) considering the boundaries of IPV; (2) normalising expectations of chronic violence; (3) relationship safety; (4) calls for trans-affirming and empowering services.
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Affiliation(s)
- Morayo Akande
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Alexander Del Farno
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Haley Adrian
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | | | - Dawn M. Johnson
- Department of Psychology, University of Akron, Akron, OH, USA
| | - Caron Zlotnick
- Department of Psychiatry and Human Behaviour, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Don Operario
- Department of Behavioural, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Iverson KM, Stolzmann KL, Brady JE, Adjognon OL, Dichter ME, Lew RA, Gerber MR, Portnoy GA, Iqbal S, Haskell SG, Bruce LE, Miller CJ. Integrating Intimate Partner Violence Screening Programs in Primary Care: Results from a Hybrid-II Implementation-Effectiveness RCT. Am J Prev Med 2023; 65:251-260. [PMID: 37031032 PMCID: PMC10568536 DOI: 10.1016/j.amepre.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 04/10/2023]
Abstract
INTRODUCTION The Veterans Health Administration initiated implementation facilitation to integrate intimate partner screening programs in primary care. This study investigates implementation facilitation's impact on implementation and clinical effectiveness outcomes. STUDY DESIGN A cluster randomized, stepped-wedge, hybrid-II implementation-effectiveness trial (January 2021-April 2022) was conducted amidst the COVID-19 pandemic. SETTING/PARTICIPANTS Implementation facilitation was applied at 9 Veterans Health Administration facilities, staged across 2 waves. Participants were all women receiving care at participating primary care clinics 3 months before (pre-implementation facilitation n=2,272) and 9 months after initiation of implementation facilitation (implementation facilitation n=5,149). INTERVENTION Implementation facilitation included an operations-funded external facilitator working for 6 months with a facility-funded internal facilitator from participating clinics. The pre-implementation facilitation period comprised implementation as usual in the Veterans Health Administration. MAIN OUTCOME MEASURES Primary outcomes were changes in (1) reach of intimate partner violence (IPV) screening programs among eligible women (i.e., those seen within participating clinics during the assessment period; implementation outcome) and (2) disclosure rates among screened women (effectiveness outcome). Secondary outcomes included disclosure rates among all eligible women and post-screening psychosocial service use. Administrative data were analyzed. RESULTS For primary outcomes, women seen during the implementation facilitation period were nearly 3 times more likely to be screened for IPV than women seen during the pre-implementation facilitation period (OR=2.70, 95% CI=2.46, 2.97). Women screened during the implementation facilitation period were not more likely to disclose IPV than those screened during the pre-implementation facilitation period (OR=1.14, 95% CI=0.86, 1.51). For secondary outcomes, owing to increased reach of screening during implementation facilitation, women seen during the implementation facilitation period were more likely to disclose IPV than those seen during the pre-implementation facilitation period (OR=2.09, 95% CI=1.52, 2.86). Women screened during implementation facilitation were more likely to use post-screening psychosocial services than those screened during pre-implementation facilitation (OR=1.29, 95% CI=1.06, 1.57). CONCLUSIONS Findings indicate that implementation facilitation may be a promising strategy for increasing the reach of IPV screening programs in primary care, thereby increasing IPV detection and strengthening connections to support services among the patient population. TRIAL REGISTRATION This study is registered at www. CLINICALTRIALS gov NCT04106193.
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Affiliation(s)
- Katherine M Iverson
- Women's Health Sciences Division, PTSD: National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Chobanian & Avedisian School of Medicine, Boston University, Boston, Massachusetts; Center for Healthcare Organization & Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts.
| | - Kelly L Stolzmann
- Center for Healthcare Organization & Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts
| | - Julianne E Brady
- Center for Healthcare Organization & Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts
| | - Omonyêlé L Adjognon
- Center for Healthcare Organization & Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts
| | - Melissa E Dichter
- Center for Health Equity Research and Promotion (CHERP), Crescenz VA Medical Center, Philadelphia, Pennsylvania; School of Social Work, Temple University, Philadelphia, Pennsylvania
| | - Robert A Lew
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC) & CSP Coordinating Center, VA Boston Healthcare System, Boston, Massachusetts
| | - Megan R Gerber
- Division of General Internal Medicine, Department of Medicine, Albany Medical College, Albany, New York; Albany Stratton VA Medical Center, Albany, New York
| | - Galina A Portnoy
- Pain Research Informatics Multi-Morbidity Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Samina Iqbal
- VA Palo Alto Healthcare System, Palo Alto, California; Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Sally G Haskell
- Pain Research Informatics Multi-Morbidity Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut; Office of Women's Health, U.S. Department of Veterans Affairs, Washington, District of Columbia; Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - LeAnn E Bruce
- Intimate Partner Violence Assistance Program, Care Management and Social Work, U.S. Department of Veterans Affairs, Washington, District of Columbia; Department of Social Work, Western Kentucky University, Bowling Green, Kentucky
| | - Christopher J Miller
- Center for Healthcare Organization & Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Trabold N, King PR, Crasta D, Iverson KM, Crane CA, Buckheit K, Bosco SC, Funderburk JS. Leveraging Integrated Primary Care to Enhance the Health System Response to IPV: Moving toward Primary Prevention Primary Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5701. [PMID: 37174219 PMCID: PMC10178447 DOI: 10.3390/ijerph20095701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
Intimate partner violence (IPV) is a prominent public health problem in the United States, with significant health impacts that are often severe and persistent. Healthcare systems have been called upon to improve both the systematic identification and treatment of IPV largely by adopting secondary and tertiary prevention efforts. Research to date demonstrates both benefits and challenges with the current strategies employed. In this paper, we summarize current knowledge about the healthcare system's response to IPV and evaluate the strengths, limitations, and opportunities. We offer recommendations to broaden the continuum of healthcare resources to address IPV, which include a population health approach to primary prevention.
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Affiliation(s)
- Nicole Trabold
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
- Rochester Institute of Technology, College of Health Science and Technology, Rochester, NY 14623, USA
| | - Paul R King
- Center for Integrated Healthcare, VA Western New York Healthcare System, Buffalo, NY 14215, USA
- Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, NY 14260, USA
| | - Dev Crasta
- Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY 14424, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Katherine M Iverson
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Cory A Crane
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
- Rochester Institute of Technology, College of Health Science and Technology, Rochester, NY 14623, USA
| | - Katherine Buckheit
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
| | - Stephen C Bosco
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
| | - Jennifer S Funderburk
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
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Allen KC, Davis A, Krishnamurti T. Indirect Identification of Perinatal Psychosocial Risks from Natural Language. IEEE TRANSACTIONS ON AFFECTIVE COMPUTING 2023; 14:1506-1519. [PMID: 37266391 PMCID: PMC10234606 DOI: 10.1109/taffc.2021.3079282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
During the perinatal period, psychosocial health risks, including depression and intimate partner violence, are associated with serious adverse health outcomes for birth parents and children. To appropriately intervene, healthcare professionals must first identify those at risk, yet stigma often prevents people from directly disclosing the information needed to prompt an assessment. In this research we use short diary entries to indirectly elicit information that could indicate psychosocial risks, then examine patterns that emerge in the language of those at risk. We find that diary entries exhibit consistent themes, extracted using topic modeling, and emotional perspective, drawn from dictionary-informed sentiment features. Using these features, we use regularized regression to predict screening measures for depression and psychological aggression by an intimate partner. Journal text entries quantified through topic models and sentiment features show promise for depression prediction, corresponding with self-reported screening measures almost as well as closed-form questions. Text-based features are less useful in predicting intimate partner violence, but topic models generate themes that align with known risk correlates. The indirect features uncovered in this research could aid in the detection and analysis of stigmatized risks.
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Greenbaum J, Kaplan D, Young J, Asnes AG, Gavril AR, Gilmartin ABH, Girardet RG, Heavilin ND, Laskey A, Messner SA, Mohr BA, Nienow SM, Rosado N, Forkey H, Keefe R, Keeshin B, Matjasko J, Edward H, Stedt E, Linton J, Gutierrez R, Caballero T, Falusi O“LO, Giri M, Griffin M, Ibrahim A, Mukerjee K, Shah S, Shapiro A, Young J. Exploitation, Labor and Sex Trafficking of Children and Adolescents: Health Care Needs of Patients. Pediatrics 2023; 151:190310. [PMID: 36827522 DOI: 10.1542/peds.2022-060416] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Abstract
Exploitation and labor and sex trafficking of children and adolescents is a major public health problem in the United States and throughout the world. Significant numbers of US and non-US-born children and adolescents (including unaccompanied immigrant minors) are affected by this growing concern and may experience a range of serious physical and mental health problems associated with human trafficking and exploitation (T/E). Despite these considerations, there is limited information available for health care providers regarding the nature and scope of T/E and how providers may help recognize and protect children and adolescents. Knowledge of risk factors, recruitment practices, possible indicators of T/E, and common medical, mental, and emotional health problems experienced by affected individuals will assist health care providers in recognizing vulnerable children and adolescents and responding appropriately. A trauma-informed, rights-based, culturally sensitive approach helps providers identify and treat patients who have experienced or are at risk for T/E. As health care providers, educators, and leaders in child advocacy and development, pediatricians play an important role in addressing the public health issues faced by children and adolescents who experience exploitation and trafficking. Working across disciplines with professionals in the community, health care providers can offer evidence-based medical screening, treatment, and holistic services to individuals who have experienced T/E and assist vulnerable patients and families in recognizing signs of T/E.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, Virginia
| | - Dana Kaplan
- Department of Pediatrics, Staten Island University Hospital, Northwell Health Physician Partners, Staten Island, New York.,The Barbara and Donald Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Janine Young
- Department of Pediatrics, University of California, San Diego, California
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15
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Crasta D, Crane CA, Trabold N, Shepardson RL, Possemato K, Funderburk JS. Relationship Health and Intimate Partner Violence in Integrated Primary Care: Individual Characteristics and Preferences for Relationship Support across Risk Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113984. [PMID: 36360867 PMCID: PMC9654718 DOI: 10.3390/ijerph192113984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 05/27/2023]
Abstract
This study explores differences in characteristics and relationship treatment preferences across different levels of intimate partner violence (IPV) among Veterans Affairs (VA) primary care patients. In Fall 2019, we sent a mail-in survey assessing relationship healthcare needs to N = 299 Veterans randomly sampled from 20 northeastern VA primary care clinics (oversampling female and younger Veterans). We compared those reporting past year use or experience of physical/sexual aggression, threats/coercion, or injury (Severe IPV; 21%), to those only reporting yelling and screaming (Verbal Conflict; 51%), and denying any IPV (No IPV; 28%). Participants across groups desired 2-6 sessions of face-to-face support for couples' health and communication. No IPV participants were older and had preferred treatment in primary care. The Verbal Conflict and Severe IPV groups were both flagged by IPV screens and had similar interest in couple treatment and relationship evaluation. The Severe IPV group had higher rates of harms (e.g., depression, alcohol use disorder, relationship dissatisfaction, fear of partner) and higher interest in addressing safety outside of VA. Exploratory analyses suggested differences based on use vs. experience of Severe IPV. Findings highlight ways integrated primary care teams can differentiate services to address dissatisfaction and conflict while facilitating referrals for Severe IPV.
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Affiliation(s)
- Dev Crasta
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua, NY 14424, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Cory A. Crane
- College of Health Science and Technology, Rochester Institute of Technology, Rochester, NY 14623, USA
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
| | - Nicole Trabold
- College of Health Science and Technology, Rochester Institute of Technology, Rochester, NY 14623, USA
| | - Robyn L. Shepardson
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
| | - Kyle Possemato
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
| | - Jennifer S. Funderburk
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
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16
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Broughton S, Ford-Gilboe M, Varcoe C. Mothering in the context of intimate partner violence: A feminist intersectional critique of the nursing literature. J Adv Nurs 2022; 78:3974-3986. [PMID: 36196459 DOI: 10.1111/jan.15450] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/27/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
AIMS To describe how mothers and mothering in the context of IPV are conceptualized in the nursing research and practice literature with attention to underlying ideologies, biases and potential harms. DESIGN Feminist intersectionality was used as a theoretical and analytic lens. DATA SOURCES Articles published between 2000 and 2021 in the nursing literature, identified by searching Google Scholar, CINAHL, PubMed and Scopus databases, and conducting bibliographic reviews of published articles. REVIEW METHODS Search terms included: intimate partner violence, domestic violence, parenting, mother and nursing. Initial screening resulted in inclusion of 98 papers for analysis. RESULTS Four dominant ways of conceptualizing mothering in the context of IPV were identified: (1) IPV is conceptualized as a discrete acute event and/or crisis, (2) mothering is treated as a practice, (3) mothers are valued as vehicles for child health and well-being and (4) mothers are seen as vulnerable and 'at risk'. These narrow constructions are rooted in ideologies such as normative motherhood, deficit and grit/resilience and neoliberalism. Emerging shifts in the literature are providing an important counter-balance. CONCLUSION Biases in nursing knowledge about mothering in the context of IPV may limit nursing's capacity to support the health of these women and their children. The integration of emerging perspectives that emphasize strengths and equity is critical in strengthening nursing knowledge and practice and in beginning to redress existing limitations and potential harms. IMPACT This critique focused on higher-income countries of the Global North but raises fundamental questions that should be considered in other contexts. Applying broader conceptualizations of mothers, mothering and IPV to research and practice can help improve the quality of care available.
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Affiliation(s)
| | | | - Colleen Varcoe
- University of British Columbia, Vancouver, British Columbia, Canada
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17
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Forster M, Rogers CJ, Rainisch B, Grigsby T, De La Torre C, Albers L, Unger JB. Adverse Childhood Experiences and Intimate Partner Violence; Findings From a Community Sample of Hispanic Young Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP18291-NP18316. [PMID: 34344225 DOI: 10.1177/08862605211035881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the United States, a substantial proportion of the adult population (36% of women and 34% of men) from all socioeconomic and ethnic backgrounds report experiencing intimate partner violence (IPV) over the life course. Family risk factors have been linked to adolescent and young adult IPV involvement, yet few studies have examined the effect of multiple, co-occurring adverse childhood experiences (ACEs) in the stability and change of IPV behaviors over young adulthood-the period of highest risk for IPV. We investigated the relationship between the degree of ACE exposure and IPV victimization and perpetration at age 22 and two years later at age 24 among a sample of Hispanic young adults (N= 1,273) in Southern California. Negative binomial regression models compared the incident rate ratio (IRR) of past-year verbal and physical IPV victimization and perpetration of respondents with 1-3 ACE and with ≥4 ACE to their peers who reported no history of ACE cross-sectionally (age 22) and longitudinally (age 24). At age 22, participants with 1-3 and ≥4 ACE were overrepresented in all IPV behaviors and had higher IRRs of verbal and physical victimization and perpetration compared to their peers with no ACE. By age 24, respondents with a history of ≥4 ACE were at significantly greater risk for escalating IPV behaviors over this time period than their peers with 1-3 ACE and no ACE. These findings highlight the importance of investing in coordinated efforts to develop strategies that help young people cope with the downstream effects of early life adversity. Research should continue to identify what individual, community, and cultural assets that promote resilience and are promising foci of IPV prevention approaches among vulnerable populations.
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Affiliation(s)
- Myriam Forster
- California State University, Northridge, Northridge, CA, USA
| | | | | | | | | | - Larisa Albers
- University of Southern California, Los Angeles, CA, USA
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18
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Ruderman LW, Packer C, Zingani A, Moses P, Burke HM. "Men can take part": examining men's role in supporting self-injectable contraception in southern Malawi, a qualitative exploration. Reprod Health 2022; 19:174. [PMID: 35945601 PMCID: PMC9361263 DOI: 10.1186/s12978-022-01476-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background The male engagement framework for reproductive health, which presents men as family planning users, supportive partners, and agents of change, is being increasingly incorporated into family planning strategies worldwide. We applied this framework to understand the perspectives of and role that men play in supporting the use of self-injection of subcutaneous depot medroxyprogesterone acetate (DMPA-SC). Methods We conducted a qualitative analysis using data from a study conducted in southern Malawi to develop and test a counseling message to introduce DMPA-SC and self-injection. We conducted 4 focus group discussions (FGD) with male community leaders and partners of DMPA-SC users, 13 interviews and FGDs with public and private sector family planning providers, and 30 interviews with female clients. We explored all participant groups’ perspectives on what could facilitate or prevent women from choosing self-injection, including views on men’s attitudes towards DMPA-SC and self-injection. Results Overall, participants expressed ways that men could be engaged as cooperative users, supportive partners, and agents of change, and felt that this would help build a more supportive environment for DMPA-SC self-injection use. Men held favorable opinions of DMPA-SC self-injection: they felt that it is useful, described ways they could actively and emotionally support their partners in its use, and described their role in normalizing it. Conclusions We suggest that DMPA-SC self-injection has the potential to be both a female-controlled and a cooperative method, based on the ability for women to use it autonomously and the option to encourage male partner involvement (only where the woman welcomes this). Shifting the conversation from viewing men as a barrier to men as a resource may allow us to harness the social capital of men and transform traditional power dynamics, therefore establishing more enabling environments to support autonomy and choice for DMPA-SC and self-injection use. Self-injectable contraception (DMPA-SC) has the potential to expand family planning access. Once users are trained to self-inject, they can obtain multiple units and self-inject every three months privately, without needing to return to a health provider. Considering men’s role in supporting self-injection can inform family planning programs’ male engagement strategies. We conducted a study in Southern Malawi which included interviews and focus group discussions with male community leaders and partners of DMPA-SC users, family planning providers, and female family planning clients. We applied the male engagement framework to these data to understand the potential roles men can play as cooperative users, supportive partners, and agents of change. We found that men can support their partners in DMPA-SC self-injection use through actively participating in the injection process, providing emotional support and encouragement, and advocating for other men and communities to accept self-injection and family planning use. We acknowledge that encouraging male participation could potentially lead to women’s autonomy being restricted, so offer concrete suggestions to create an enabling environment that keeps women’s and girls’ needs central. For example, we propose that program materials expand their description of DMPA-SC self-injection to include a potentially cooperative option, which may be appropriate for women who want to involve their partners. Further, we suggest that social and behavioral change programs channel men’s social capital in order to normalize self-injection. When their traditional role as norm influencers is harnessed, men may encourage their communities to support women’s autonomy and choice for DMPA-SC and self-injection use.
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Affiliation(s)
- Lucy W Ruderman
- Reproductive, Maternal, Newborn and Child Health Division, FHI 360, 359 Blackwell Street, Suite 200, Durham, NC, 27701, USA
| | - Catherine Packer
- Reproductive, Maternal, Newborn and Child Health Division, FHI 360, 359 Blackwell Street, Suite 200, Durham, NC, 27701, USA.
| | - Akuzike Zingani
- Centre for Health, Agriculture Development Research and Consulting (CHAD), Blantyre, Malawi
| | - Philemon Moses
- Centre for Health, Agriculture Development Research and Consulting (CHAD), Blantyre, Malawi
| | - Holly M Burke
- Reproductive, Maternal, Newborn and Child Health Division, FHI 360, 359 Blackwell Street, Suite 200, Durham, NC, 27701, USA
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Burnett C, Rawat E, Hooker L, Schminkey D, Bacchus L, Hinton I. IPV nurse education: Scoping things out to see who's doing what? NURSE EDUCATION TODAY 2022; 115:105407. [PMID: 35660165 DOI: 10.1016/j.nedt.2022.105407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/11/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Introducing best practice approaches to help nursing students identify and respond to patients who are/have been exposed to intimate partner violence (IPV) is instrumental to their professional development. The objectives of this study are to gather preliminary data from the American Association for the Colleges of Nursing (AACN) affiliated schools of nursing to determine 1) if they offer any training of students at the undergraduate or graduate level in identifying and responding to IPV; 2) if so, what are the components of that training, outcomes, and satisfaction with the existing approach; 3) if not, what are the individual and institutional level barriers to offering this training; and 4) if schools are interested in incorporating best practice, IPV training content into their curriculum. DESIGN AND METHODS A total of 836 AACN affiliated nursing schools across the US were surveyed using a 64-item electronic survey. RESULTS Of the 95 (11%) schools that completed at least 40% of the survey, approximately 60% offer IPV training once at the undergraduate level and only 30% offered such preparation at the graduate level. We found that most IPV education took place as embedded material within an existing course. Those nursing schools not providing any IPV education identified that they would like to at both levels and the 50% of nursing schools already providing this education said they wanted to provide more. The greatest barriers to offering IPV education were lack of faculty expertise and time constraints, yet about 70% of the participants stated that IPV education should be an essential part of undergraduate and graduate nursing school. CONCLUSION This study provides useful insights to inform IPV curriculum development by identifying common gaps in IPV education experienced by participating schools and strategies for addressing them.
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Affiliation(s)
- C Burnett
- Institutional Equity, Effectiveness and Success, Virginia Commonwealth University, Box 843022, Richmond, VA, USA.
| | - E Rawat
- INOVA Fairfax Medical Campus or INOVA Health System, Fairfax, VA, USA.
| | - L Hooker
- Child, Family and Community Health Lead and Prevention of Violence against Women co-lead, Judith Lumley Centre, Australia; Rural Department of Nursing and Midwifery, Rural JLC, La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo 3552, VIC, Australia.
| | - D Schminkey
- James Madison University College of Health and Behavioral Studies, Harrisonburg, VA, USA.
| | - L Bacchus
- London School of Hygiene & Tropical Medicine, Department of Global Health and Development, London WC1H 9SH, United Kingdom.
| | - I Hinton
- University of Virginia, School of Nursing, Charlottesville, VA, USA.
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20
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Velonis A, Maddox R, Buhariwala P, Kamalanathan J, Hassan MA, Fadhil T, O'Campo P. Asking the Right Questions: Screening Men for Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP13813-NP13829. [PMID: 33849303 DOI: 10.1177/08862605211005155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
With lifetime intimate partner violence (IPV) victimization rates for self-identified men between 14% and 20%, and an expanding understanding of gender as a nonbinary construct, practitioners in some clinical environments have expressed interest in screening all patients for IPV. Yet, few IPV screening instruments have been validated for use in nonfemale populations. This research tests the appropriateness and acceptability of a screening instrument developed for use with women.A literature review was completed to determine the current state of research into IPV screening practices tailored to men. Next, cognitive interviews were conducted to test a 9-question IPV screening instrument with men considered at average and elevated risk for experiencing partner violence. Participants were read the questions aloud and asked about item comprehension and question appropriateness and acceptability.The literature review uncovered no published reports describing routine clinic based IPV screening of men, and only two screening instruments had been validated with men. Twenty men participated in cognitive interviews from a variety of settings in a large urban center. All participants accurately described the intended meaning of each question and verified the appropriateness of asking the questions.This work addresses the gap in research on routine IPV screening with men, building on efforts to screen individuals and support improved health and response to violence to those across the gender spectrum.
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Affiliation(s)
- Alisa Velonis
- MAP Centre for Urban Health Solutions, St. Michael's Hospital Toronto, Ontario, Canada
- University of Illinois Chicago School of Public Health, Chicago, IL, USA
| | - Raglan Maddox
- MAP Centre for Urban Health Solutions, St. Michael's Hospital Toronto, Ontario, Canada
- University of Canberra, Australian Capital Territory, Australia
| | - Pearl Buhariwala
- MAP Centre for Urban Health Solutions, St. Michael's Hospital Toronto, Ontario, Canada
| | - Janisha Kamalanathan
- MAP Centre for Urban Health Solutions, St. Michael's Hospital Toronto, Ontario, Canada
| | - Maha Awaiz Hassan
- MAP Centre for Urban Health Solutions, St. Michael's Hospital Toronto, Ontario, Canada
| | - Tamam Fadhil
- MAP Centre for Urban Health Solutions, St. Michael's Hospital Toronto, Ontario, Canada
| | - Patricia O'Campo
- MAP Centre for Urban Health Solutions, St. Michael's Hospital Toronto, Ontario, Canada
- University of Toronto, Ontario, Canada
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21
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Foschiera LN, de Freitas CPP, Luft CZ, Godoi AR, Dupont MF, Habigzang LF. Evidence of Effectiveness of a Psychotherapy Protocol for Women with a History of Intimate Partner Violence: Follow-up Study. TRENDS IN PSYCHOLOGY 2022. [PMCID: PMC9294837 DOI: 10.1007/s43076-022-00213-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Laura Nichele Foschiera
- Escola de Ciências da Saúde E da Vida/Programa de Pós-Graduação Em Psicologia, Pontifícia Universidade Católica Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Clarissa Pinto Pizarro de Freitas
- Departamento de Psicologia/Programa de Pós-Graduação Em Psicologia Clínica, Pontifícia Universidade Católica Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caroline Zilli Luft
- Escola de Ciências da Saúde E da Vida/Programa de Pós-Graduação Em Psicologia, Pontifícia Universidade Católica Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Aline Ruoso Godoi
- Escola de Ciências da Saúde E da Vida/Programa de Pós-Graduação Em Psicologia, Pontifícia Universidade Católica Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Melina Friedrich Dupont
- Escola de Ciências da Saúde E da Vida/Programa de Pós-Graduação Em Psicologia, Pontifícia Universidade Católica Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Luísa Fernanda Habigzang
- Escola de Ciências da Saúde E da Vida/Programa de Pós-Graduação Em Psicologia, Pontifícia Universidade Católica Do Rio Grande Do Sul, Porto Alegre, Brazil
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22
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Chen Y, Cheung S, Huang CC. Intimate Partner Violence During Pregnancy: Effects of Maternal Depression Symptoms and Parenting on Teen Depression Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP7034-NP7056. [PMID: 33096950 DOI: 10.1177/0886260520967754] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Past studies have indicated that mothers who are victims of intimate partner violence (IPV) have a greater risk of developing depression symptoms. Furthermore, existing literature provides evidence that children's mental health can be affected by their mother's mental health well past infancy and early childhood. Given this, children of IPV victims are particularly at risk of developing depression symptoms. Guided by trauma theory, the ecobiodevelopmental (EBD) framework, and social learning theory, this study investigates the long-term relationship between maternal IPV victimization during pregnancy and teen depression symptoms. This study utilizes longitudinal data from the Fragile Families and Child Wellbeing Study to examine the relationship between IPV during pregnancy and maternal depression symptoms at early childhood, as well as the mechanism by which maternal depression symptoms affect child depression symptoms in the adolescent stage of development. The findings indicate that mothers who were victims of IPV during pregnancy were more likely to have depression symptoms when children turned 3 and that maternal depression symptoms could directly predict children's depression symptoms at age 15. Meanwhile, maternal depression symptoms could indirectly increase adolescent depression symptoms via physical punishment at age 5 and bullying victimization at age 9. While extensive evidence has shown that IPV during pregnancy has detrimental effects on mothers and children, our study adds to the literature that such detriments can last as long as a decade. Given that depression symptoms can be detrimental to later development, the findings call for universal and comprehensive IPV screening tools and swift service referrals for pregnant women who are experiencing IPV. At the same time, trauma-informed parenting education for women, along with school- and community-based interventions for children, may also mitigate these harmful associations.
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Affiliation(s)
- Yafan Chen
- Rutgers University School of Social Work, New Brunswick, NJ, USA
| | - Shannon Cheung
- Rutgers University School of Social Work, New Brunswick, NJ, USA
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23
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Paphitis SA, Bentley A, Asher L, Osrin D, Oram S. Improving the mental health of women intimate partner violence survivors: Findings from a realist review of psychosocial interventions. PLoS One 2022; 17:e0264845. [PMID: 35299229 PMCID: PMC8929660 DOI: 10.1371/journal.pone.0264845] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is highly prevalent and is associated with a range of mental health problems. A broad range of psychosocial interventions have been developed to support the recovery of women survivors of IPV, but their mechanisms of action remain unclear. METHODS Realist review following a prospectively published protocol in PROSPERO (CRD42018114207) and reported using the Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMSES) guidelines. RESULTS Evidence was extracted from 60 reviews and triangulated in expert consultations. Mechanisms of action were categorised as either associated with intervention design and delivery or with specific intervention components (access to resources and services; safety, control and support; increased knowledge; alterations to affective states and cognitions; improved self-management; improved family and social relations). CONCLUSIONS Findings suggest that psychosocial interventions to improve the mental health of women survivors of IPV have the greatest impact when they take a holistic view of the problem and provide individualised and trauma-informed support.
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Affiliation(s)
- Sharli Anne Paphitis
- Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
- * E-mail:
| | - Abigail Bentley
- Gender Violence and Health Centre, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Laura Asher
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - David Osrin
- Institute for Global Health, University College London, London, United Kingdom
| | - Sian Oram
- Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
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24
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Pederson A, Mirlashari J, Lyons J, Brotto LA. How to Facilitate Disclosure of Violence while Delivering Perinatal Care: The Experience of Survivors and Healthcare Providers. JOURNAL OF FAMILY VIOLENCE 2022; 38:571-583. [PMID: 35342223 PMCID: PMC8938212 DOI: 10.1007/s10896-022-00371-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Gender-based Violence (GBV) during the perinatal period is a serious concern as it is associated with many adverse outcomes for both the mother and the baby. It is well known that violence is under-reported. Thus, official statistics (both police reports and survey data) underestimate the prevalence of violence in general and during the perinatal period specifically. In this study conducted in Canada, we sought to explore the barriers to and facilitators of women disclosing their experiences of GBV within healthcare services to safely facilitate more disclosure in the future and reduce the harms that arise from GBV. We used thematic analysis to analyze in-depth interviews with 16 healthcare providers (nurses, midwives and physicians) and 12 survivors of GBV. The data reflect three main themes: "raising awareness of gender-based violence", "creating a shift in the healthcare system's approach toward gender-based violence" and "providing support for survivors and care providers." Our findings suggest that the healthcare system should increase its investments in raising awareness regarding GBV, training healthcare providers to respond appropriately, and building trust between survivors and healthcare providers. Healthcare providers need to be aware of their role and responsibility regarding identifying GBV as well as how to support survivors who talk about violence. Expanding a relationship-based approach in the care system and providing support for both survivors and health care providers would likely lead to more disclosures.
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Affiliation(s)
- Ann Pederson
- Population Health School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Jila Mirlashari
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Janet Lyons
- Division of General Gynecology & Obstetrics, University of British Columbia, BC Women’s Hospital, Provincial Health Services Authority (PHSA), Vancouver, Canada
| | - Lori A. Brotto
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
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25
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Bright MA, Parrott M, Martin S, Thompson L, Roussos-Ross D, Montoya-Williams D. Streamlining Universal Prenatal Screening for Risk for Adverse Birth Outcomes. Matern Child Health J 2022; 26:1022-1029. [PMID: 35312912 DOI: 10.1007/s10995-022-03420-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Many of the medical risk factors for adverse birth outcomes (e.g., preeclampsia) are regularly monitored in prenatal care. However, many of the psychosocial risk factors associated with adverse birth outcomes (e.g., maternal stress, anxiety, depression, intimate partner violence) are not regularly addressed during routine prenatal care. Comprehensive prenatal screening for psychosocial risk factors for adverse birth outcomes can improve maternal and neonatal outcomes. In this study, we examine an existing tool for opportunities to streamline and improve screening. METHODS We reviewed medical records for 528 mother-infant dyads, recording maternal responses to a 21-item prenatal risk screening tool, and gestational age/birth weight of infants. Multiple approaches to scoring were used to predict likelihood of adverse birth outcome. RESULTS Women who answered yes to any of the top four interrelated items were 3.32 times more likely to have an adverse birth outcome. Sensitivity and specificity were 68% and 65%, respectively. CONCLUSION FOR PRACTICE We identified a short surveillance tool to identify women who are at highest risk and require more in-depth screening, and to rule out women who are at very low risk of an adverse birth outcome.
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Affiliation(s)
- Melissa A Bright
- Department of Obstetrics and Gynecology, University of Florida, PO Box 110070, Gainesville, USA. .,Center for Violence Prevention Research, Melrose, FL, USA. .,Department of Pediatrics, Division of General Pediatrics, University of Florida, PO Box 110070, Gainesville, USA.
| | - Melanie Parrott
- Medical Student, College of Medicine, University of Florida, Gainesville, USA
| | - Serena Martin
- Medical Student, College of Medicine, University of Florida, Gainesville, USA
| | - Lindsay Thompson
- Department of Pediatrics, Division of General Pediatrics, University of Florida, PO Box 110070, Gainesville, USA
| | - Dikea Roussos-Ross
- Department of Obstetrics and Gynecology, University of Florida, PO Box 110070, Gainesville, USA
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Women Tell All: A Comparative Thematic Analysis of Women's Perspectives on Two Brief Counseling Interventions for Intimate Partner Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052513. [PMID: 35270204 PMCID: PMC8909494 DOI: 10.3390/ijerph19052513] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 02/04/2022] [Accepted: 02/18/2022] [Indexed: 11/24/2022]
Abstract
Background: Intimate partner violence (IPV) is a significant public health problem that is commonly experienced by women and associated with psychosocial health issues. Recovering from IPV through Strengths and Empowerment (RISE) is a brief, clinician-administered, variable-length (1–6 sessions), modular, individualized psychosocial counseling intervention developed for women experiencing IPV. We present qualitative feedback and quantitative helpfulness ratings from women patients of the Veterans Health Administration who completed a randomized clinical trial (RCT) comparing RISE to a clinician-administered advocacy-based Enhanced Care as Usual (ECAU; a single structured session consisting of psychoeducation, safety-planning, resources, and referrals). Methods: 58 participants (Mage = 39.21) completed post-intervention semi-structured qualitative interviews, including helpfulness ratings, at two follow-up assessments (10- and 14-weeks post-enrollment) to assess the acceptability, usefulness, and perceived fit of the interventions for women’s needs. Interviews were transcribed and analyzed using a hybrid deductive-inductive analytic approach. Results: While both the RISE and ECAU interventions were deemed helpful (interventions were rated as ‘highly helpful’ by 77% of RISE and 52% of ECAU participants), differences were identified in perceived impacts of the intervention, application of content, approach to patient-centeredness, and implementation recommendations. Conclusions: Findings shed light on women Veterans’ experiences and preferences for IPV psychosocial counseling interventions. Such knowledge can inform evidence-based, trauma-informed, and individualized care for women Veterans who experience IPV and may have relevance to other populations of women who experience IPV.
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27
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Safe Pregnancy intervention for intimate partner violence: a randomised controlled trial in Norway among culturally diverse pregnant women. BMC Pregnancy Childbirth 2022; 22:144. [PMID: 35189843 PMCID: PMC8862262 DOI: 10.1186/s12884-022-04400-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/10/2022] [Indexed: 01/10/2023] Open
Abstract
Background Intimate partner violence (IPV) during pregnancy is a global health problem with adverse consequences for mothers, infants and families. We hypothesise that information about IPV and safety behaviours during pregnancy has the potential to increase quality of life and the use of safety behaviours and prevent IPV. Methods A multicentre randomised controlled trial among culturally diverse pregnant women in Norway, to test the effect of a tablet-based video intervention about IPV and safety behaviours. Women attending routine antenatal check-ups alone (baseline) were screened for violence (Abuse Assessment Screen) by responding to questions on a tablet, and randomised (1:1) by computer to receive an intervention or a control video. The intervention video presented information about IPV and safety behaviours. The controls viewed a video promoting healthy pregnancy in general. Outcome measures were assessed three months post-partum: The World Health Organization Quality of Life-BREF, the Composite Abuse Scale on violence during the last 12 months and use of safety behaviours based on a 15-item checklist. A general linear model for repeated measures was used to examine the intervention’s effect. The analyses were conducted by intention to treat. Results Among 1818 eligible women, 317 reported IPV and were randomised to an intervention (157) or a control group (160). A total of 251 (79.2%) women completed the follow-up questionnaire: 120 (76.4%) in the intervention group and 131 (81.9%) in the control group. At follow-up, 115 (45.8%) women reported a history of IPV. Few women (n = 39) reported IPV during the last 12 months. No differences in quality-of-life domains and overall quality of life and health were found between the intervention and the control groups. We detected no differences between the use of safety behaviours or IPV frequency and severity during the last 12 months. Conclusion Our intervention did not improve women’s quality of life, use of safety behaviours or exposure to violence. Nevertheless, a tablet-based tool may motivate women experiencing IPV to seek help and support. More research is needed regarding tablet-based interventions for women experiencing IPV, particularly culturally sensitive interventions. Trial registration NCT03397277 registered in clinicaltrials.gov on 11/01/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04400-z.
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Saboori Z, Gold RS, Green KM, Wang MQ. Community Health Worker Knowledge, Attitudes, Practices and Readiness to Manage Intimate Partner Violence. J Community Health 2022; 47:17-27. [PMID: 34244918 PMCID: PMC8269983 DOI: 10.1007/s10900-021-01012-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/30/2022]
Abstract
Intimate partner violence (IPV) is an important public health concern with higher prevalence among women. Community health workers (CHWs) are trusted frontline public health workers that bridge gaps between communities and healthcare services. Despite their effectiveness in delivering services and improving outcomes for different chronic conditions, there is a dearth of understanding regarding CHW management of IPV. The purpose of this study is to examine knowledge, attitudes, practices, and readiness to manage IPV among a sample of CHWs (n = 152). Participants completed an online version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), which was modified for CHW practice. Psychometrics of the newly adapted tool, along with empirical relationships between knowledge, attitudes, and readiness to manage IPV were examined. Most sub-scales yielded moderate to high reliability (0.70 < α's < 0.97), some sub-scales had low reliability (0.57 < α's < 0.64), and construct validity was established for several of the subscales. On average, many CHWs had low scores on objective knowledge of IPV (mean = 15.4 out of 26), perceived preparation to manage IPV (mean = 3.8 out of 7), and perceived knowledge of IPV (mean = 3.7 out of 7). About 56% of CHWs indicated having no previous IPV training, 34% did not screen for IPV, and 65% were in the contemplation stage of behavior change. Multiple regression models indicated that knowledge, staff capabilities and staff preparation were significant predictors of perceived preparedness to manage IPV (all p's < 0.05). Results can inform future credentialing requirements and training programs for CHWs to better assist their clients who are victims of IPV.
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Affiliation(s)
- Zahra Saboori
- Department of Behavioral and Community Health, University of Maryland College Park School of Public Health, 4200 Valley Drive, Suite 1234, College Park, MD, 20742, USA.
| | - Robert S Gold
- Department of Behavioral and Community Health, University of Maryland College Park School of Public Health, 4200 Valley Drive, Suite 1234, College Park, MD, 20742, USA
| | - Kerry M Green
- Department of Behavioral and Community Health, University of Maryland College Park School of Public Health, 4200 Valley Drive, Suite 1234, College Park, MD, 20742, USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, University of Maryland College Park School of Public Health, 4200 Valley Drive, Suite 1234, College Park, MD, 20742, USA
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29
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Kishton R, Sinko L, Ortiz R, Islam MN, Fredrickson A, Sheils NE, Buresh J, Cronholm PF, Matone M. Describing the Health Status of Women Experiencing Violence or Abuse: An Observational Study Using Claims Data. J Prim Care Community Health 2022; 13:21501319221074121. [PMID: 35345928 PMCID: PMC8968984 DOI: 10.1177/21501319221074121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: Violence against women (VAW) can result in long-term and varied sequela for survivors, making it difficult to evaluate healthcare intervention. This study seeks to improve understanding of the healthcare experiences of women survivors prior to a violence-related diagnosis, allowing healthcare systems to better design strategies to meet the needs of this population. Methods: Using population-based data from 2016 to 2019, this cross-sectional observational study presents healthcare spending, utilization, and diagnostic patterns of privately insured women, age 18 or older, in the 10-months prior to an episode of care for a documented experience of violence (DEV). Results: Of 12 624 764 women meeting enrollment criteria, 10 980 women had DEV. This group had higher general medical complexity, despite being 10 years younger than the comparison group (mean age 32.7 vs 43.5). These relationships held up when comparing participants in each cohort by age. Additional key findings including higher numbers of medical visits across clinical settings and higher total cost ($10 138-$4585). Conclusions: The study utilized population-based data, to describe specific areas of health and medical cost for women with DEV. Increased medical complexity and utilization patterns among survivors broaden the understanding of the health profiles and healthcare touchpoints of survivors to inform and optimize strategies for medical system engagement and resource allocation for this public health crisis.
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Affiliation(s)
- Rachel Kishton
- University of Pennsylvania, Philadelphia, PA, USA
- Rachel Kishton, Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Penn Presbyterian Medical Center Andrew Mutch Building, Floor 7, 51 N. 39th Street Philadelphia, PA 19104, USA.
| | - Laura Sinko
- Temple University College of Public Health, Philadelphia, PA, USA
| | - Robin Ortiz
- University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | - John Buresh
- OptumLabs at United Health Group, Minnetonka, MN, USA
| | | | - Meredith Matone
- University of Pennsylvania, Philadelphia, PA, USA
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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Kimberg L, Vasquez JA, Sun J, Anderson E, Ferguson C, Arreguin M, Rodriguez RM. Fears of disclosure and misconceptions regarding domestic violence reporting amongst patients in two US emergency departments. PLoS One 2021; 16:e0260467. [PMID: 34855809 PMCID: PMC8638952 DOI: 10.1371/journal.pone.0260467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 11/10/2021] [Indexed: 11/18/2022] Open
Abstract
Patients often do not disclose domestic violence (DV) to healthcare providers in emergency departments and other healthcare settings. Barriers to disclosure may include fears and misconceptions about whether, and under what circumstances, healthcare providers report DV to law enforcement and immigration authorities. We sought to assess undocumented Latino immigrants (UDLI), Latino legal residents/citizens (LLRC) and non-Latino legal residents/citizens (NLRC) beliefs about disclosure of DV victimization to healthcare providers and healthcare provider reporting of DV to law enforcement and immigration authorities. From 10/2018-2/2020, we conducted this survey study at two urban emergency departments (EDs) in California. Participants, enrolled by convenience sampling, responded to survey questions adapted from a previously published survey instrument that was developed to assess undocumented immigrant fears of accessing ED care. Our primary outcomes were the proportions of UDLI, LLRC and NLRC who knew of someone who had experienced DV in the past year, whether these DV victims were afraid to access ED care, reasons DV victims were afraid to access ED care, and rates of misconceptions (defined according to current California law) about the consequences of disclosing DV to healthcare providers. Of 667 patients approached, 531 (80%) agreed to participate: 32% UDLI, 33% LLRC, and 35% NLRC. Of the 27.5% of respondents who knew someone who experienced DV in the past year, 46% stated that the DV victim was afraid to seek ED care; there was no significant difference in this rate between groups. The most common fears reported as barriers to disclosure were fear the doctor would report DV to police (31%) and fear that the person perpetrating DV would find out about the disclosure (30.3%). Contrary to our hypothesis, UDLI had lower rates of misconceptions about healthcare provider and law enforcement responses to DV disclosure than LLRC and NLRC. Fear of disclosing DV and misconceptions about the consequences of disclosure of DV to healthcare providers were common, indicating a need for provider, patient, and community education and changes that lower barriers to help-seeking.
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Affiliation(s)
- Leigh Kimberg
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Juan A. Vasquez
- Department of Emergency Medicine, NYU Langone Health, New York, United States of America
| | - Jennifer Sun
- Department of Emergency Medicine, Highland Hospital-Alameda Health System, Oakland, California, United States of America
| | - Erik Anderson
- Department of Emergency Medicine, Highland Hospital-Alameda Health System, Oakland, California, United States of America
| | - Clarissa Ferguson
- Department of Emergency Medicine, University of California, San Francisco, California, United States of America
| | - Mireya Arreguin
- Department of Emergency Medicine, University of California, San Francisco, California, United States of America
| | - Robert M. Rodriguez
- Department of Emergency Medicine, University of California, San Francisco, California, United States of America
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31
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Creech SK, Pulverman CS, Kroll-Desrosiers A, Kinney R, Dichter ME, Mattocks K. Intimate Partner Violence Among Pregnant Veterans: Prevalence, Associated Mental Health Conditions, and Health Care Utilization. J Gen Intern Med 2021; 36:2982-2988. [PMID: 33464464 PMCID: PMC8481457 DOI: 10.1007/s11606-020-06498-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) is a prevalent and serious health concern for women veterans, associated with mental and physical health symptoms. The adverse impacts of IPV are exacerbated during pregnancy, with added risks for pregnancy and postpartum outcomes. OBJECTIVE Identify the scope of IPV among pregnant veterans and associations with health outcomes. DESIGN Data were obtained from a national retrospective cohort study. PARTICIPANTS Study participants were 442 pregnant veterans using VHA maternity care benefits. MAIN MEASURES Mental health history was assessed via self-report measure and chart review; history of IPV and perinatal depression were assessed via brief validated self-report measures. KEY RESULTS Fourteen percent of the sample reported past-year IPV. Report of past-year IPV was associated with higher self-reported rates of lifetime mental health disorders including depression (p = 0.01), posttraumatic stress disorder (p = 0.02), anxiety disorders (p = 0.05), mood disorders (p = 0.01), bipolar disorder (p = 0.001), and eating disorders (p = 0.003); past-year IPV was also associated with the diagnosis of posttraumatic stress disorder during pregnancy (p = 0.002). Additionally, past-year IPV was associated with higher rates of military sexual trauma (MST; p = 0.03), pregnancy health risk behaviors (i.e., smoking, alcohol, and drug use; p = 0.004), greater number of VHA mental health visits during pregnancy (p = 0.04), and a lower likelihood of seeking social support from a spouse or partner (p < 0.0001). CONCLUSIONS Results indicate substantial rates of IPV among pregnant veterans, and high rates of mental health conditions which may be exacerbated by MST experience and lower likelihood of seeking social support. Clinicians treating pregnant veterans should screen for and address IPV and mental health treatment needs, and risks should be assessed among pregnant veterans experiencing IPV.
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Affiliation(s)
- Suzannah K Creech
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Health Care System, Waco, USA.
- Department of Psychiatry, Dell Medical School of the University of Texas at Austin, Austin, USA.
| | - Carey S Pulverman
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Health Care System, Waco, USA
- Department of Psychiatry, Dell Medical School of the University of Texas at Austin, Austin, USA
| | - Aimee Kroll-Desrosiers
- VHA Central Western Massachusetts Healthcare System, Leeds, USA
- VHA Center for Health Equity Research and Promotion, Crescenz VHA Medical Center, Philadelphia, USA
| | - Rebecca Kinney
- VHA Central Western Massachusetts Healthcare System, Leeds, USA
| | - Melissa E Dichter
- VHA Center for Health Equity Research and Promotion, Crescenz VHA Medical Center, Philadelphia, USA
- Temple University School of Social Work, Philadelphia, USA
| | - Kristin Mattocks
- VHA Central Western Massachusetts Healthcare System, Leeds, USA
- University of Massachusetts Medical School, Worcester, USA
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Mutiso VN, Musyimi CW, Gitonga I, Rebello TJ, Tele A, Pike KM, Ndetei DM. Toward Community Coverage on Self-Screening, Diagnosis, and Help-Seeking Behavior for Both Gender Victims of Intimate Partner Violence (IPV) in a Kenyan Setting: The Development of IPV-Brief Self-Screener (IPV-BSS) Version of the WHO-IPV Instrument. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP9344-NP9363. [PMID: 31208269 DOI: 10.1177/0886260519855666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Intimate partner violence (IPV) is a major public health concern. The prevalence of IPV in women in Kenya is in the range of 41% to 45% but has also been reported in 20% of men. The most widely used instrument for the screening and diagnosis of IPV is the World Health Organization-Intimate Partner Violence (WHO-IPV). However, it is lengthy for routine large-scale screening and is administered by a trained person, thus limiting the number it can reach for screening. There is therefore a need for a shorter screening version that can be self-administered to reach critical masses. Those who screen positive can then be subjected to the longer version. In addition, the short version should be culturally sensitive, can be used by either gender, can be used in busy clinical settings as the patients wait to be attended to, and can be used for large-scale community populations to raise awareness and promote help-seeking behavior. It should be applicable in similar cultural settings and is aligned to the longer version of the WHO-IPV instrument. This study aimed to develop such a tool. We administered the WHO-IPV to two groups: firstly, postnatal mothers attending postnatal clinics and secondly, men and women attending general clinics to which they had been referred. These referrals were by traditional healers (TH), faith healers (FH), and community health workers (CHW) who had been trained to screen for mental disorders using the Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG) master checklist. Using factor analysis of the scores, we came up with questions that had the highest predictive value for different types of IPV diagnosis and which could therefore be used for self-screening purposes. We call the tool the Intimate Partner Violence-Brief Self-Screener (IPV-BSS; Adapted by the Africa Mental Health Research and Training Foundation from the WHO-IPV).
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Affiliation(s)
- Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | | | - Isaiah Gitonga
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | | | - Albert Tele
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Kathleen M Pike
- Columbia University, Global Mental Health Program, New York, USA
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
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Wahab RA, Chan M, Vijapura C, Brown AL, Asghar E, Frazee-Katz C, Mahoney MC. Intimate Partner Violence and the Role of Breast Imaging Centers. JOURNAL OF BREAST IMAGING 2021; 3:482-490. [PMID: 38424794 DOI: 10.1093/jbi/wbab046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Indexed: 03/02/2024]
Abstract
Intimate partner violence (IPV) is defined as physical violence, sexual violence, stalking, or psychological harm by a current or former intimate partner. In the United States, one in three women will experience a form of IPV in their lifetime. Screening for IPV at breast imaging centers provides an important opportunity to identify and assist affected women. Breast imaging centers provide a private environment where passive and active IPV screening methods can be employed. In addition, when obtaining a mammogram or breast ultrasound, the patient's upper chest is exposed, which could demonstrate patterns of abuse. This article discusses the need for IPV screening, via both passive and active methods, and implementation steps for breast imaging centers.
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Affiliation(s)
- Rifat A Wahab
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
| | - Maegan Chan
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
| | - Charmi Vijapura
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
| | - Ann L Brown
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
| | - Emaan Asghar
- University of Cincinnati, College of Arts and Sciences, Mason, OH, USA
| | | | - Mary C Mahoney
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
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Grillo AR, Danitz SB, Dichter ME, Driscoll MA, Gerber MR, Hamilton AB, Wiltsey-Stirman S, Iverson KM. Strides Toward Recovery From Intimate Partner Violence: Elucidating Patient-Centered Outcomes to Optimize a Brief Counseling Intervention for Women. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP8431-NP8453. [PMID: 30994401 DOI: 10.1177/0886260519840408] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Women in the United States continue to experience intimate partner violence (IPV) at unprecedented rates, necessitating the development and implementation of personalized, effective healthcare-based interventions. Methods of developing patient-centered interventions for IPV should elicit the voice of the target population (i.e., women who experience IPV) while assuring that outcomes identified as important are incorporated into the refined intervention. This pilot study is part of a multiphase, larger study aiming to refine an IPV intervention and clinical outcome measurements prior to formal evaluation of the effectiveness of the intervention. Specifically, this study elucidates patient-centered outcomes identified by women who have experienced IPV. Women patients of the Veterans Health Administration (VHA) in New England participated in focus groups to provide feedback and desired outcomes of a new IPV intervention. Patient-centered outcomes were defined by the participants. Focus groups were transcribed and analyzed using conventional content analysis and matrix analysis. A total of 25 women participated in focus groups (n = 5) at two large VHA facilities. Participant feedback revealed five common themes related to desired outcomes. Women opined increased feelings of empowerment as a key outcome of engaging in an IPV intervention. Women desired increased social connectedness and support to be gained during treatment, citing providers and other survivors of IPV as exemplary sources. Self-esteem was viewed as critical to enhancing recovery, as was increased knowledge across domains of IPV (e.g., warning signs, the link between mental and physical health for self and children). Finally, women identified valued action and goal setting, such as achieving more independence, as an optimal outcome. Addressing IPV against women requires patient-centered interventions that specifically target the types of outcomes deemed important by the end users: women who experience IPV. Findings have implications for tailoring treatments for IPV and selecting measures that tap into women's desired outcomes.
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Affiliation(s)
- Alessandra R Grillo
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Sara B Danitz
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Melissa E Dichter
- VA Center for Health Equity Research and Promotion, Crescenz VA Medical Center, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Mary A Driscoll
- VA Connecticut Healthcare System, New Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Megan R Gerber
- Boston University School of Medicine, Boston, MA, USA
- Women's Health Services, VA Boston Healthcare System, Boston, MA, USA
| | - Alison B Hamilton
- VA Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- University of California, Los Angeles, CA, USA
| | - Shannon Wiltsey-Stirman
- National Center for PTSD, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Stanford School of Medicine, Stanford, CA, USA
| | - Katherine M Iverson
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
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Hicks PM, Murtaugh MA, DeAngelis MM. The possible impact of increased physical intimate partner violence during the COVID-19 pandemic on ocular health. SAGE Open Med 2021; 9:20503121211035263. [PMID: 34377470 PMCID: PMC8326617 DOI: 10.1177/20503121211035263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/08/2021] [Indexed: 12/23/2022] Open
Abstract
During the COVID-19 outbreak, sheltering at home has led to an increase in physical intimate partner violence cases. Intimate partner violence-sustained ocular injuries may be higher during the pandemic due to the increase in physical intimate partner violence. Left untreated, intimate partner violence-related ocular or orbital trauma can lead to permanent vision loss. Even with treatment, patients often lose vision from intimate partner violence-related traumatic ocular injuries. Eye care providers and eye care facilities should understand the community services available to intimate partner violence survivors to better care for these patients. Due to the potential lasting economic burden and social strain of this pandemic, eye care providers and facilities should stay vigilant as there may still be a sustained increase in intimate partner violence even after the global COVID-19 pandemic.
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Affiliation(s)
- Patrice M Hicks
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Maureen A Murtaugh
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Margaret M DeAngelis
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Ophthalmology, University of Buffalo, Buffalo, NY, USA
- VA Western New York Healthcare System, Buffalo, NY, USA
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Burnett C, Crowder J, Bacchus LJ, Schminkey D, Bullock L, Sharps P, Campbell J. "It Doesn't Freak Us Out the Way It Used to": An Evaluation of the Domestic Violence Enhanced Home Visitation Program to Inform Practice and Policy Screening for IPV. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP7488-NP7515. [PMID: 30741071 DOI: 10.1177/0886260519827161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Domestic Violence Enhanced Home Visitation (DOVE) intervention used in the Perinatal Nurse Home Visiting Intervention Enhanced With mHealth Technology (RCT: R01HD071771) is a nurse-lead evidenced-based intervention that has been shown to decrease violence overtime. This summative mixed-methods impact evaluation is intended to provide insight to enhance the DOVE IPV protocol for screening and intervention by (a) identifying which core aspects of DOVE facilitated or inhibited its success and what was most critical to optimal IPV (intimate partner violence) screening and intervention practices, (b) informing how DOVE IPV screening and intervention were influenced by the experiences of home visitor (HV), and (c) identifying policy considerations and best practice recommendations for the DOVE protocol. Participants were HVs and managers (N = 13) in rural/urban home visiting programs delivering DOVE across three states. The sample had a mean age of 48.76. Three fourths were baccalaureate-prepared nurses with an average of 10.5 years of home visiting experience. The method used in this study was one-to-one qualitative in-depth interviews with HVs. Data were interpretively analyzed using Nvivo 10 to generate three themes. Participants endorsed screening women for IPV with DOVE being the approach of choice to facilitate IPV screening and intervening with women. HVs found DOVE helped enhance their IPV knowledge, screening, and intervening capabilities while filling an existing void in this type of preparation of HV nurses. Establishing a relationship with the women before initiating screening was an important aspect in delivering DOVE as was the training, support, and increased comfort level in addressing IPV. The evidence offers an understanding of which core aspects of DOVE contributed to its success and what was most critical to optimal IPV screening and intervention practices. Furthermore, this evaluation provided multilevel insights into how best to advance home visiting practices and policies when screening and intervening with perinatal women exposed to IPV.
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Mazza M, Marano G, del Castillo AG, Chieffo D, Monti L, Janiri D, Moccia L, Sani G. Intimate partner violence: A loop of abuse, depression and victimization. World J Psychiatry 2021; 11:215-221. [PMID: 34168968 PMCID: PMC8209536 DOI: 10.5498/wjp.v11.i6.215] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/25/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Intimate partner violence has been recognized as a serious public health issue. Exposure to violence contributes to the genesis of, and exacerbates, mental health conditions, and existing mental health problems increase vulnerability to partner violence, a loop that imprisons victims and perpetuates the abuse. A recently described phenomenon is when male violence against females occurs within intimate relationships during youth, and it is termed adolescent or teen dating violence. In this narrative review, factors associated with intimate partner violence and consequences of exposure of children to parental domestic violence are discussed, along with possible intensification of violence against women with the spread of coronavirus disease 2019 pandemic and subsequent lockdown. Intervention programs with a multicomponent approach involving many health care settings and research have a pivotal role in developing additional strategies for addressing violence and to provide tailored interventions to victims. Prevention policy with a particular attention on healthy child and adolescent development is mandatory in the struggle against all forms of violence.
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Affiliation(s)
- Marianna Mazza
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giuseppe Marano
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Angela Gonsalez del Castillo
- Service of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Daniela Chieffo
- Service of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Laura Monti
- Service of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Delfina Janiri
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Lorenzo Moccia
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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Kalra N, Hooker L, Reisenhofer S, Di Tanna GL, García-Moreno C. Training healthcare providers to respond to intimate partner violence against women. Cochrane Database Syst Rev 2021; 5:CD012423. [PMID: 34057734 PMCID: PMC8166264 DOI: 10.1002/14651858.cd012423.pub2] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) includes any violence (physical, sexual or psychological/emotional) by a current or former partner. This review reflects the current understanding of IPV as a profoundly gendered issue, perpetrated most often by men against women. IPV may result in substantial physical and mental health impacts for survivors. Women affected by IPV are more likely to have contact with healthcare providers (HCPs) (e.g. nurses, doctors, midwives), even though women often do not disclose the violence. Training HCPs on IPV, including how to respond to survivors of IPV, is an important intervention to improve HCPs' knowledge, attitudes and practice, and subsequently the care and health outcomes for IPV survivors. OBJECTIVES To assess the effectiveness of training programmes that seek to improve HCPs' identification of and response to IPV against women, compared to no intervention, wait-list, placebo or training as usual. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and seven other databases up to June 2020. We also searched two clinical trials registries and relevant websites. In addition, we contacted primary authors of included studies to ask if they knew of any relevant studies not identified in the search. We evaluated the reference lists of all included studies and systematic reviews for inclusion. We applied no restrictions by search dates or language. SELECTION CRITERIA All randomised and quasi-randomised controlled trials comparing IPV training or educational programmes for HCPs compared with no training, wait-list, training as usual, placebo, or a sub-component of the intervention. DATA COLLECTION AND ANALYSIS We used standard methodological procedures outlined by Cochrane. Two review authors independently assessed studies for eligibility, undertook data extraction and assessed risks of bias. Where possible, we synthesised the effects of IPV training in a meta-analysis. Other analyses were synthesised in a narrative manner. We assessed evidence certainty using the GRADE approach. MAIN RESULTS We included 19 trials involving 1662 participants. Three-quarters of all studies were conducted in the USA, with single studies from Australia, Iran, Mexico, Turkey and the Netherlands. Twelve trials compared IPV training versus no training, and seven trials compared the effects of IPV training to training as usual or a sub-component of the intervention in the comparison group, or both. Study participants included 618 medical staff/students, 460 nurses/students, 348 dentists/students, 161 counsellors or psychologists/students, 70 midwives and 5 social workers. Studies were heterogeneous and varied across training content delivered, pedagogy and time to follow-up (immediately post training to 24 months). The risk of bias assessment highlighted unclear reporting across many areas of bias. The GRADE assessment of the studies found that the certainty of the evidence for the primary outcomes was low to very low, with studies often reporting on perceived or self-reported outcomes rather than actual HCPs' practices or outcomes for women. Eleven of the 19 included studies received some form of research grant funding to complete the research. Within 12 months post-intervention, the evidence suggests that compared to no intervention, wait-list or placebo, IPV training: · may improve HCPs' attitudes towards IPV survivors (standardised mean difference (SMD) 0.71, 95% CI 0.39 to 1.03; 8 studies, 641 participants; low-certainty evidence); · may have a large effect on HCPs' self-perceived readiness to respond to IPV survivors, although the evidence was uncertain (SMD 2.44, 95% CI 1.51 to 3.37; 6 studies, 487 participants; very low-certainty evidence); · may have a large effect on HCPs' knowledge of IPV, although the evidence was uncertain (SMD 6.56, 95% CI 2.49 to 10.63; 3 studies, 239 participants; very low-certainty evidence); · may make little to no difference to HCPs' referral practices of women to support agencies, although this is based on only one study (with 49 clinics) assessed to be very low certainty; · has an uncertain effect on HCPs' response behaviours (based on two studies of very low certainty), with one trial (with 27 participants) reporting that trained HCPs were more likely to successfully provide advice on safety planning during their interactions with standardised patients, and the other study (with 49 clinics) reporting no clear impact on safety planning practices; · may improve identification of IPV at six months post-training (RR 4.54, 95% CI 2.5 to 8.09) as in one study (with 54 participants), although three studies (with 48 participants) reported little to no effects of training on identification or documentation of IPV, or both. No studies assessed the impact of training HCPs on the mental health of women survivors of IPV compared to no intervention, wait-list or placebo. When IPV training was compared to training as usual or a sub-component of the intervention, or both, no clear effects were seen on HCPs' attitudes/beliefs, safety planning, and referral to services or mental health outcomes for women. Inconsistent results were seen for HCPs' readiness to respond (improvements in two out of three studies) and HCPs' IPV knowledge (improved in two out of four studies). One study found that IPV training improved HCPs' validation responses. No adverse IPV-related events were reported in any of the studies identified in this review. AUTHORS' CONCLUSIONS Overall, IPV training for HCPs may be effective for outcomes that are precursors to behaviour change. There is some, albeit weak evidence that IPV training may improve HCPs' attitudes towards IPV. Training may also improve IPV knowledge and HCPs' self-perceived readiness to respond to those affected by IPV, although we are not certain about this evidence. Although supportive evidence is weak and inconsistent, training may improve HCPs' actual responses, including the use of safety planning, identification and documentation of IPV in women's case histories. The sustained effect of training on these outcomes beyond 12 months is undetermined. Our confidence in these findings is reduced by the substantial level of heterogeneity across studies and the unclear risk of bias around randomisation and blinding of participants, as well as high risk of bias from attrition in many studies. Further research is needed that overcomes these limitations, as well as assesses the impacts of IPV training on HCPs' behavioral outcomes and the well-being of women survivors of IPV.
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Affiliation(s)
- Naira Kalra
- Gender Innovation Lab, Office of the Chief Economist, Africa Region, World Bank, Washington, DC, USA
| | - Leesa Hooker
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Sonia Reisenhofer
- College of Science, Health & Engineering, La Trobe University, Bundoora, Australia
| | - Gian Luca Di Tanna
- Statistics Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Claudia García-Moreno
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Bermea AM, Slakoff DC, Goldberg AE. Intimate Partner Violence in the LGBTQ+ Community: Experiences, Outcomes, and Implications for Primary Care. Prim Care 2021; 48:329-337. [PMID: 33985708 DOI: 10.1016/j.pop.2021.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Lesbian, gay, bisexual, transgender, queer, and other sexual and gender (LGBTQ+) minorities experience intimate partner violence (IPV) at higher rates than heterosexual and/or cisgender people. Providers often are less prepared to work with LGBTQ+ survivors, which can be the result of a reliance on stereotypes on what constitutes an IPV victim. This article provides recommendations for working with LGBTQ+ survivors, including screening for IPV regardless of sexual orientation or gender identity, participating in LGBTQ+-affirming trainings regarding IPV, and creating a welcoming and inclusive space that promotes LGBTQ+ survivors' comfort in disclosing IPV.
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Affiliation(s)
- Autumn M Bermea
- Department of Human Sciences, The Ohio State University, 1787 Neil Avenue, Columbus, OH 43210, USA.
| | - Danielle C Slakoff
- Division of Criminal Justice, California State University, Sacramento, 6000 J Street, Sacramento, CA 95819, USA. https://twitter.com/DSlakoffPhD
| | - Abbie E Goldberg
- Department of Psychology, Clark University, 950 Main Street, Worcester, MA 01610, USA
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Sales JM, Anderson KM, Kokubun CW. Application of the Consolidated Framework for Implementation Research to Facilitate Violence Screening in HIV Care Settings: a Review of the Literature. Curr HIV/AIDS Rep 2021; 18:309-327. [PMID: 33866483 DOI: 10.1007/s11904-021-00555-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW This review summarizes the literature on violence screening practices within HIV care settings globally as well as identified salient multi-level barriers and facilitators for adopting and implementing violence screening within HIV care. We utilized the Consolidated Framework for Implementation Research (CFIR) to systematically identify multi-level factors related to violence screening within HIV services. RECENT FINDINGS Across the 15 articles included, several highly salient CFIR constructs emerged as particularly relevant for violence screening adoption and implementation within HIV including inner setting factors, outer setting factors, as well as select constructs specific to characteristics of the violence screening process, the individuals charged with screening, and violence screening execution. This review underscores the importance of considering CFIR constructs to bolster successful violence screening implementation in HIV care settings. We describe several potential implementation strategies to overcome the most salient barriers identified across this limited body of summarized research.
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Affiliation(s)
- Jessica M Sales
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
| | - Katherine M Anderson
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Caroline W Kokubun
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
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Tavrow P, Bloom B, Withers M. Challenges of Using Videos in Exam Rooms of Safety-Net Clinics to Encourage Patient Self-Disclosure of Intimate Partner Violence and to Increase Provider Screening. Violence Against Women 2021; 27:2990-3010. [PMID: 33860700 DOI: 10.1177/10778012211000136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Identifying intimate partner violence (IPV) in clinics allows for early intervention. We tested a comprehensive approach in five safety-net clinics to encourage female victims to self-identify and providers to screen. The main components were (a) short, multilingual videos for female patients; (b) provider training; and (c) management tools. Although videos were viewed 2,150 times, only 9% of eligible patients watched them. IPV disclosure increased slightly (6%). Lack of internal champions, high turnover, increased patient load, and technological challenges hindered outcomes. Safety-net clinics need feasible methods to encourage IPV screening. Management champions and IT support are essential for video-based activities.
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Affiliation(s)
| | - Brittnie Bloom
- San Diego State University, CA, USA.,University of California, San Diego, USA
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Miller-Walfish S, Kwon J, Raible C, Ali A, Bell JH, James L, Miller E. Promoting Cross-Sector Collaborations to Address Intimate Partner Violence in Health Care Delivery Systems Using a Quality Assessment Tool. J Womens Health (Larchmt) 2021; 30:1660-1666. [PMID: 33666518 DOI: 10.1089/jwh.2020.8438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: As part of a Domestic Violence and Health care Partnership (DVHCP) project in California, 19 leadership teams consisting of representatives from domestic violence agencies and health care delivery systems in California came together to improve care related to intimate partner violence (IPV). We evaluated the impact of a Quality Assessment/Quality Improvement (QA/QI) tool on health care delivery systems' ability to collaborate with victim service agencies to address IPV. Methods: Each leadership team completed the QA/QI tool every 6 months between 2014 and 2017. Fifteen clinics that completed the tool at least twice are included in this analysis. Results: The largest changes noted in the QA/QI tool were having written protocols for assessing for IPV, providers distributing educational safety cards about IPV to patients, scripts for providers on how to assess and support survivors of IPV, trainings led by IPV agency advocates, and support for staff to discuss difficult cases. Conclusions: Implementation of a QA/QI tool can guide health care delivery systems to make changes in provider practices and clinic protocols to improve care and support for survivors of IPV. Such clinic-level changes may support providers to more readily or consistently integrate addressing IPV in clinical encounters while facilitating and promoting cross-sector collaborations with victim service advocacy and related social service agencies.
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Affiliation(s)
- Summer Miller-Walfish
- Division of Adolescent and Young Adult Medicine, Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jane Kwon
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Claire Raible
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Anisa Ali
- Futures Without Violence, San Francisco, California, USA
| | | | - Lisa James
- Futures Without Violence, San Francisco, California, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Sawyer S, Coles J, Williams A, Williams B. Paramedics as a New Resource for Women Experiencing Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP2999-NP3018. [PMID: 29673303 DOI: 10.1177/0886260518769363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Intimate partner violence (IPV) has a major impact on the health and well-being of women. The need for a coordinated response from health care professions encountering IPV patients is well established, and guidelines for individual health care professions are needed. Paramedics are believed to frequently encounter IPV patients, and this study aims to create a guideline to direct their response based on expert opinion. A clinical guideline for paramedics was created using current evidence and recommendations from health agencies. A panel of family violence researchers and service delivery experts such as physicians, family violence support agencies, and police commented on the guideline via a Policy Delphi Method to obtain consensus agreement. A total of 42 experts provided feedback over three rounds resulting in 100% consensus. Results include clinical indicators to recognize IPV patients in the prehospital environment, a description of how paramedics should discuss IPV with patients, recommended referral agencies and pathways, and appropriate documentation of case findings. This study has created the first comprehensive, consensus-based guideline for paramedics to recognize and refer IPV patients to care and support. The guideline could potentially be modified for use by ambulance services worldwide and can be used as the basis for building the capacity of paramedics to respond to IPV, which may lead to increased referrals to care and support.
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Affiliation(s)
| | - Jan Coles
- Monash University, Victoria, Australia
| | - Angela Williams
- Monash University, Victoria, Australia
- Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia
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Hegarty K, Valpied J, Taft A, Brown SJ, Gold L, Gunn J, O'Doherty L. Two-year follow up of a cluster randomised controlled trial for women experiencing intimate partner violence: effect of screening and family doctor-delivered counselling on quality of life, mental and physical health and abuse exposure. BMJ Open 2020; 10:e034295. [PMID: 33303427 PMCID: PMC7733186 DOI: 10.1136/bmjopen-2019-034295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES This was a 2-year follow-up study of a primary care-based counselling intervention (weave) for women experiencing intimate partner violence (IPV). We aimed to assess whether differences in depression found at 12 months (lower depression for intervention than control participants) would be sustained at 24 months and differences in quality in life, general mental and physical health and IPV would emerge. DESIGN Cluster randomised controlled trial. Researchers blinded to allocation. Unit of randomisation: family doctors. SETTING Fifty-two primary care clinics, Victoria, Australia. PARTICIPANTS Baseline: 272 English-speaking, female patients (intervention n=137, doctors=35; control n=135, doctors=37), who screened positive for fear of partner in past 12 months. Twenty-four-month response rates: intervention 59% (81/137), control 63% (85/135). INTERVENTIONS Intervention doctors received training to deliver brief, woman-centred counselling. Intervention patients were invited to receive this counselling (uptake rate: 49%). Control doctors received standard IPV information; delivered usual care. PRIMARY AND SECONDARY OUTCOME MEASURES Twenty-four months primary outcomes: WHO Quality of Life-Bref dimensions, Short-Form Health Survey (SF-12) mental health. SECONDARY OUTCOMES SF-12 physical health and caseness for depression and anxiety (Hospital Anxiety Depression Scale), post-traumatic stress disorder (Check List-Civilian), IPV (Composite Abuse Scale), physical symptoms (≥6 in last month). Data collected through postal survey. Mixed-effects regressions adjusted for location (rural/urban) and clustering. RESULTS No differences detected between groups on quality of life (physical: 1.5, 95% CI -2.9 to 5.9; psychological: -0.2, 95% CI -4.8 to 4.4,; social: -1.4, 95% CI -8.2 to 5.4; environmental: -0.8, 95% CI -4.0 to 2.5), mental health status (-1.6, 95% CI -5.3 to 2.1) or secondary outcomes. Both groups improved on primary outcomes, IPV, anxiety. CONCLUSIONS Intervention was no more effective than usual care in improving 2-year quality of life, mental and physical health and IPV, despite differences in depression at 12 months. Future refinement and testing of type, duration and intensity of primary care IPV interventions is needed. TRIAL REGISTRATION NUMBER ACTRN12608000032358.
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Affiliation(s)
- Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Family Violence Prevention, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Jodie Valpied
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Angela Taft
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Stephanie Janne Brown
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Lisa Gold
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Jane Gunn
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lorna O'Doherty
- Faculty of Health and Life Sciences, Coventry University, Coventry, West Midlands, UK
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Todahl J, Nekkanti A, Schnabler S. Universal Screening and Education: A Client-Centered Protocol for Normalizing Intimate Partner Violence Conversation in Clinical Practice. JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2020. [DOI: 10.1080/15332691.2020.1835595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Jeff Todahl
- Counseling Psychology and Human Services Department, University of Oregon, Eugene, Oregon, USA
| | - Akhila Nekkanti
- Counseling Psychology and Human Services Department, University of Oregon, Eugene, Oregon, USA
| | - Simone Schnabler
- Center for the Prevention of Abuse and Neglect, University of Oregon, Eugene, Oregon, USA
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Guyatt P, Bzovsky S, Bhandari M, Sprague S. Top 10 Things Every Radiologist Needs to Know About Intimate Partner Violence [Formula: see text]. Can Assoc Radiol J 2020; 72:222-227. [PMID: 32960099 DOI: 10.1177/0846537120956542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Intimate partner violence (IPV) is considered to be the leading cause of nonfatal injury to women worldwide. Moreover, the need for effective training for health care professionals (HCPs) and protocol for addressing IPV in health care contexts are well-documented. This article addresses key questions that radiologists may have related to supporting patients who have experienced IPV. METHODS Peer-reviewed journal articles and other formal reports were located using Google Scholar and PubMed in order to assemble this review. CONCLUSIONS Radiologists are well-equipped to help identify possible instances of IPV if they are aware of the injury patterns commonly associated with IPV. Along with other HCPs, radiologists can also advocate for the implementation of protocols that will guide their responses to victims of IPV within their own health care institution.
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Affiliation(s)
- Paige Guyatt
- Division of Orthopaedic Surgery, Department of Surgery, 3710McMaster University, Hamilton, Ontario, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, 3710McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, 3710McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence, and Impact, 3710McMaster University, Hamilton, Ontario, Canada
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, 3710McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence, and Impact, 3710McMaster University, Hamilton, Ontario, Canada
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Rizkalla K, Maar M, Pilon R, McGregor L, Reade M. Improving the response of primary care providers to rural First Nation women who experience intimate partner violence: a qualitative study. BMC Womens Health 2020; 20:209. [PMID: 32957935 PMCID: PMC7507614 DOI: 10.1186/s12905-020-01053-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 08/20/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Some legacies of colonialism are that Indigenous women living in Canada experience higher rates of intimate partner violence (IPV) and that violence is often more severe relative to non-Indigenous women. This results in avoidable physical, psychological, emotional, financial, sexual and spiritual harm in the lives of Indigenous women, families, and communities. Trusted primary care providers are well positioned to provide brief interventions and referrals to treatment and services, but little is known about the providers' preparedness to support Indigenous women. Information on what enables or prevents providers to respond to Indigenous patients who experience IPV is needed in order to ensure this potential lifeline for support is realized. METHODS The purpose of this community-based participatory study was to elucidate the barriers and facilitators to care for rural Indigenous women who experience IPV from the perspectives of primary care providers and to recommend strategies to improve their preparedness. Using a Grounded Theory approach, we conducted qualitative research with 31 providers to discuss their experiences with patients affected by IPV. RESULTS The results showed providers often feel a degree of unpreparedness to deal with IPV in a clinical setting. Underlying the feelings of unpreparedness were: Recognition of patients' under disclosure of IPV due to stigma, shame and fear Lack of formal provider training on appropriate approaches to IPV Lack of referral network due to fragmented, scarce services for IPV Lack of understanding of jurisdictional complexity of First Nations and non-First Nations specific services for IPV Uncertainty how to negotiate cultural safety around IPV Multiple-role relationship & confidentiality dilemmas characteristic of small communities Risk of jeopardizing patient-provider relationship CONCLUSIONS: Our recommendations to improve provider preparedness to address IPV include reducing the stigma of IPV; creating effective referral pathways; improving cultural safety within the referral network; developing services for perpetrators; engaging natural helpers in the community, and; developing policies, procedures and continuing education related to patients who experience IPV in the clinical and community setting. We suggest that increasing providers' comfort to respond to IPV for rural and Indigenous women will ultimately lead to improved safety and health outcomes.
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Affiliation(s)
- Kristin Rizkalla
- Department of Interdisciplinary Health, School of Rural and Northern Health, Laurentian University, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada.
| | - Marion Maar
- Division of Human Sciences, Northern Ontario School of Medicine, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada
| | - Roger Pilon
- School of Nursing- Department of Health, Laurentian University, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada
| | - Lorrilee McGregor
- School of Nursing- Department of Health, Laurentian University, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada
| | - Maurianne Reade
- Division of Clinical Sciences, Northern Ontario School of Medicine, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada
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A cross-sectional survey of pregnant women’s perceptions of routine domestic and family violence screening and responses by midwives: Testing of three new tools. Women Birth 2020; 33:393-400. [DOI: 10.1016/j.wombi.2019.06.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/06/2019] [Accepted: 06/25/2019] [Indexed: 11/21/2022]
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Hegarty K, McKibbin G, Hameed M, Koziol-McLain J, Feder G, Tarzia L, Hooker L. Health practitioners' readiness to address domestic violence and abuse: A qualitative meta-synthesis. PLoS One 2020; 15:e0234067. [PMID: 32544160 PMCID: PMC7297351 DOI: 10.1371/journal.pone.0234067] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 05/18/2020] [Indexed: 11/19/2022] Open
Abstract
Health practitioners play an important role in identifying and responding to domestic violence and abuse (DVA). Despite a large amount of evidence about barriers and facilitators influencing health practitioners' care of survivors of DVA, evidence about their readiness to address DVA has not been synthesised. This article reports a meta-synthesis of qualitative studies exploring the research question: What do health practitioners perceive enhances their readiness to address domestic violence and abuse? Multiple data bases were searched in June 2018. Inclusion criteria included: qualitative design; population of health practitioners in clinical settings; and a focus on intimate partner violence. Two reviewers independently screened articles and findings from included papers were synthesised according to the method of thematic synthesis. Forty-seven articles were included in the final sample, spanning 41 individual studies, four systematic reviews and two theses between the years of 1992 and 2018; mostly from high income countries. Five themes were identified as enhancing readiness of health practitioners to address DVA: Having a commitment; Adopting an advocacy approach; Trusting the relationship; Collaborating with a team; and Being supported by the health system. We then propose a health practitioners' readiness framework called the CATCH Model (Commitment, Advocacy, Trust, Collaboration, Health system support). Applying this model to health practitioners' different readiness for change (using Stage of Change framework) allows us to tailor facilitating strategies in the health setting to enable greater readiness to deal with intimate partner abuse.
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Affiliation(s)
- Kelsey Hegarty
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- The Royal Women’s Hospital, Melbourne, Victoria, Australia
| | - Gemma McKibbin
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Mohajer Hameed
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Koziol-McLain
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Gene Feder
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Laura Tarzia
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Leesa Hooker
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
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Meyer SR, Rege S, Avalaskar P, Deosthali P, García-Moreno C, Amin A. Strengthening health systems response to violence against women: protocol to test approaches to train health workers in India. Pilot Feasibility Stud 2020; 6:63. [PMID: 32426157 PMCID: PMC7212611 DOI: 10.1186/s40814-020-00609-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 04/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, including in low- and middle-income [LMIC] countries, there is increased attention to and investment in interventions to prevent and respond to violence against women; however, most of these approaches are delivered outside of formal or informal health systems. The World Health Organization published clinical and policy guidelines Responding to intimate partner violence and sexual violence against women in 2013. Further evidence is needed concerning implementation of the Guidelines, including how health care providers perceive training interventions, if the training approach meets their needs and is of relevance to them and how to ensure sustainability of changes in practice due to training. This manuscript describes a study protocol for a mixed methods study of the implementation of the Guidelines and related tools in tertiary hospitals in two districts in Maharashtra, India. METHODS The study will employ a mixed-methods study design. A quantitative assessment of health care providers' and managers' knowledge, attitudes, and practices will be conducted pre, post, and 6 months after the training. Qualitative methods will include a participatory stakeholders' meeting to inform the design of the training intervention design, in-depth interviews [IDIs] and focus-group discussions [FGDs] with health care providers and managers 3-6 months after training, and IDIs with women who have disclosed violence to a trained health care provider, approximately 6 months after training. The study will also validate two tools: a readiness assessment of health facilities and a health management information system form in a facility register format which will be used to document cases of violence. DISCUSSION The multiple components of this study will generate data to improve our understanding of how implementation of the Guidelines works, what barriers and facilitators to implementation exist in this context, and how current implementation practices result in changes in terms of health services and providers' practices of responding to women affected by violence. The results will be useful for governmental and non-governmental and United Nations Agency efforts to improve health systems and services for women affected by violence, as well as for researchers working on health systems responses to violence against women in India and possibly other contexts.
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Affiliation(s)
- Sarah R. Meyer
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Sangeeta Rege
- CEHAT–Centre for Inquiry into Health and Allied Themes, Mumbai, India
| | - Prachi Avalaskar
- CEHAT–Centre for Inquiry into Health and Allied Themes, Mumbai, India
| | - Padma Deosthali
- CEHAT–Centre for Inquiry into Health and Allied Themes, Mumbai, India
| | - Claudia García-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Avni Amin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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