1
|
Iverson KM, Brady JE, Adjognon OL, Stolzmann K, Dichter ME, Bruce LE, Portnoy GA, Iqbal S, Gerber MR, Haskell SG, Miller CJ. Twelve-Month Sustainment of IPV Screening and Response Programs in Primary Care: Contextual Factors Impacting Implementation Success. Womens Health Issues 2024:S1049-3867(24)00062-8. [PMID: 39174417 DOI: 10.1016/j.whi.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/27/2024] [Accepted: 07/17/2024] [Indexed: 08/24/2024]
Abstract
PURPOSE The Veterans Health Administration (VHA) employed implementation facilitation (IF) as a strategy to boost uptake of intimate partner violence (IPV) screening programs in primary care. This study examined the sustainment of screening uptake 1 year after IF and identified factors impacting sustainment success. METHODS A mixed-methods evaluation using quantitative and qualitative data was conducted. IPV screening rates from the conclusion of the IF period (i.e., initial adoption) through the 1-year sustainment period served as the primary outcome. We categorized sites into four groups of screening adoption and sustainment success (high adoption and high sustainment, moderate adoption and moderate sustainment, low adoption and low sustainment, and no adoption and/or no sustainment). Qualitative analysis of key informant interviews was used to identify contextual factors affecting screening 12 months post-IF. A mixed sustainment analysis matrix integrated quantitative and qualitative findings and enabled the identification of cross-site patterns. MAIN FINDINGS Seven of the nine sites sustained IPV screening at the most basic level (saw static or increased screening rates). High adopting and high sustaining sites (n = 3) were marked by consistently supportive medical center leadership, ongoing training for clinicians, clear protocols for responding to positive screens, and robust referral options for women experiencing IPV. Nonsustaining sites (n = 2) were marked by a host of barriers including staffing shortages, competing priorities, and inconsistent messaging from leadership regarding the importance of IPV screening. CONCLUSIONS Knowing barriers and facilitators to successful IPV screening sustainment can inform health care systems to tailor IF and other implementation strategies to sustain IPV screening in primary care. Sustainment of IPV screening requires attention to a combination of facilitators (e.g., consistent leadership support and robust referral options) as well as addressing key barriers (e.g., staff turnover and competing priorities).
Collapse
Affiliation(s)
- Katherine M Iverson
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
| | - Julianne E Brady
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts
| | - Omonyêlé L Adjognon
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts; Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts
| | - Kelly Stolzmann
- Center for Healthcare Organization and 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
| | - LeAnn E Bruce
- Intimate Partner Violence Assistance Program, Care Management and Social Work Services, Department of Veterans Affairs, Washington, District of Columbia; Department of Social Work, Western Kentucky University, Bowling Green, Kentucky
| | - Galina A Portnoy
- Pain Research Informatics Multi-morbidity Education (PRIME) Center of Innovation, 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, Stanford University School of Medicine, Stanford, California
| | - Megan R Gerber
- Division of General Internal Medicine, Albany Medical College, Albany, New York; Albany Stratton VA Medical Center, Albany, New York
| | - Sally G Haskell
- Pain Research Informatics Multi-morbidity Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, Connecticut; Office of Women's Health, Department of Veterans Affairs, Washington, District of Columbia; Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Christopher J Miller
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
2
|
Camarda A, Bradford JY, Dixon C, Horigan AE, DeGroot D, Kaiser J, MacPherson-Dias R, Perry A, Slifko A, Slivinski A, Bishop-Royse J, Delao AM. ENA Clinical Practice Guideline Synopsis: Intimate Partner Violence Screening. J Emerg Nurs 2024; 50:573-577. [PMID: 38960549 DOI: 10.1016/j.jen.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 07/05/2024]
|
3
|
Zemlak JL, Marineau L, Willie TC, Addison H, Edwards G, Kershaw T, Alexander KA. Contraceptive Use Among Women Experiencing Intimate Partner Violence and Reproductive Coercion: The Moderating Role of PTSD and Depression. Violence Against Women 2024; 30:2075-2095. [PMID: 36762382 PMCID: PMC11384232 DOI: 10.1177/10778012231153372] [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] [Indexed: 02/11/2023]
Abstract
Women experiencing reproductive coercion (RC) report more unintended pregnancies and mental health symptoms that can influence contraceptive use patterns. We examined associations between RC and contraceptive use among intimate partner violence (IPV) exposed women aged 18-35 (N = 283). We tested depression, post-traumatic stress disorder (PTSD), and co-morbid depression and PTSD as effect modifiers. Though no association was found between RC and contraception, PTSD significantly modified this relationship. Among Black women (n = 112), those reporting RC and either PTSD or comorbid PTSD and depression were less likely to use partner-independent contraception compared to those reporting RC without mental health symptoms. PTSD could be a barrier to contraceptive choice among this population.
Collapse
Affiliation(s)
- Jessica L Zemlak
- Marquette University College of Nursing, Milwaukee, WI, USA
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Lea Marineau
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Tiara C Willie
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Helena Addison
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Kamila A Alexander
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
4
|
Fico P, Atwood S, Arbour M. Beyond ''Screen & Refer'': Understanding Families' Use of Resources for Health-Related Social Needs Identified via Primary Care. Acad Pediatr 2024:S1876-2859(24)00237-7. [PMID: 38950731 DOI: 10.1016/j.acap.2024.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/12/2024] [Accepted: 06/23/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE As health-related social needs (HRSN) screening increases, attention to families' resource preferences lags. This study of a pediatric primary care intervention (DULCE) with reliable HRSN screening and resource connection explored whether resources adequately addressed families' needs and, when HRSN persisted, families' reasons for declining resources. METHODS This retrospective cohort, mixed-methods study analyzed data from 989 families that received care at seven pediatric clinics implementing DULCE in three states. DULCE screens for seven HRSN around the 1-month and 4-month well-child visits; we calculated the percent of initial and ongoing positive screens. For positive rescreens, we calculated the percent that had all eligible or wanted resources and that were interested in further resources. We also analyzed case notes, which elicited families' resource preferences, and explored demographic characteristics associated with ongoing HRSN. RESULTS Half of enrolled families (508 of 989) initially screened positive for HRSN; 124 families had positive rescreens; 26 expressed interest in further assistance. Most families with ongoing concrete supports needs accessed all eligible resources (60-100%); 20-58% had everything they wanted. Fewer families with ongoing maternal depression and intimate partner violence accessed all eligible resources (48% and 18%, respectively); most reported having all wanted resources (76% and 90%, respectively). Families declined resources due to lack of perceived need, the HRSN resolving, or families addressed HRSN themselves. White families were more likely to rescreen positive. CONCLUSIONS Pediatric medical homes must honor family-centered decision-making while empowering families to accept beneficial resources. Health care systems should advocate for resources that families need and want.
Collapse
Affiliation(s)
- Placidina Fico
- Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Sidney Atwood
- Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
| | - MaryCatherine Arbour
- Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, Mass.
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Musa-Maliki AU, Duma SE. Barriers to routine screening for intimate partner violence during pregnancy in Nigeria. Heliyon 2024; 10:e30504. [PMID: 38742052 PMCID: PMC11089367 DOI: 10.1016/j.heliyon.2024.e30504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
Background The benefits of routine screening for intimate partner violence (IPV) among pregnant women include early identification, prompt management, referral of IPV victims, and creating awareness about IPV. Despite these benefits, the practice of routine screening of IPV remains limited in midwifery settings in low-income countries. The purpose of this study is to identify and describe midwives' perspectives of the barriers in conducting routine screening of IPV for pregnant women in northern Nigeria. Methods A case study qualitative descriptive design was used to collect data from ten midwives in the antenatal clinic of a tertiary hospital. Non-participant observation and individual face-to-face semi-structured interviews were used as data collection methods. Thematic data analysis was carried out using Yin's five stage analytical cycle. Findings Three themes, with related subthemes, emerged from the data: (i) The theme of "Internal" barriers to IPV screening has four subthemes; midwives' personal discomfort in asking IPV- related questions, perceived mistrust of midwives by pregnant women, midwives' own perceptions of IPV as a personal matter, and midwives' lack of skills to screen for IPV. (ii) "External" barriers to IPV screening subsumes three subthemes: antenatal card related barriers, workload related barriers, and protocol barriers. (iii) "Structural" barriers to IPV screening have two subthemes: lack of space for privacy and lack of resources for managing pregnant women who have experienced IPV. Conclusion Knowing the barriers to midwives' screening practices is important because it may help in the development of contextually relevant and acceptable screening guidelines for midwives in Nigeria. Education and training of midwives will eliminate the internal barriers while the external barriers will need the intervention of hospital authorities and government to eliminate their effects on screening.
Collapse
Affiliation(s)
| | - Sinegugu E. Duma
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
7
|
Kozhimannil KB, Sheffield EC, Fritz AH, Interrante JD, Henning-Smith C, Lewis VA. Health insurance coverage and experiences of intimate partner violence and postpartum abuse screening among rural US residents who gave birth 2016-2020. J Rural Health 2024. [PMID: 38733132 DOI: 10.1111/jrh.12843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/11/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE Intimate partner violence (IPV) is elevated among rural residents and contributes to maternal morbidity and mortality. Postpartum health insurance expansion efforts could address multiple causes of maternal morbidity and mortality, including IPV. The objective of this study was to describe the relationship between perinatal health insurance, IPV, and postpartum abuse screening among rural US residents. METHODS Using 2016-2020 data on rural residents from the Pregnancy Risk Assessment Monitoring System, we assessed self-report of experiencing physical violence by an intimate partner and rates of abuse screening at postpartum visits. Health insurance at childbirth and postpartum was categorized as private, Medicaid, or uninsured. We also measured insurance transitions from childbirth to postpartum (continuous private, continuous Medicaid, Medicaid to private, and Medicaid to uninsured). FINDINGS IPV rates varied by health insurance status at childbirth, with the highest rates among Medicaid beneficiaries (7.7%), compared to those who were uninsured (1.6%) or privately insured (1.6%). When measured by insurance transitions, the highest IPV rates were reported by those with continuous Medicaid coverage (8.6%), followed by those who transitioned from Medicaid at childbirth to private insurance (5.3%) or no insurance (5.9%) postpartum. Nearly half (48.1%) of rural residents lacked postpartum abuse screening, with the highest proportion among rural residents who were uninsured at childbirth (66.1%) or postpartum (52.1%). CONCLUSION Rural residents who are insured by Medicaid before or after childbirth are at elevated risk for IPV. Medicaid policy efforts to improve maternal health should focus on improving detection and screening for IPV among rural residents.
Collapse
Affiliation(s)
- Katy Backes Kozhimannil
- Division of Health Policy and Management, Rural Health Research Center, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Emily C Sheffield
- Division of Health Policy and Management, Rural Health Research Center, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Alyssa H Fritz
- Division of Health Policy and Management, Rural Health Research Center, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Julia D Interrante
- Division of Health Policy and Management, Rural Health Research Center, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Carrie Henning-Smith
- Division of Health Policy and Management, Rural Health Research Center, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Valerie A Lewis
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
8
|
Gaber SN, Rydeman IB, Mattsson E, Kneck Å. Asking about violence and abuse among patients experiencing homelessness: a focus group study with healthcare professionals. BMC Health Serv Res 2024; 24:531. [PMID: 38671423 PMCID: PMC11046839 DOI: 10.1186/s12913-024-10914-3] [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: 07/18/2023] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND People experiencing homelessness are at increased risk of violence and abuse, however, there is insufficient knowledge about rates of inquiry or readiness of healthcare professionals to address violence and abuse among this population. This study aimed to explore healthcare professionals' experiences and perceptions of asking about violence and abuse among patients experiencing homelessness. METHODS This study used a qualitative, interpretive, and exploratory design. We performed focus group discussions with healthcare professionals (n = 22) working at an integrative healthcare unit for people experiencing homelessness. Data were analysed using reflexive thematic analysis, following Braun and Clarke's six-phase approach. Findings are reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS The overarching theme of the analysis is that addressing violence and abuse is at risk of "falling through the cracks". The theme is supported by three sub-themes: Hesitance to address violence and abuse, The complex dynamics of violence and abuse in homelessness, and Challenges in addressing violence and abuse amidst competing priorities and collaborative efforts. The normalisation of violence and abuse within the context of homelessness perpetuates a "cycle" where the severity and urgency of addressing violence and abuse are overlooked or minimised, hindering effective interventions. Moreover, healthcare professionals themselves may inadvertently contribute to this normalisation. The hesitance expressed by healthcare professionals in addressing the issue further reinforces the prevailing belief that violence and abuse are inherent aspects of homelessness. This normalisation within the healthcare system adds another layer of complexity to addressing these issues effectively. CONCLUSIONS The findings underscore the need for targeted interventions and coordinated efforts that not only address the immediate physical needs of people experiencing homelessness but also challenge and reshape the normalised perceptions surrounding violence and abuse. By prioritising awareness, education, and supportive interventions, we can begin to "break the cycle" and provide a safer environment where violence and abuse are not accepted or overlooked.
Collapse
Affiliation(s)
- Sophie Nadia Gaber
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden.
- Department of Women's and Children's Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden.
| | - Ing-Britt Rydeman
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Elisabet Mattsson
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- Department of Women's and Children's Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden
| | - Åsa Kneck
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
| |
Collapse
|
9
|
Witcraft SM, Johnson E, Eitel AE, Moreland AD, King C, Terplan M, Guille C. Listening to Black Pregnant and Postpartum People: Using Technology to Enhance Equity in Screening and Treatment of Perinatal Mental Health and Substance Use Disorders. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01989-z. [PMID: 38605223 DOI: 10.1007/s40615-024-01989-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024]
Abstract
Perinatal mood and anxiety disorders (PMADs), perinatal substance use disorders (PSUDs), and intimate partner violence (IPV) are leading causes of pregnancy-related deaths in the United States. Screening and referral for PMADs, PSUDs and IPV is recommended, however, racial disparities are prominent: Black pregnant and postpartum people (PPP) are less likely to be screened and attend treatment compared to White PPP. We conducted qualitative interviews to better understand the experience of Black PPP who used a text/phone-based screening and referral program for PMADs/PSUDs and IPV-Listening to Women and Pregnant and Postpartum People (LTWP). We previously demonstrated that LTWP led to a significant reduction in racial disparities compared to in-person screening and referral, and through the current study, sought to identify facilitators of PMAD/PSUD symptom endorsement and treatment attendance. Semi-structured interviews were conducted with 68 Black PPP who were or had been pregnant within the last 24 months, and who either had or did not have a PMAD or PSUD. Participants were enrolled in LTWP and provided feedback on their experience. Using a grounded theory approach, four themes emerged: usability, comfort, necessity, and recommendations. Ease of use, brevity, convenience, and comfort in discussing mental health and substance use via text were highlighted. Need for a program like LTWP in Black communities was discussed, given the reduction in perceived judgement and access to trusted information and resources for PMADs/PSUDs, which may lessen stigma. These qualitative findings illuminate how technology-based adaptations to behavioral health screening and referral can reduce perceived negative judgment and facilitate identification and referral to treatment, thereby more adequately meeting needs of Black PPP.
Collapse
Affiliation(s)
- Sara M Witcraft
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, MSC 861, 29425, Charleston, SC, USA.
| | - Emily Johnson
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street, MSC 160, 29425, Charleston, SC, USA
| | - Anna E Eitel
- College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, MSC 617, 29425, Charleston, SC, USA
| | - Angela D Moreland
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, MSC 861, 29425, Charleston, SC, USA
| | - Courtney King
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, MSC 861, 29425, Charleston, SC, USA
| | - Mishka Terplan
- Friends Research Institute, 1040 Park Avenue, Ste. 103, 21201, Baltimore, MD, USA
| | - Constance Guille
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, MSC 861, 29425, Charleston, SC, USA
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston South Carolina, 171 Ashley Ave, 29425, Charleston, SC, USA
| |
Collapse
|
10
|
Waltzman D, Daugherty J, Haarbauer-Krupa J, Zheng X, Jorge C, Basile KC. Association Between Lifetime Sexual Violence and Recent Traumatic Brain Injury Among Adults: 2017 Connecticut Behavioral Risk Factor Surveillance System. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1351-1367. [PMID: 37804158 PMCID: PMC10962142 DOI: 10.1177/08862605231203962] [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] [Indexed: 10/09/2023]
Abstract
Sexual violence (SV) is a critical public health problem that is associated with numerous negative health consequences, including immediate- and long-term physical and mental health conditions and health-risk behaviors. Some of these health-risk behaviors (e.g., substance use, unsafe driving practices, poor mental health, lower impulse control, and abnormal brain circuitry) might increase the risk for sustaining a traumatic brain injury (TBI). A TBI causes neurological or neuropsychological changes and may also lead to various symptoms that affect a person's cognition, mobility, behavior, and mental health. Determining if those who have experienced SV are at increased risk of sustaining a TBI in their lifetime is critical given the high prevalence and health impacts of SV, the potential vulnerability to TBI after SV, and the known detrimental effects of TBI. This exploratory study examined data from the 2017 Connecticut behavioral risk factor surveillance system and found that lifetime SV victimization (controlling for age and sex) was associated with increased odds of reporting a recent TBI in the past 12 months (adjusted odds ratio [AOR] = 2.1; 95% confidence interval [CI] [1.03, 4.21]). Further research is needed to better understand how SV history is related to the risk of sustaining a TBI. Healthcare professionals can support patients who experience SV by providing resources to help reduce associated physical and mental health conditions and health-risk behaviors.
Collapse
Affiliation(s)
- Dana Waltzman
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jill Daugherty
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Juliet Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xi Zheng
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Celeste Jorge
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Kathleen C. Basile
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
11
|
Sherman ADF, Higgins MK, Balthazar MS, Hill M, Klepper M, Schneider JS, Adams D, Radix A, Mayer KH, Cooney EE, Poteat TC, Wirtz AL, Reisner SL. Stigma, social and structural vulnerability, and mental health among transgender women: A partial least square path modeling analysis. J Nurs Scholarsh 2024; 56:42-59. [PMID: 38228564 PMCID: PMC10792251 DOI: 10.1111/jnu.12906] [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: 08/26/2022] [Revised: 03/22/2023] [Accepted: 04/20/2023] [Indexed: 01/18/2024]
Abstract
INTRODUCTION Existing literature suggests that transgender women (TW) may be at high risk for adverse mental health due to stress attributed to combined experiences of stigma and complex social and structural vulnerabilities. Little research has examined how these co-occurring experiences relate to mental health. We aimed to test a theoretically driven conceptual model of relationships between stigma, social and structural vulnerabilities, and mental health to inform future intervention tailoring. DESIGN/METHODS Partial least square path modeling followed by response-based unit segmentation was used to identify homogenous clusters in a diverse community sample of United States (US)-based TW (N = 1418; 46.2% White non-Hispanic). This approach examined associations between latent constructs of stigma (polyvictimization and discrimination), social and structural vulnerabilities (housing and food insecurity, unemployment, sex work, social support, and substance use), and mental health (post-traumatic stress and psychological distress). RESULTS The final conceptual model defined the structural relationship between the variables of interest within stigma, vulnerability, and mental health. Six clusters were identified within this structural framework which suggests that racism, ethnicism, and geography may be related to mental health inequities among TW. CONCLUSION Our findings around the impact of racism, ethnicism, and geography reflect the existing literature, which unfortunately shows us that little change has occurred in the last decade for TW of color in the Southern US; however, the strength of our evidence (related to sampling structure and sample size) and type of analyses (accounting for co-occurring predictors of health, i.e., stigma and complex vulnerabilities, reflecting that of real-world patients) is a novel and necessary addition to the literature. Findings suggest that health interventions designed to offset the negative effects of stigma must include anti-racist approaches with components to reduce or eliminate barriers to resources that contribute to social and structural vulnerabilities among TW. Herein we provide detailed recommendations to guide primary, secondary, and tertiary prevention efforts. CLINICAL RELEVANCE This study demonstrated the importance of considering stigma and complex social and structural vulnerabilities during clinical care and design of mental health interventions for transgender women who are experiencing post-traumatic stress disorder and psychological distress. Specifically, interventions should take an anti-racist approach and would benefit from incorporating social support-building activities.
Collapse
Affiliation(s)
| | - Melinda K. Higgins
- Nell Hodson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Monique S. Balthazar
- Nell Hodson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Georgia State University Byrdine F. Lewis College of Nursing and Health Professions, Atlanta, Georgia, USA
| | - Miranda Hill
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Jason S. Schneider
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Dee Adams
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Asa Radix
- Department of Medicine, Callen-Lorde Community Health Center, New York, New York, USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA
| | - Erin E. Cooney
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tonia C. Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Andrea L. Wirtz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sari L. Reisner
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | |
Collapse
|
12
|
Teshome L, Adugna H, Deribe L. Health providers readiness in managing intimate partner violence in public health institutions, Ethiopia. PLoS One 2023; 18:e0295494. [PMID: 38134007 PMCID: PMC10745191 DOI: 10.1371/journal.pone.0295494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/25/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Intimate Partner Violence (IPV) is a worldwide public health problem and major human and legal rights abuses of women. It affects the physical, sexual, and psychological aspects of the victims therefore, it requires complex and multifaceted interventions. Health providers are responsible for providing essential healthcare services for IPV victims. However, there is a lack of detailed information on whether or not health providers are ready to identify and manage IPV. Therefore, this study aimed to assess health providers' readiness and associated factors in managing IPV in public health institutions at Hawassa, Ethiopia. METHOD Institutional based cross-sectional study was conducted through a simple random sample of 424 health providers. Data was collected with an anonymous questioners using physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool. Linear regression analysis was used to examine relationships among variables. The strength of association was assessed by using unstandardized β with 95% CI. RESULTS The mean score of perceived provider's readiness in managing IPV was 26.18± 6.69. Higher providers age and providers perceived knowledge had positive association with provider perceived readiness in managing IPV. Whereas not had IPV training, absence of a protocol for dealing with IPV management, and provider attitude had a negative association with provider perceived readiness in managing IPV. CONCLUSION AND RECOMMENDATION This study reviled that health providers had limited perceived readiness to manage IPV. Provision of training for providers and develop protocol for IPV managements have an important role to improve providers readiness in the managements of IPV.
Collapse
Affiliation(s)
- Lidiya Teshome
- Midwifery Department, Hawassa Health Science College, Hawassa, Ethiopia
| | - Haweni Adugna
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Leul Deribe
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
13
|
Bourdeau AI, Harley KG, Nguyen AM. Association between maternity care practitioner type and postpartum depression screening. Birth 2023; 50:923-934. [PMID: 37435935 DOI: 10.1111/birt.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 02/27/2023] [Accepted: 06/01/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Postpartum depression (PPD) is increasingly common in the United States and poses a significant threat to maternal and neonatal health. Universal screening for postpartum depression is recommended by numerous organizations, including the American College of Obstetricians and Gynecologists, but is not achieved in practice. METHODS A cross-sectional, weighted, state-representative study of California residents who gave birth in 2016 using the Listening to Mothers in California 2018 data set. Primary exposure was type of maternity care professional providing care during pregnancy, and the primary outcome was PPD screening. The secondary exposure was self-reported depression or anxiety during pregnancy, and the secondary outcome was attending a postpartum office visit. Bivariate analyses were conducted using Rao-Scott chi-square tests, and multivariate analyses were conducted using logistic regression. RESULTS Compared to participants cared for by obstetricians, participants cared for by midwives had 2.6 times the odds of reporting being screened for PPD after controlling for covariates (95% CI = 1.5, 4.4). Receiving care from any other practitioner type compared with an obstetrician was not associated with a different rate of postpartum depression screening. Reporting depression or anxiety during pregnancy was associated with 0.7 times the odds (95% CI = 0.5, 1.0) of returning for postpartum care after controlling for covariates. CONCLUSIONS Being cared for by a midwife during pregnancy increases the likelihood of being screened for postpartum depression. In addition, even perfectly implemented universal screening will miss a vulnerable sector of the population that is at high risk for postpartum depression and is less likely to return for postpartum care.
Collapse
Affiliation(s)
- Althea I Bourdeau
- School of Public Health, University of California, Berkeley, California, USA
| | - Kim G Harley
- School of Public Health, University of California, Berkeley, California, USA
| | | |
Collapse
|
14
|
Willie TC, Alexander KA, Sharpless L, Zemlak JL, Smith MV, Kershaw TS. Recent Economic Intimate Partner Violence and Posttraumatic Stress Symptoms Among a Racially and Ethnically Diverse Sample of U.S. Women Experiencing Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11091-11116. [PMID: 37387530 DOI: 10.1177/08862605231178357] [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] [Indexed: 07/01/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a prevalent consequence of physical and sexual intimate partner violence (IPV); however, little is known about the unique contributions of economic IPV. Furthermore, women's economic self-sufficiency may explicate the potential relationship between economic IPV and PTSD symptoms. Guided by the Stress Process Theory and Intersectionality, this study examined associations between economic IPV and women's PTSD symptoms and assessed economic self-sufficiency as a mediator. Participants were 255 adult women experiencing IPV recruited from metropolitan Baltimore, MD, and the state of CT who participated in two different studies. Participants completed surveys on IPV, economic self-sufficiency, and PTSD. Path analyses were conducted to examine direct and indirect associations of economic IPV with economic self-sufficiency and PTSD. Economic IPV was uniquely associated with PTSD symptoms while controlling for other forms of IPV. Economic self-sufficiency significantly partially mediated the association between economic IPV and PTSD symptoms such that economic IPV was associated with PTSD symptoms through economic self-sufficiency. Economic IPV may limit women's ability to make autonomous decisions related to finances, which could be distressing. The mental health impact of economic IPV may be particularly debilitating for women with low economic self-sufficiency as their posttraumatic stress occurs within the context of feeling unable to meet their financial goals and also having a partner control their economic resources. Fostering economic empowerment and asset building may be a strengths-based approach to reduce the PTSD symptomatology among women experiencing IPV.
Collapse
Affiliation(s)
- Tiara C Willie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Megan V Smith
- Yale School of Public Health, New Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | | |
Collapse
|
15
|
Alhusen J, McDonald M, Emery B. Intimate partner violence: A clinical update. Nurse Pract 2023; 48:40-46. [PMID: 37643145 DOI: 10.1097/01.npr.0000000000000088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
ABSTRACT Intimate partner violence (IPV) is a significant public health issue associated with substantial morbidity and mortality. NPs are ideally positioned to screen for and intervene in IPV, thereby mitigating the health risks IPV carries for women, infants, and young children. Safety planning and appropriate referrals to community-based resources are critical components of addressing IPV.
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Lévesque S, Rousseau C, Raynault-Rioux L, Laforest J. Canadian service providers' perspectives on reproductive coercion and abuse: a participatory action research to address their needs and support their actions. Reprod Health 2023; 20:100. [PMID: 37391776 PMCID: PMC10311789 DOI: 10.1186/s12978-023-01640-w] [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: 09/30/2022] [Accepted: 06/16/2023] [Indexed: 07/02/2023] Open
Abstract
Reproductive coercion and abuse (RCA) is a form of violence that affects sexual and reproductive health. Women and individuals who experienced RCA in an intimate relationship frequently consult service providers (SPs), such as health professionals or violence counselors. The objective of this article, which is the result of a participative action research project targeting RCA perpetrated by in an intimate partner, is twofold: (1) to better understand the practices as well as the barriers and facilitators encountered by SPs and (2) to develop information and awareness tools with them that meet their needs. To this end, we first held focus groups with 31 SPs. The use of thematic analysis revealed intervention strategies that focus on caring and listening, identifying signs of RCA, and creating a safe environment for disclosure. Their practices also focused on harm-reduction strategies and effective referrals. Despite the importance they gave to this issue, lack of time, inappropriate settings, and inadequate training hindered them from intervening effectively with individuals who were victims of RCA. They also indicated the need for easy-to-follow practice guidelines and patient education tools. Based on these findings and the best practices identified in the grey and scientific literature, we developed a practice guide for SPs and a booklet on RCA. The development of these guide and booklets involved a lot of back and forth to meet the needs expressed by the community and health professionals.
Collapse
Affiliation(s)
- Sylvie Lévesque
- Sexology Department, Université du Québec à Montréal, CP 8888, Succ. Centre-Ville, Montréal, QC, H3C 3P8, Canada.
| | - Catherine Rousseau
- Population Health, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Julie Laforest
- Population Health and Well-Being, Institut National de Santé Publique du Québec, Montréal, Canada
| |
Collapse
|
18
|
Price A, Couch K. Patient-Centered Intimate Partner Violence Screening, Brief Intervention, and Referral to Treatment. Nurs Womens Health 2023:S1751-4851(23)00120-4. [PMID: 37321558 DOI: 10.1016/j.nwh.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/12/2023] [Accepted: 05/10/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To increase rates of screening for intimate partner violence (IPV), education, and follow-up of women being seen at a private obstetrics and gynecology clinic to 52% in 90 days. DESIGN Quality improvement project. SETTING/LOCAL PROBLEM IPV screening was not the standard of care at a private suburban obstetric and gynecologic practice. METHODS This project used an evidence-backed model for improvement that incorporated plan-do-study-act cycles to implement four core interventions. INTERVENTIONS The Hurt, Insult, Threaten, Scream (HITS) screening tool, the investigator-developed Duluth model tool, a case management log, and a team engagement plan were implemented. RESULTS Implementation of the HITS screening tool was associated with an increase in IPV screening to 94.7% from a baseline of 2.5%. In addition, the IPV disclosure rate increased 7.5% over the course of the initiative. The majority of staff (64%) participated in IPV educational offerings, and an increase in IPV knowledge was noted in team surveys, on which scores increased from 68% to 76.9%. CONCLUSION The combined use of the HITS screening tool and the Duluth model tool were associated with increased rates of IPV screening. Women who screened positive for IPV were referred to appropriate resources. These findings can be used as a guide for clinics to implement IPV screening into practice.
Collapse
|
19
|
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.
Collapse
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
| |
Collapse
|
20
|
Adhia A, Rebbe R, Lane Eastman A, Foust R, Putnam-Hornstein E. Intimate Partner Violence-Related Emergency Department and Hospital Visits in California Following the ICD-10-CM Transition, 2016-2018. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:6230-6241. [PMID: 36196989 DOI: 10.1177/08862605221127220] [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: 06/16/2023]
Abstract
With the transition to the International Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification (ICD-10-CM), additional research is needed to understand which diagnostic codes for intimate partner violence (IPV) are being used. The current study examined characteristics of IPV visits and frequency of diagnostic codes to identify IPV in all emergency department (ED) and inpatient hospital visits for adults in California from 2016-2018, after ICD-10-CM implementation. Five ICD-10-CM codes outlined in the Uniform Data System Reporting Instructions were used to identify IPV. Fewer than 0.1% of visits (17,347 ED visits and 1,430 hospitalizations) included documentation of IPV. Visits with documented IPV were more common among patients who were younger, female, Black, primarily English-speaking, and publicly insured compared to visits with no documented IPV. There were fairly consistent patterns over time in the specific ICD-10-CM codes used for IPV between 2016 and 2018. Physical and sexual abuse were the most common codes for types of abuse. Among the 15 EDs and 15 hospitals in California with the highest volume of IPV visits, there was variability in the use of ICD-10-CM codes for IPV visits. Accurate documentation of IPV in administrative data may improve patient care and increase understanding of the burden and effects of IPV on individuals and communities.
Collapse
Affiliation(s)
- Avanti Adhia
- University of Washington School of Nursing, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | - Rebecca Rebbe
- University of Southern California, Los Angeles, CA, USA
| | | | - Regan Foust
- University of Southern California, Los Angeles, CA, USA
| | - Emily Putnam-Hornstein
- University of Southern California, Los Angeles, CA, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
21
|
Baloch S, Hameed M, Hegarty K. Health Care Providers Views on Identifying and Responding to South Asian Women Experiencing Family Violence: A Qualitative Meta Synthesis. TRAUMA, VIOLENCE & ABUSE 2023; 24:794-808. [PMID: 35044880 DOI: 10.1177/15248380211043829] [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: 05/03/2023]
Abstract
Family violence (FV) is a universal public health problem in South Asia with negative-health outcomes for South Asian women. Health care providers (HCPs) play a pivotal role in identifying and supporting women experiencing FV, but little is known about their experiences with South Asian women. A systematic review was conducted to explore and address health care providers' views on identification and response to South Asian women experiencing FV. Nine online databases, reference lists were searched, and a priori inclusion and exclusion criteria were applied independently by two reviewers. A meta-synthesis approach was utilized to integrate findings from qualitative studies. Eight studies involving 250 participants met the inclusion criteria. Studies were published between 2007 and 2020 within South Asian countries (Pakistan, India, and Sri Lanka) and one study from the USA and UK. The meta-synthesis identified three themes: Context of societal norms and attitudes towards women in South Asia; Influence of family honor, Privacy and shame; and Concern about health care provider's personal safety. Findings revealed that FV is often perceived as a normal routine issue and is considered a "private issue" in South Asian society. Family honor and values play a pivotal role in silencing women experiencing FV as disclosure is considered shameful and disgrace to family honor. Furthermore, health care providers avoid intervening in FV cases due to risk for their personal safety. Finally, this review provides the evidence to support a specific framework for FV interventions among south Asian women for policy makers and practitioners.
Collapse
Affiliation(s)
- Surriya Baloch
- 2281The University of Melbourne, Melbourne, VIC, Australia
| | - Mohajer Hameed
- 2281The University of Melbourne, Melbourne, VIC, Australia
| | - Kelsey Hegarty
- 2281The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
22
|
Yang J, Parent MC, Johnson NL. The Role of Minority Stressors in Digital Dating Abuse Victimization and Perpetration among Sexual Minority Men. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3906-3923. [PMID: 36000406 DOI: 10.1177/08862605221109920] [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: 06/15/2023]
Abstract
Digital dating abuse (DDA), a manifestation of intimate partner violence (IPV), is becoming more relevant. Despite elevated rates of IPV among sexual minority individuals and increased experiences of DDA, research has focused largely on face-to-face forms of IPV (e.g., physical assault) among presumed heterosexual couples. The minority stress theory offers a lens through which we can understand the elevated rates of IPV, including DDA, among sexual minority individuals. The purpose of this study was to explore the role of minority stressors in DDA victimization and perpetration among sexual minority men. A sample of 491 cisgender gay and bisexual men (Mage = 31.35, SDage = 11.60) was recruited online. Consistent with prior research, discrimination was associated positively with internalized homophobia (IHP). Discrimination and IHP were directly linked to DDA victimization and perpetration. Indirect effect from discrimination to DDA victimization and perpetration, mediated by IHP, were significant. This study highlights the relationship between minority stressors and DDA among sexual minority men and indicates the need for more work on DDA among marginalized groups including sexual and gender minorities.
Collapse
|
23
|
Sweeny AL, Bourke C, Torpie TM, Sargeant S, Hughes J, Watson J, Conroy S, Carrasco A, Tighe K, Thornton NS, Cumner AS, Baird K. Improving domestic violence screening practices in the emergency department: an Australian perspective. J Accid Emerg Med 2023; 40:114-119. [PMID: 35288455 DOI: 10.1136/emermed-2021-211167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/24/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Domestic violence (DV) is a major cause of morbidity worldwide. The ED is a location recommended for opportunistic screening. However, screening within EDs remains irregular. OBJECTIVE To examine intrinsic and extrinsic barriers to routine screening in Australian EDs, while describing actions taken after identification of DV. METHODS Emergency clinicians at nine public hospitals participated in an anonymous online survey. Factor analysis was performed to identify principal components around attitudes and beliefs towards screening. RESULTS In total, 496 emergency clinicians participated. Universal screening was uncommon; less than 2% of respondents reported screening all adults or all women. Although willing, nearly half (45%) reported not knowing how to screen. High patient load and no single rooms were 'very or severely limiting' for 88% of respondents, respectively, while 24/7 social work and interpreter services, and online/written DV protocols were top enablers. Factor analysis identified four distinct intrinsic belief components: (1) screening is not futile and could be done in ED, (2) screening will not cause harm, (3) there is a duty to screen and (4) I am willing to screen. CONCLUSION This study describes a culture of Queensland ED clinicians that believe DV screening in ED is important and interventions are effective. Most ED clinicians are willing to screen. In this setting, availability of social work and interpreter services are important mitigating resources. Clinician education focusing on duty to screen, coupled with a built-in screening tool, and e-links to a local management protocol may improve the uptake of screening and subsequently increase detection.
Collapse
Affiliation(s)
- Amy Lynn Sweeny
- Emergency Department, Gold Coast Hospital and Health Service, Southport, Queensland, Australia .,School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Caitlin Bourke
- Emergency Medicine, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Faculty of Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Thomas Martin Torpie
- Emergency Department, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Sally Sargeant
- School of Health and Human Services, Southern Cross University - Gold Coast Campus, Coolangatta, Queensland, Australia
| | - James Hughes
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Julie Watson
- Social Work, Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Sheree Conroy
- Emergency Department, Darling Downs Hospital and Health Service, Toowoomba, Queensland, Australia
| | - Angel Carrasco
- Social Work and Support Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Kym Tighe
- Social Work and Support Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | | | - Amber-Shea Cumner
- Emergency Department, Gold Coast Hospital and Health Service, Southport, Queensland, Australia.,School of Social Work, Griffith University Faculty of Health, Gold Coast, Queensland, Australia
| | - Kathleen Baird
- Midwifery, University of Technology Sydney, Sydney, New South Wales, Australia.,School of Nursing and Midwifery, Griffith University Faculty of Health, Gold Coast, Queensland, Australia
| |
Collapse
|
24
|
Heyman RE, Lorber MF, Kim S, Wojda-Burlij AK, Stanley SM, Ivic A, Snyder DK, Rhoades GK, Whisman MA, Beach SRH. Overlap of relationship distress and intimate partner violence in community samples. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2023; 37:37-44. [PMID: 36048072 PMCID: PMC9870926 DOI: 10.1037/fam0001031] [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] [Indexed: 05/24/2023]
Abstract
Mixed-gender couples presenting for couple therapy are at 2-3 times higher risk for physical intimate partner violence (IPV) than community couples. However, it is unclear if this elevation of relative risk is the same in the general population because relationship distress and treatment-seeking are often confounded. We used archival data from three representative U.S. civilian samples and one representative U.S. Air Force sample to test the hypothesis that clinically significant relationship distress is associated with increased risk of various forms of IPV. In these community samples, those in mixed-gender distressed relationships were at 2-3 times higher risk than those in nondistressed relationships for any physical IPV during the past year and at 3-6 times higher risk for clinically significant psychological and physical IPV during the past year. Given that the increase in IPV risk is similar for individuals in distressed community relationships and therapy-seeking relationships, the prior findings of the elevated rates of IPV in clinical samples are unlikely to be due to therapy-seeking. Although epidemiological risk involves statistical, not causal, associations, the increased co-occurrence of IPV in distressed mixed-gender couples fits with numerous theories of IPV and has implications for both screening and future research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | - Sangwon Kim
- Family Translational Research Group, New York University
| | | | | | - Ana Ivic
- Family Translational Research Group, New York University
| | - Douglas K. Snyder
- Department of Psychological and Brain Sciences, Texas A&M University
| | | | - Mark A. Whisman
- Department of Psychology and Neuroscience, University of Colorado
| | | |
Collapse
|
25
|
Mejri N, Lajnef I, Berrazega Y, Rachdi H, Bohli M, Kochbati L, Hamouda B. Intimate partner violence after cancer diagnosis: an SOS call. Support Care Cancer 2023; 31:103. [PMID: 36622425 DOI: 10.1007/s00520-022-07571-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/30/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE The aim of the present study was to measure the frequency and types of IPV among patients with cancer and evaluate risk factors. METHODS The study was a cross-sectional, questionnaire-based study, conducted between January and April 2022, including 141 patients treated with cancer regardless of gender, site, or stage. We developed the study questionnaire by adapting items from the "WHO multi-country questionnaire on violence against women" and "The Women's Experiences with Battering Scale." Odds ratio (OR) and spearman tests were performed to assess the impact of several factors associated with the reported IPV. RESULTS Median age was 50 years old, 38.3% were male cancer patients. IPV prevalence was 24.8%, we observed 5 cases of torture (3%). The most common forms of violence were placing severe restriction on certain types of food and clothing in 21%, psychological violence in 20%, exposing intimate information about the patient health status to others in 17%, ignoration in 13.5%, putting restrictions on visiting friends or families in 9.2%, verbal assault in 9.2%, physical violence in 7.9%, and 7.1% racist conducts. Financial violence was rare in 4.3%. There was no difference in the incidence of IPV between man and women. We observed a significant correlation between IPV prevalence and disease stage (19.1% M0 vs 34.6% M1, p=0.04, OR=2.2 [1-4.8]), patient's educational level (48.5% vs 17.6%, p=0.01, OR= 4.4 [1.8-10.2]), and being under ongoing cancer therapy (11.4% vs 30.9%, p=0.013, OR=3.4 [1.2-9.7]) CONCLUSION: Patients were shown to be victims of several forms of IPV regardless of gender.
Collapse
Affiliation(s)
- Nesrine Mejri
- Medical Oncology Department, Abderrahmen Mami Hospital, Ariana, Tunisia.
| | - Ines Lajnef
- Medical Oncology Department, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Yosra Berrazega
- Medical Oncology Department, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Haifa Rachdi
- Medical Oncology Department, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Mariem Bohli
- Radiation Therapy Department, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Lotfi Kochbati
- Radiation Therapy Department, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Boussen Hamouda
- Medical Oncology Department, Abderrahmen Mami Hospital, Ariana, Tunisia
| |
Collapse
|
26
|
Collins K, Kochuparambil Sebastian S, Franck G. Improving Domestic Violence Screening and Follow-Up in a Community Health Clinic. J Prim Care Community Health 2023; 14:21501319231189074. [PMID: 37503785 PMCID: PMC10387764 DOI: 10.1177/21501319231189074] [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: 03/19/2023] [Revised: 06/02/2023] [Accepted: 06/30/2023] [Indexed: 07/29/2023] Open
Abstract
PURPOSE To implement an improved DV screening and follow-up protocol at a suburban community health clinic that is consistently used by staff with appropriate female patients as well as to assess provider/staff barriers to this. METHODS The project was completed at a community health clinic and included 2 presentations: the first to outline current practices as well as the intervention plan at the pre-intervention time point and then to review results of the intervention and elicit feedback post intervention. Provider/staff barrier surveys were completed at both time points. The intervention consisted of completion of the HITS DV screening tool on all appropriate female patients and a system-level algorithm-based follow-up care plan for positive cases. RESULTS Eligible patient screening increased by 3.1% and patients screening positive increased from 0 to 1 from baseline to intervention. Average scores on the barrier surveys improved for all questions and improved significantly for 3 of the questions. The algorithm implemented was utilized for the positive screening. CONCLUSIONS Use of a DV screening tool, that has shown good concurrent and construct validity in the literature, a system-level algorithm for follow-up care and addressing provider/staff barriers to screening and follow-up are essential components of a successful DV screening and follow-up program.
Collapse
Affiliation(s)
| | | | - Gwyneth Franck
- The University of Illinois at Chicago College of Nursing, USA
| |
Collapse
|
27
|
Dobarrio-Sanz I, Fernández-Vargas A, Fernández-Férez A, Vanegas-Coveña DP, Cordero-Ahiman OV, Granero-Molina J, Fernández-Sola C, Hernández-Padilla JM. Development and Psychometric Assessment of a Questionnaire for the Detection of Invisible Violence against Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11127. [PMID: 36078848 PMCID: PMC9518585 DOI: 10.3390/ijerph191711127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/02/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Invisible violence against women (IVAW) can be understood as the set of attitudes, behaviors, and subtle beliefs that men use to subordinate women and that are culturally accepted. These behaviors can be a risk factor for intimate partner violence (IPV), so it is important to design tools that allow us to detect it early. The aim of this study was to design and psychometrically assess a questionnaire for the detection of invisible violence against women (Q-IVAW). METHODOLOGY A descriptive cross-sectional methodological study carried out in three phases: (1) development of the initial version; (2) pilot study (N = 51); and (3) final validation study (N = 990). The tool's reliability, validity, and legibility were assessed. To assess reliability, the internal consistency (Cronbach's α) was analyzed. The validity assessment included an analysis of content, criterion, and construct validity. RESULTS The EFA revealed that the Q-IVAW was comprised of five factors that explained 55.85% of the total variance found. The Q-IVAW showed very high reliability (α = 0.937), excellent content validity, and good construct validity. The criterion validity analysis showed a moderate correlation between A-IPVAW and Q-IVAW (r = 0.30; p < 0.001). CONCLUSION The psychometric assessment of the Q-IVAW yielded good results, which could support the tool's ability to assess how often women are subjected to inviable violent behaviors by their partners.
Collapse
Affiliation(s)
- Iria Dobarrio-Sanz
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
| | | | | | | | - Otilia Vanessa Cordero-Ahiman
- Grupo de Investigación en Economía Regional (GIER), Facultad de Ciencias Económicas y Administrativas, Universidad de Cuenca, Cuenca 010107, Ecuador
| | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 7500000, Chile
| | - Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 7500000, Chile
| | | |
Collapse
|
28
|
Li Q, Zeng J, Zhao B, Perrin N, Campbell J. Chinese nurses' preparedness and opinions in responding to intimate partner violence: An adaptation and validation study. J Adv Nurs 2022; 78:3847-3859. [PMID: 35975282 DOI: 10.1111/jan.15415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 07/16/2022] [Accepted: 08/03/2022] [Indexed: 11/30/2022]
Abstract
AIM To adapt and psychometrically test two scales from The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) for measuring nurses' preparedness to manage intimate partner violence (IPV) and opinions on IPV in China. DESIGN A cross-sectional study for cross-cultural adaptation and validation of instruments. METHODS The study was conducted in two tertiary hospitals in northeastern and southwestern China in 2020: (Step 1) translation and back-translation by four translators; (Step 2) expert consultation to assess content validity by a five-person panel; (Step 3) cognitive debriefing to evaluate the online survey with six nurses; (Step 4) pilot testing to finalize the survey with 79 nurses; and (Step 5) psychometric evaluation of construct validity and internal consistency reliability including post hoc analysis with 1071 nurses. RESULTS The Chinese scales of Perceived Preparation and Opinions demonstrated generally acceptable content validity, construct validity and internal consistency reliability; some factor analysis results were uninterpretable, and socially desirable responses existed. A post hoc inspection of item and score distributions assisted the item classification into Confident, Cautious and Concerned regarding the authenticity of nurses' responses. CONCLUSION Reliability and construct validity of the Chinese versions of Perceived Preparation and Opinions were supported in this sample. The instrument measures nurses' preparedness and opinions towards IPV. Item classification into Confident, Cautious and Concerned categories is a pragmatic way to interpret the results. IMPACT The Chinese scales can be used to measure nurses' preparedness and opinions towards IPV in China. The study also provides an approach for interpretation of results and identification of socially desirable responses in validation and survey studies in other contexts. The adaptation and use of the Chinese scales serve as a primary step in responding to IPV in China's health sector and can be used as a template for adapting the instrument in other low- and middle-income countries.
Collapse
Affiliation(s)
- Quanlei Li
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jing Zeng
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Bing Zhao
- School of Nursing, Shenyang Medical College, Shenyang, China
| | - Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | |
Collapse
|
29
|
Hegarty KL, Andrews S, Tarzia L. Transforming health settings to address gender‐based violence in Australia. Med J Aust 2022; 217:159-166. [PMID: 35796723 PMCID: PMC9546247 DOI: 10.5694/mja2.51638] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 12/02/2022]
Abstract
Gender‐based violence includes intimate partner violence, sexual violence and other harmful acts directed at people based on their gender. It is common in Australia and causes great ill health, especially for women victims/survivors, with Indigenous women particularly affected. Health services are an opportune place for early intervention for victims/survivors of gender‐based violence as they attend frequently. Interventions that are evidence‐based and respond to consensus from victim/survivor voices include universal education, screening in antenatal care, first line supportive care, and referral for advocacy and psychological interventions, including mother–child work. Health care staff require training, protocols, scripts, referral pathways, understanding of cultural safety and antiracist practice in service delivery, and leadership support to undertake this sensitive work, including support, if needed, for their own experiences of gender‐based violence. Using a trauma‐, violence‐ and gender‐informed approach across health systems, taking into account structural inequities, is essential to sustain the gender‐based violence work in health services. Gender‐based violence experienced by Indigenous women is distinct and of urgent concern as rates rapidly increase. Inequities across the health system are pronounced for Indigenous women.
Collapse
Affiliation(s)
- Kelsey L Hegarty
- Safer Families Centre University of Melbourne Melbourne VIC
- Centre for Family Violence Prevention, Royal Women’s Hospital Melbourne VIC
| | - Shawana Andrews
- Safer Families Centre University of Melbourne Melbourne VIC
- Melbourne Poche Centre for Indigenous Health University of Melbourne Melbourne VIC
| | - Laura Tarzia
- Safer Families Centre University of Melbourne Melbourne VIC
- Centre for Family Violence Prevention, Royal Women’s Hospital Melbourne VIC
| |
Collapse
|
30
|
Almegewly WH, Hawamdah S, Moussa FL, Dator WLT, Alonezi A, Al-Eissa M. Measuring Nurses' and Physicians' Attitudes and Perceptions of the Appropriate Interventions towards Intimate Partner Violence in Saudi Arabia. Healthcare (Basel) 2022; 10:1430. [PMID: 36011088 PMCID: PMC9408212 DOI: 10.3390/healthcare10081430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/26/2022] [Accepted: 07/26/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Intimate partner violence (IPV) is considered the most common form of violence against women worldwide, concerning public health, safety, and human rights. However, little to no studies in Saudi Arabia have explored the attitude and perception of health care providers working in emergency departments toward IPV. This study aimed to measure the attitude and perception of Emergency Room (ER) health care providers towards the appropriate intervention for IPV. Methods: This is a cross-sectional quantitative study. Data was collected from a convenient sample of nurses (n = 88) and physicians (n = 18) working in ER, using Readiness to Manage Intimate Partner Violence Survey (PREMIS). Data was collected from two hospitals in Riyadh, Saudi Arabia, and descriptive analysis was used to analyze the data. Results: The majority of the respondents were aged 18−40 (n = 106, 78%), while 22% were 41−60 years old, 69% were female, and 31% were male. Eighty-five percent were nurses and 15% were physicians. The majority of the respondents did not have any training on IPV and had gained knowledge or skills mostly during their medical/nursing classroom and clinical training. The analysis revealed that the participants had moderate levels of overall preparedness, knowledge about IPV, and perceived knowledge, with a mean score of 2.30, 18.62, and 2.18, respectively. The respondents had low scores in practice issues in new diagnosis (0.91), current screening (1.69), and actions when IPV is identified (0.91). The perceived preparedness and knowledge have a significant positive correlation, as shown by an r value of 0.8476 and a p-value of <0.05. Conclusion: The study shows that participants stated minimal previous IPV knowledge and training. It is necessary to put in place adequate resources and specific training programs to overcome this issue for both ER nurses and physicians.
Collapse
Affiliation(s)
- Wafa Hamad Almegewly
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | | | - Fatchima Laouali Moussa
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (F.L.M.); (W.L.T.D.)
| | - Wireen Leila Tanggawohn Dator
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (F.L.M.); (W.L.T.D.)
| | - Anwar Alonezi
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | - Majid Al-Eissa
- Department of National Family Safety Program, Ministry of National Guard Health Affairs (MNGHA), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia;
- Department of Pediatrics, King Abdullah International Medical Research Center (KAIMRC), Riyadh 11481, Saudi Arabia
| |
Collapse
|
31
|
Maranhão DDA, Ramos GGF, Galfano GS, Troster EJ. Knowledge of gynecologists in the public health system care of women victims of violence. Rev Assoc Med Bras (1992) 2022; 68:759-764. [PMID: 35766688 PMCID: PMC9575881 DOI: 10.1590/1806-9282.20211003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/05/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE: This study aimed to evaluate the knowledge of the obstetricians and
gynecologists in the care of women victims of violence in the public health
system and the existence of institutional mechanisms to support them. METHODS: A cross-sectional and observational study was conducted with an electronic
questionnaire by physicians who provided care in the obstetrics and
gynecology emergency unit of the public health system. This study aimed to
identify the care for victims of violence who received the institutional
mechanisms of support, the difficulties encountered in determining the
appropriate care, and estimates of the prevalence of violence against
women. RESULTS: Notably, 92 physicians responded to the questionnaire. Of these, 85% had
already provided care in one or more cases of violence, and 60% believed
that <20% of the women received adequate care in these cases, mainly due
to the short-time frame of the consultation, lack of team preparation, and
lack of institutional resources. A total of 61% of the participants believed
that they were not prepared to provide adequate care in those cases. CONCLUSIONS: Most of the physicians interviewed, although reported to have sufficient
knowledge to adequately treat victims of violence, did not provide such care
due to lack of institutional support.
Collapse
|
32
|
Kosiak K, Contreras IM, Stoever J, Toohey J, Novaco RW. Organization-Based Factors Bearing on Provider Screening and Referral Practices for Women Exposed to Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11520-NP11540. [PMID: 33594898 DOI: 10.1177/0886260521991894] [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
Essential steps in the provision of health care for women exposed to intimate partner violence (IPV) are screening and referral for specialized services, as might occur in primary care settings. Prior to participating in a cross-disciplinary IPV training program, medical care (N = 223) and social/behavioral practitioners (N = 197) completed a survey that ascertained current practices, provisions, and perceived barriers related to IPV screening and referral. Roughly half of the study participants did not routinely screen their patients/clients for IPV, with no differences for the professional groupings. Utilization of referral resources was significantly lower for medical care providers, 78.5% of whom did not use any. Perceived barriers to screening and referral were examined as practitioner-based and organization-based, and we identified tangible provisions (protocols and practice materials) as a relevant variable. As we conjectured, organization-based barriers were more strongly associated with lower rates of screening and referral than were practitioner-based barriers, regardless of professional grouping. Moreover, tangible provisions, controlling for perceived barriers, significantly added to routine screening and frequency of referral resources usage, particularly for medical care providers. Results are discussed in the context of a systems-level approach to improving IPV services in health care with organizational practice enhancements.
Collapse
|
33
|
Jeffers NK, Zemlak JL, Celius L, Willie TC, Kershaw T, Alexander KA. 'If the Partner Finds Out, then there's Trouble': Provider Perspectives on Safety Planning and Partner Interference When Offering HIV Pre-exposure Prophylaxis (PrEP) to Women Experiencing Intimate Partner Violence (IPV). AIDS Behav 2022; 26:2266-2278. [PMID: 35032282 PMCID: PMC9338767 DOI: 10.1007/s10461-021-03565-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2021] [Indexed: 01/02/2023]
Abstract
Pre-exposure prophylaxis is an effective women-controlled HIV prevention strategy but women experiencing intimate partner violencefear partners' interference and subsequent violence could limit its utility. This study explores provider perceptions of safety planning strategies to prevent escalating violence, mitigate partner interference, and promote daily oral PrEP adherence. We conducted interviews (N = 36) with healthcare providers (n = 18) and IPV service providers (n = 18) in Baltimore and New Haven. Using the Contextualized Assessment for Strategic Safety Planning model we organized data into two categories: the appraisal process and strategic safety planning. Themes revealed during the appraisal process, providers conduct routine IPV screening, facilitate HIV risk perception, and offer PrEP. Strategic safety planning utilizes concealment tactics, informal sources of support, role playing and cover stories. Future interventions to enhance PrEP services among women exposed to IPV should implement safety planning strategies, integrate PrEP care with IPV services, and employ novel PrEP modalities to maximize effectiveness.
Collapse
Affiliation(s)
- Noelene K Jeffers
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Lourdes Celius
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Tiara C Willie
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Kamila A Alexander
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
| |
Collapse
|
34
|
Simmons J, Swahnberg K. Characteristics Associated With Being Asked About Violence Victimization in Health Care: A Swedish Random Population Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP8479-NP8506. [PMID: 33283603 PMCID: PMC9136474 DOI: 10.1177/0886260520977836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Recommendations to routinely question patients about violence victimization have been around for many years; nonetheless, many patients suffering in the aftermath of violence go unnoticed in health care. The main aim of this study was to explore characteristics associated with being asked about experiences of violence in health care and thereby making visible victims that go unnoticed. In this study, we used cross-sectional survey data from 754 men (response rate 35%) and 749 women (response rate 38%) collected at random from the Swedish population, age 25-85. Questions were asked about experiences of emotional, physical, and sexual violence from both family, partner, and other perpetrators. Only 13.1% of those reporting some form of victimization reported ever being asked about experiences of violence in health care. Low subjective social status was associated with being asked questions (adj OR 2.23) but not with victimization, possibly indicating prejudice believes among providers concerning who can be a victim of violence. Other factors associated with increased odds of being asked questions were: being a woman (adj OR 2.09), young age (24-44 years, adj OR 6.90), having been treated for depression (adj OR 2.45) or depression and anxiety (adj OR 2.19) as well as reporting physical violence (adj OR 2.74) or polyvictimization (adj OR 2.85). The main finding of the study was that only few victims had been asked questions. For example, among those reporting ≥4 visits to a primary care physician during the past 12 months, 43% reported some form of victimization but only 6% had been asked questions. Our findings underline the importance of continuing to improve the health care response offered to victims of violence.
Collapse
|
35
|
Anguzu R, Cassidy LD, Beyer KMM, Babikako HM, Walker RJ, Dickson-Gomez J. Facilitators and barriers to routine intimate partner violence screening in antenatal care settings in Uganda. BMC Health Serv Res 2022; 22:283. [PMID: 35232438 PMCID: PMC8889632 DOI: 10.1186/s12913-022-07669-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 02/21/2022] [Indexed: 11/14/2022] Open
Abstract
Background Uganda clinical guidelines recommend routine screening of pregnant women for intimate partner violence (IPV) during antenatal care (ANC). Healthcare providers play a critical role in identifying IPV during pregnancy in ANC clinics. This study explored facilitators and barriers for IPV screening during pregnancy (perinatal IPV screening) by ANC-based healthcare workers in Uganda. Methods We conducted qualitative in-depth interviews among twenty-eight purposively selected healthcare providers in one rural and an urban-based ANC health center in Eastern and Central Uganda respectively. Barriers and facilitators to IPV screening during ANC were identified iteratively using inductive-deductive thematic analysis. Results Participants had provided ANC services for a median (IQR) duration of 4.0 (0.1–19) years. Out of 28 healthcare providers, 11 routinely screened women attending ANC clinics for IPV and 10 had received IPV-related training. Barriers to routine IPV screening included limited staffing and space resources, lack of comprehensive gender-based violence (GBV) training and provider unawareness of the extent of IPV during pregnancy. Facilitators were availability of GBV protocols and providers who were aware of IPV (or GBV) tools tended to use them to routinely screen for IPV. Healthcare workers reported the need to establish patient trust and a safe ANC clinic environment for disclosure to occur. ANC clinicians suggested creation of opportunities for triage-level screening and modification of patients’ ANC cards used to document women’s medical history. Some providers expressed concerns of safety or retaliatory abuse if perpetrating partners were to see reported abuse. Conclusions Our findings can inform efforts to strengthen GBV interventions focused on increasing routine perinatal IPV screening by ANC-based clinicians. Implementation of initiatives to increase routine perinatal IPV screening should focus on task sharing, increasing comprehensive IPV training opportunities, including raising awareness of IPV severity, trauma-informed care and building trusting patient-physician relationships. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07669-0.
Collapse
Affiliation(s)
- Ronald Anguzu
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, Wisconsin, USA.
| | - Laura D Cassidy
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, Wisconsin, USA
| | - Kirsten M M Beyer
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, Wisconsin, USA
| | - Harriet M Babikako
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Makerere University College of Health Sciences, New Mulago Gate Road, Mulago, Kampala, Uganda.,Department of Child Health and Development Center, School of Medicine, Makerere University, College of Health Sciences, Mulago Hill, Hospital Complex, P.O. Box 7072, Kampala, Kampala, Uganda
| | - Rebekah J Walker
- Center for Advancing Population Sciences (CAPS), Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Julia Dickson-Gomez
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, Wisconsin, USA
| |
Collapse
|
36
|
Natal M. Intimate Partner Violence Experiences Among Puerto Rican Mothers. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP2626-NP2651. [PMID: 33843332 DOI: 10.1177/0886260520944556] [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] [Indexed: 06/12/2023]
Abstract
This qualitative, transcendental, phenomenological study explored the subjective experiences of Puerto Rican mothers, aged 18 and older, who experienced intimate partner violence (IPV) and their perceptions of how provider and law enforcement approaches to screening impacted disclosure. Participant recruitment was coordinated with gatekeepers, and community and domestic violence organizations, who posted bilingual flyers. A total of nine Puerto Rican woman aged 18 and older who experienced IPV participated and agreed to consent to audio-recorded interviews. Data analysis integrated content and thematic procedures, including transcribing, reading, auditing, and coding the interviews based on statements, quotes, and sentences, then grouped into themes that captured the essence of their lived experiences. The IPV was perpetrated primarily by the children's biological fathers and escalated over time. Four of the eight participants (one was lost to follow-up) had been screened while seeking medical care for IPV-related injuries, two disclosed their IPV, and one of the two was provided with a referral for IPV resources. All had multiple previous encounters with law enforcement but were afraid and ashamed to disclose the IPV. Lack of disclosure was associated with Hispanic cultural values and norms that included collectivism or keeping group cohesiveness, familism that socially emphasizes the family unit, marianismo as an ascribed female gender role of self-sacrifice and caregiving, and threats that their children would be removed from the home. Most of the women did not have knowledge of resources available to them and wanted to keep the family unit together. All believed they would be blamed for the incidents. Major implications include the need for multilanguage and multimedia campaigns to improve access to information, transparency with IPV screenings that may influence IPV disclosure, and systemwide education that addresses mother-blaming.
Collapse
|
37
|
Aguillard K, Hughes R, Gemeinhardt GL, Schick V, McCurdy S. "They Didn't Ask." Rural Women With Disabilities and Experiences of Violence Describe Interactions With the Healthcare System. QUALITATIVE HEALTH RESEARCH 2022; 32:656-669. [PMID: 34978225 DOI: 10.1177/10497323211059142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Women with disabilities are at risk of experiencing multiple forms of severe and prolonged violence, yet guidelines for screening this population are unclear, screening rates are historically low, and screening tools may be inadequate to capture disability-related aspects of abuse. We conducted qualitative in-depth interviews with 33 rural women in the United States with diverse disabilities and experiences of violence. They described overarching healthcare provider and system factors that influenced their trust and confidence in healthcare delivery as an avenue to support their safety. Women described interactions with the healthcare system during their experience of violence as a missed opportunity for identifying and responding to their abuse and connecting them with resources. We conclude with policy and practice recommendations based on women with disabilities' perspectives and insights.
Collapse
Affiliation(s)
| | | | | | - Vanessa Schick
- 12340University of Texas School of Public Health, Houston, TX, USA
| | - Sheryl McCurdy
- 12340University of Texas School of Public Health, Houston, TX, USA
| |
Collapse
|
38
|
Palmwood EN, Valadez EA, Zajac LA, Griffith AL, Simons RF, Dozier M. Early exposure to parent-perpetrated intimate partner violence predicts hypervigilant error monitoring. Int J Psychophysiol 2022; 173:58-68. [PMID: 35031350 PMCID: PMC8857045 DOI: 10.1016/j.ijpsycho.2022.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/19/2021] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
Abstract
Early exposure to intimate partner violence (IPV) places children at risk for ongoing emotional difficulties, including problems with self-regulation and high levels of internalizing symptoms. However, the impact of IPV exposure on children's error monitoring remains unknown. The present study utilized electroencephalography (EEG) to examine the impact of exposure to IPV in infancy on error monitoring in middle childhood. Results indicated that parents' perpetration of IPV against their romantic partners when children were under 24 months of age predicted hypervigilant error monitoring in children at age 8 (N = 30, 16 female), as indexed by error-related neural activity (ERN and Pe difference amplitudes), above and beyond the effects of general adversity exposure and parental responsiveness. There was no association between partner perpetration of IPV and children's error monitoring. Results illustrate the harmful effects of early exposure to parent-perpetrated IPV on error monitoring and highlight the importance of targeting children's and parents' cognitive and emotional responses to error commission in psychotherapy.
Collapse
Affiliation(s)
- Erin N. Palmwood
- Department of Psychological Science, University of Mary Washington, Fredericksburg, VA
| | - Emilio A. Valadez
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | | | | | - Robert F. Simons
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE
| | - Mary Dozier
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE
| |
Collapse
|
39
|
Miller DP, Foley KL, Bundy R, Dharod A, Wright E, Dignan M, Snavely AC. Universal Screening in Primary Care Practices by Self-administered Tablet vs Nursing Staff. JAMA Netw Open 2022; 5:e221480. [PMID: 35258581 PMCID: PMC8905387 DOI: 10.1001/jamanetworkopen.2022.1480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 01/19/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- David P. Miller
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kristie L. Foley
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Richa Bundy
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ajay Dharod
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Elena Wright
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mark Dignan
- Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington
| | - Anna C. Snavely
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
40
|
Miller CJ, Stolzmann K, Dichter ME, Adjognon OL, Brady JE, Portnoy GA, Gerber MR, Iqbal S, Iverson KM. Intimate Partner Violence Screening for Women in the Veterans Health Administration: Temporal Trends from the Early Years of Implementation 2014-2020. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2022; a:1-19. [PMID: 36713478 PMCID: PMC9881187 DOI: 10.1080/10926771.2021.2019160] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/28/2021] [Accepted: 11/23/2021] [Indexed: 06/10/2023]
Abstract
Thousands of women Veterans experience intimate partner violence (IPV) each year. The Veterans Health Administration (VHA) has encouraged IPV screening in Veterans Affairs medical centers (VAMCs) since 2014. Through retrospective analysis of VHA administrative data from fiscal year (FY) 2014 into FY2020, we examined IPV screening implementation outcomes of reach and adoption, as well as screen-positive rates using descriptive and multivariate linear regression analyses. We examined reach and screen-positive rates overall and as a function of childbearing age (18-44 vs. 45+ years). In FY2014 only one VAMC was screening women for IPV; by FY2020, over half of VAMCs had adopted IPV screening. This rollout of IPV screening was associated with a large increase in the number of women primary care patients screened (from fewer than 500 in FY2014, to nearly 35,000 in early FY2020). Overall, among women screened, 6.7% screened positive for IPV; this rate was higher among women of childbearing age (8.1% vs. 5.6%). Despite the spread of IPV screening practices during the early years of implementation in VHA, additional work is needed. This study is the first comprehensive analysis of implementation outcomes associated with VHA's IPV screening efforts, and lays the groundwork for ongoing evaluation and quality improvement.
Collapse
Affiliation(s)
- Christopher J. Miller
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Kelly Stolzmann
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Melissa E. Dichter
- VA Center for Health Equity Research and Promotion (CHERP), Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Omonyele L. Adjognon
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Julianne E. Brady
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Galina A. Portnoy
- Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut USA
| | | | - Samina Iqbal
- VA Palo Alto Healthcare System, Palo Alto, California, USA
| | - Katherine M. Iverson
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
| |
Collapse
|
41
|
Hoops K, Fahimi J, Khoeur L, Studenmund C, Barber C, Barnhorst A, Betz ME, Crifasi CK, Davis JA, Dewispelaere W, Fisher L, Howard PK, Ketterer A, Marcolini E, Nestadt PS, Rozel J, Simonetti JA, Spitzer S, Victoroff M, Williams BH, Howley L, Ranney ML. Consensus-Driven Priorities for Firearm Injury Education Among Medical Professionals. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:93-104. [PMID: 34232149 DOI: 10.1097/acm.0000000000004226] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
PURPOSE Firearm injury is a leading cause of morbidity and mortality in the United States. However, many medical professionals currently receive minimal or no education on firearm injury or its prevention. The authors sought to convene a diverse group of national experts in firearm injury epidemiology, injury prevention, and medical education to develop consensus on priorities to inform the creation of learning objectives and curricula for firearm injury education for medical professionals. METHOD In 2019, the authors convened an advisory group that was geographically, demographically, and professionally diverse, composed of 33 clinicians, researchers, and educators from across the United States. They used the nominal group technique to achieve consensus on priorities for health professions education on firearm injury. The process involved an initial idea-generating phase, followed by a round-robin sharing of ideas and further idea generation, facilitated discussion and clarification, and the ranking of ideas to generate a prioritized list. RESULTS This report provides the first national consensus guidelines on firearm injury education for medical professionals. These priorities include a set of crosscutting, basic, and advanced learning objectives applicable to all contexts of firearm injury and all medical disciplines, specialties, and levels of training. They focus on 7 contextual categories that had previously been identified in the literature: 1 category of general priorities applicable to all contexts and 6 categories of specific contexts, including intimate partner violence, mass violence, officer-involved shootings, peer (nonpartner) violence, suicide, and unintentional injury. CONCLUSIONS Robust, data- and consensus-driven priorities for health professions education on firearm injury create a pathway to clinician competence and self-efficacy. With an improved foundation for curriculum development and educational program-building, clinicians will be better informed to engage in a host of firearm injury prevention initiatives both at the bedside and in their communities.
Collapse
Affiliation(s)
- Katherine Hoops
- K. Hoops is assistant professor, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jahan Fahimi
- J. Fahimi is associate professor, Department of Emergency Medicine, University of California, San Francisco School of Medicine and Institute for Health Policy Studies, San Francisco, California
| | - Lina Khoeur
- L. Khoeur is a third-year medical student, University of California, San Francisco School of Medicine, San Francisco, California
| | - Christine Studenmund
- C. Studenmund is a third-year medical student, University of California, San Francisco School of Medicine, San Francisco, California
| | - Catherine Barber
- C. Barber is senior researcher, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Amy Barnhorst
- A. Barnhorst is associate professor, Department of Psychiatry and Behavioral Sciences and Department of Emergency Medicine, University of California, Davis School of Medicine, Davis, California
| | - Marian E Betz
- M.E. Betz is associate professor, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Cassandra K Crifasi
- C.K. Crifasi is assistant professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - John A Davis
- J.A. Davis is professor and associate dean for curriculum, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California
| | - William Dewispelaere
- W. Dewispelaere is a resident, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Lynn Fisher
- L. Fisher is assistant professor, Department of Family and Community Medicine, University of Kansas School of Medicine, Wichita, Kansas
| | - Patricia K Howard
- P.K. Howard is adjunct assistant professor, University of Kentucky, Lexington, Kentucky
| | - Andrew Ketterer
- A. Ketterer is clinical instructor, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Evie Marcolini
- E. Marcolini is assistant professor, Department of Emergency Medicine and Department of Neurology, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - Paul S Nestadt
- P.S. Nestadt is assistant professor, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - John Rozel
- J. Rozel is associate professor, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Joseph A Simonetti
- J.A. Simonetti is assistant professor, Department of Medicine, University of Colorado School of Medicine, and Veterans Health Administration, Aurora, Colorado
| | - Sarabeth Spitzer
- S. Spitzer is a resident, Department of Surgery, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
| | - Michael Victoroff
- M. Victoroff is clinical professor, Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Brian H Williams
- B.H. Williams is associate professor, Department of Surgery, University of Chicago Pritzker School of Medicine and Biological Sciences, Chicago, Illinois
| | - Lisa Howley
- L. Howley is senior director of strategic initiatives and partnerships, Association of American Medical Colleges, Washington, DC
| | - Megan L Ranney
- M.L. Ranney is associate professor, Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| |
Collapse
|
42
|
Gaddappa S, Deshpande S, Gaikwad N, Rokade J, Prabhu P, Arora S, Rege S. Strengthening Health Systems' Response to Violence Against Women in Three Tertiary Health Facilities of Maharashtra. J Obstet Gynaecol India 2021; 71:90-95. [PMID: 34924720 DOI: 10.1007/s13224-021-01596-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background Domestic violence is known to have a significant impact on the health of women. Despite this, the health system in India is not equipped to respond to women facing violence. This can be attributed to limited information on how the evidence-based guidelines can be implemented in resource-constrained settings. To fill this gap, implementation research was carried out in three tertiary medical teaching hospitals in Maharashtra. Methods The project was implemented in the OBGY, Medicine and Emergency department of a medical college and a district hospital in the state of Maharashtra. The intervention included consultation with key providers of three departments and a 5 day training of trainers on VAW. The trainers conducted 2 day onsite training for the health care providers. System-level interventions included the development of SOPs, IEC material, documentation format and identifying places for a private consultation. The research involved a pre- and post-test to assess change in KAP of providers after training, analysis of documentation register and interviews with trained providers and survivors. Results Findings indicate a significant change in knowledge, attitude and practice of the providers. Documentation registers introduced in the facility departments showed 531 women facing violence were responded by providers in 9 months. In 59% of cases, the provider suspected violence based on presenting health complaints, indicating the success of the capacity building programmes in the development of skills to identify VAW signs and symptoms, as well as provide psychological support to women/girls. There was a high acceptability of intervention among providers. Survivors also recognised the usefulness of health care facility-based support services for violence. Conclusion A multi-component intervention comprising of building capacity of providers and facility readiness is feasible to implement in low- and middle-income countries (LMIC) and can strengthen health systems' response to VAW.
Collapse
Affiliation(s)
- Shrinivas Gaddappa
- Aurangabad Government Medical College and Hospital, Aurangabad, Maharashtra India
| | - Sonali Deshpande
- Aurangabad Government Medical College and Hospital, Aurangabad, Maharashtra India
| | | | - Jyoti Rokade
- Miraj Government Medical College and Hospital, Miraj, Maharashtra India
| | - Priya Prabhu
- Miraj Government Medical College and Hospital, Miraj, Maharashtra India
| | - Sanjida Arora
- Centre for Enquiry Into Health and Allied Themes, Mumbai, India
| | - Sangeeta Rege
- Centre for Enquiry Into Health and Allied Themes, Mumbai, India
| |
Collapse
|
43
|
Guille C, Maldonado L, Simpson AN, Newman R, King C, Cortese B, Quigley E, Dietrich N, Kerr A, Aujla R, King K, Ford D, Brady KT. A Non-Randomized Trial of In-Person Versus Text/Telephone Screening, Brief Intervention and Referral to Treatment for Pregnant and Postpartum Women. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2021; 3:172-183. [PMID: 36101654 PMCID: PMC9175992 DOI: 10.1176/appi.prcp.20210027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Systems of care that improve mental health and substance use disorder Screening, Brief Intervention and Referral to Treatment (SBIRT) for pregnant and postpartum women are needed. Aims The aim of this study is to determine if women receiving prenatal care from January 2020 to April 2021 are more likely to be screened, screen positive, be referred for treatment and attend treatment with technology facilitated SBIRT, compared to women receiving prenatal care and in-person SBIRT January 2017 to December 2019. Materials & Methods Technology facilitated SBIRT, designated Listening to Women (LTW), includes text message-based screening, phone-based brief intervention, and referral to treatment by a remote care coordinator. A total of 3535 pregnant and postpartum women were included in the quasi-experimental study and data were collected via text message and Electronic Health Record. Results In-person SBIRT was completed by 65.2% (1947/2988) of women while 98.9% (547/553) of women approached agreed to take part in LTW and 71.9% (393/547) completed SBIRT via LTW. After controlling for potentially confounding variables, women enrolled in LTW were significantly more likely to be screened (relative risk [RR]: 1.10, 95% CI 1.03-1.16), screen positive (RR 1.91, 95% CI 1.72-2.10), referred to treatment (RR 1.55, 95% CI 1.43-1.69) and receive treatment (RR 4.95, 95% CI 3.93-6.23), compared to women receiving in-person SBIRT. Black women enrolled in LTW were significantly more likely to screen positive (RR 1.65, 95% CI 1.35-2.01), be referred to treatment (RR 1.54, 95% CI 1.35-1.76) and attend treatment (RR 5.49, 95% CI 3.69-8.17), compared to Black women receiving in-person SBIRT. Discussion LTW appears to increase the proportion of pregnant and postpartum women receiving key elements of SBIRT.
Collapse
Affiliation(s)
- Constance Guille
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
- Department of Obstetrics and GynecologyMedical University of South CarolinaCharleston
| | - Lizmarie Maldonado
- Department of Healthcare Leadership and ManagementMedical University of South CarolinaCharleston
| | - Annie N. Simpson
- Department of Healthcare Leadership and ManagementMedical University of South CarolinaCharleston
| | - Roger Newman
- Department of Obstetrics and GynecologyMedical University of South CarolinaCharleston
| | - Courtney King
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| | - Bernadette Cortese
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| | - Erin Quigley
- Biomedical Informatics CenterMedical University of South CarolinaCharleston
| | - Nicole Dietrich
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| | - Anna Kerr
- Department of Obstetrics and GynecologyMedical University of South CarolinaCharleston
| | - Rubin Aujla
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| | - Kathryn King
- Department of PediatricsMedical University of South CarolinaCharleston
| | - Dee Ford
- Department of PulmonologyMedical University of South CarolinaCharlestonSC
| | - Kathleen T. Brady
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| |
Collapse
|
44
|
Ali P, McGarry J, Younas A, Inayat S, Watson R. Nurses', midwives' and students' knowledge, attitudes and practices related to domestic violence: A cross-sectional survey. J Nurs Manag 2021; 30:1434-1444. [PMID: 34734662 DOI: 10.1111/jonm.13503] [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: 02/08/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 11/30/2022]
Abstract
AIMS To measure registered nurses', registered midwives', and nursing and midwifery students' current levels of knowledge, attitude and practices related to intimate partner violence. BACKGROUND Nurses and midwives whether registered or students need to be confident and competent in identifying and responding to intimate partner violence. DESIGN A cross-sectional survey. METHODS Data were collected through online surveys using the Physician Readiness to Manage Intimate Partner Violence Survey. Descriptive and inferential statistics were used to analyse the data. RESULTS Nursing and midwifery students were less knowledgeable and prepared than nurses and midwives. Midwives had more positive attitudes compared with nurses towards women experiencing intimate partner violence. CONCLUSIONS Heath care institutions and regulatory bodies should provide resources and support to nursing and midwifery professionals. Personal experiences of domestic abuse and professional experience of supporting victims of domestic abuse/intimate partner violence affected practitioner's abilities to identify and manage intimate partner violence. IMPLICATIONS FOR NURSING MANAGEMENT Nurse and midwifery managers can ensure that clinical and organisational policies and protocols are revisited and updated regularly and that interdisciplinary collaboration is promoted and emphasized for prompt identification and management of intimate partner violence.
Collapse
Affiliation(s)
- Parveen Ali
- Health Sciences School, University of Sheffield & Doncaster and Bassettlaw Teaching Hospitals, Sheffield, United Kingdom, UK
| | - Julie McGarry
- Health Sciences School, University of Sheffield & Sheffield Teaching Hospitals, Sheffield, United Kingdom, UK
| | - Ahtisham Younas
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.,Swat College of Nursing, Qambar, Pakistan
| | - Shahzad Inayat
- Nursing and Health Sciences, Al-Nafees Medical College & Isra College of Nursing, Isra University Islamabad, Islamabad, Pakistan
| | - Roger Watson
- Faculty of Health and Social Care, University of Hull, Hull, UK
| |
Collapse
|
45
|
Renner LM, Wang Q, Logeais ME, Clark CJ. Health Care Providers' Readiness to Identify and Respond to Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:9507-9534. [PMID: 31402775 DOI: 10.1177/0886260519867705] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Screening rates for intimate partner violence (IPV) among most health care providers are low; yet, positive interactions with providers can benefit people who experience IPV, with respect to increased safety, support, and self-efficacy. Missing is a broad assessment and comparison of knowledge, attitudes, and behavior across the range of providers who are likely to be involved in a response to IPV disclosure. The purpose of our study was to assess health care providers' IPV preparation, knowledge, opinions, and practices and examine differences across three types of health care providers (medical providers, nursing staff, and social/behavioral health providers). We used an anonymous online survey to gather self-reported information on preparation, knowledge, opinions, and practices around IPV. A random sample of 402 providers was drawn from 13 clinics in a large multispecialty outpatient practice setting. The respondents (N = 204) consisted of medical providers (n = 70), nursing staff (n = 107), and social/behavioral health providers (n = 27). Data analyses consisted of univariate, bivariate, and multivariate analyses. Social/behavioral health providers reported more preparation, knowledge, victim understanding, and less job-related constraints, yet they reported lower screening rates than medical providers and nursing staff. Overall, no provider group seemed well-equipped to work with patients who disclose IPV. Our findings identify unmet needs within our health system to better train health care providers and restructure care models to support IPV identification and response. A focus on interprofessional training and care collaboration would bolster competency and reduce constraints felt by the health care workforce.
Collapse
Affiliation(s)
| | - Qi Wang
- University of Minnesota, Minneapolis, MN, USA
| | | | | |
Collapse
|
46
|
Roesch PT, Velonis AJ, Sant SM, Habermann LE, Hirschtick JL. Implications of Interpersonal Violence on Population Mental Health Status in a Low-Income Urban Community-Based Sample of Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:8891-8914. [PMID: 31319734 DOI: 10.1177/0886260519862365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Research links interpersonal violence (IPV) perpetrated by a close personal contact, such as a family member or partner, to poor mental health; however, few studies assess associations by gender and explore the community-wide impacts of IPV on rates of depression and posttraumatic stress disorder (PTSD). Using Sinai Community Health Survey (2015-2016), a face-to-face probability survey in 10 Chicago neighborhoods, we examined the association of a broad IPV measure, ever being emotionally or physically abused by a partner or someone important to you, with current depressive (DEPsym) or PTSD symptoms (PTSDsym), stratified by gender. After logistic regression model building, we used direct model-based standardization to calculate adjusted relative prevalence and population attributable prevalence fractions. Of 1,535 respondents, 8% of men and 15% of women had DEPsym; 15% and 20% had PTSDsym, respectively; and 12% and 26% ever experienced IPV, respectively. Controlling for confounders, men who experienced IPV had a 3.6 times (95% confidence interval [CI]: [1.5, 6.8]) higher prevalence of DEPsym and a 2.5 times (95% CI: [1.3, 4.9]) higher prevalence of PTSDsym. Women who experienced IPV had a 2.2 times (95% CI: [1.1, 3.9]) higher prevalence of DEPsym. If the association between IPV and mental health is causal, almost one in three cases of DEPsym (males: 31.7%; females: 27.3%) and one in five cases of PTSDsym (19.2%) among males may be attributed to IPV. Our findings underscore the need for a public health response to IPV and mental health, and additional research on evidence-driven practices that address this association among men and women.
Collapse
|
47
|
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.
Collapse
|
48
|
Cottler-Casanova S, Horowicz M, Gayet-Ageron A, Abdulcadir J. Female genital mutilation/cutting (FGM/C) coding capacities in Swiss university hospitals using the International Classification of Diseases (ICD). BMC Public Health 2021; 21:1151. [PMID: 34134688 PMCID: PMC8207741 DOI: 10.1186/s12889-021-11160-6] [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: 12/02/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The real prevalence and incidence of women living with or at risk of female genital mutilation/cutting (FGM/C) is unknown in Switzerland and many parts of Europe, as there are no representative surveys similar to DHS or MICS for European countries. Indirect estimates are commonly used to estimate the number of women with FGM/C in high-income countries, but may not reflect the actual FGM/C prevalence among migrants. Direct measures may provide more accurate estimates that could guide policy- and clinical decision-making. Swiss hospital data may provide a sample of patients that can be used to describe the prevalence of FGM/C in Swiss hospitals. Our study assesses the number of inpatient women and girls in Swiss university hospitals from countries with high FGM/C prevalence, and of inpatients with a coded diagnosis of FGM/C. METHODS We conducted an exploratory descriptive study in Switzerland to assess the number of women and girls admitted to Swiss university hospitals between 2016 and 2018 from 30 FGM/C practicing countries, as well as inpatients with a coded diagnosis of FGM/C using anonymized data. We calculated indirect estimates for inpatient women and girls living with or at risk of FGM/C and compared them with the number of inpatients with a coded diagnosis of FGM/C. RESULTS 8720 women and girls from FGM/C practicing countries were admitted. 207 patients had a coded diagnosis of FGM/C, including 7 with a nationality outside the 30 targeted countries, corresponding to an overall prevalence of 2.3% (95%CI, 2.0-2.6). The number of FGM/C cases by hospital was significantly different across years (P < 0.001), with a higher proportion of cases collected in Geneva, Switzerland. CONCLUSIONS The comparison between indirect estimates of inpatients with or at risk of FGM/C and the low number of FGM/C cases coded, suggests low recording and coding capacities of FGM/C. The capacity of coding primary and secondary diagnosis of FGM/C in Swiss university hospitals seems low. Protocol number: 2018-01851: SwissEthics Committee, Canton of Geneva, Switzerland.
Collapse
Affiliation(s)
- S Cottler-Casanova
- Division of Gynaecology, Department of the Woman, the Child and the Adolescent, Geneva University Hospitals, 30 Bld de la Cluse, 1211, Geneva, Switzerland.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - M Horowicz
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - A Gayet-Ageron
- CRC & Division of clinical-epidemiology, Department of health and community medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - J Abdulcadir
- Division of Gynaecology, Department of the Woman, the Child and the Adolescent, Geneva University Hospitals, 30 Bld de la Cluse, 1211, Geneva, Switzerland.
| |
Collapse
|
49
|
Jiang L, Sutherland MA, Hutchinson MK, Si B. A Multi-Center Structural Equation Modeling Approach to Investigate Interpersonal Violence Screening for Public Health Promotion. Front Public Health 2021; 9:637222. [PMID: 34178912 PMCID: PMC8226006 DOI: 10.3389/fpubh.2021.637222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/17/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Interpersonal violence is a significant public health issue. Routine health screening is a cost-effective strategy that may reduce harmful physical and mental consequences. However, existing research finds consistently low rates of violence screening offered by healthcare providers, e.g., nurses, nurse practitioners, physicians. There is a critical need for research that helps understand how providers' screening behaviors are impacted by individual-level and organizational-level factors to promote the uptake of routine screening for interpersonal violence. Two recent studies, i.e., The Health Care Providers study and Nurse Practitioners Violence Screening study, involved quantitative data collected to measure providers' screening behavior and multi-level factors impacting violence screening. Methods: The current analysis includes a combination of multi-center data collected from The Health Care Providers and Nurse Practitioners Violence Screening studies, respectively. The total sample is 389 providers across the United States. The proposed research develops a system-level multi-center structural equation model framework to rigorously integrate data from the two studies and examine providers' screening behavior for interpersonal violence based upon Theory of Planned Behavior from a quantitative perspective. Results & Conclusions: We successfully examine the efficacy of the Theory of Planned Behavior proposed by Ajzen to predict healthcare providers' screening behavior for interpersonal violence. Organizational factors, e.g., availability of policy for interpersonal violence screening, organizational priority given to violence screening relative to other priorities, and if providers within the health center are interested in improving care quality, were significantly associated with providers' screening behavior. The knowledge and insights generated from our study may facilitate the design and optimization of health professional training and practice environment, and lead to improved women's health and quality of care.
Collapse
Affiliation(s)
- Lan Jiang
- Department of Systems Science and Industrial Engineering, Thomas J. Watson School of Engineering and Applied Science, Binghamton University, Binghamton, NY, United States
| | | | | | - Bing Si
- Department of Systems Science and Industrial Engineering, Thomas J. Watson School of Engineering and Applied Science, Binghamton University, Binghamton, NY, United States
| |
Collapse
|
50
|
Martínez-García E, Montiel-Mesa V, Esteban-Vilchez B, Bracero-Alemany B, Martín-Salvador A, Gázquez-López M, Pérez-Morente MÁ, Alvarez-Serrano MA. Sexist Myths Emergency Healthcare Professionals and Factors Associated with the Detection of Intimate Partner Violence in Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115568. [PMID: 34071054 PMCID: PMC8197153 DOI: 10.3390/ijerph18115568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/12/2021] [Accepted: 05/18/2021] [Indexed: 12/11/2022]
Abstract
This study analysed the capacity of emergency physicians and nurses working in the city of Granada (Spain) to respond to intimate partner violence (IPV) against women, and the mediating role of certain factors and opinions towards certain sexist myths in the detection of cases. This is a cross-sectional study employing the physician readiness to manage intimate partner violence survey (PREMIS) between October 2020 and January 2021, with 164 surveys analysed. Descriptive and analytical statistics were applied, designing three multivariate regression models by considering opinions about different sexist myths. Odds ratios and 95% confidence intervals (CIs) were considered for the detection of cases. In the past six months, 34.8% of professionals reported that they had identified some cases of IPV, particularly physicians (OR = 2.47, 95% CI = 1.14–5.16; OR = 2.65, 95% CI = 1.26–5.56). Those who did not express opinions towards sexist myths related to the understanding of the victim or the consideration of alcohol/drug abuse as the main causes of violence and showed a greater probability of detecting a case (NS) (OR = 1.26 and OR = 1.65, respectively). In order to confirm the indicia found, further research is required, although there tends to be a common opinion towards the certain sexual myth of emergency department professionals not having an influence on IPV against women.
Collapse
Affiliation(s)
- Encarnación Martínez-García
- Guadix High Resolution Hospital, 18500 Granada, Spain;
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Verónica Montiel-Mesa
- Virgen de las Nieves University Hospital, Andalusian Health Service, 18014 Granada, Spain;
| | | | | | - Adelina Martín-Salvador
- Department of Nursing, Faculty of Health Sciences, University of Granada, 52005 Melilla, Spain
- Correspondence: (A.M.-S.); (M.Á.P.-M.)
| | - María Gázquez-López
- Department of Nursing, Faculty of Health Sciences, University of Granada, 51001 Ceuta, Spain; (M.G.-L.); (M.A.A.-S.)
| | - María Ángeles Pérez-Morente
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
- Correspondence: (A.M.-S.); (M.Á.P.-M.)
| | | |
Collapse
|