Restricted accessResearch articleFirst published online 2021-12
Challenges of Using Videos in Exam Rooms of Safety-Net Clinics to Encourage Patient Self-Disclosure of Intimate Partner Violence and to Increase Provider Screening
Identifying intimate partner violence (IPV) in clinics allows for early intervention. We tested a comprehensive approach in five safety-net clinics to encourage female victims to self-identify and providers to screen. The main components were (a) short, multilingual videos for female patients; (b) provider training; and (c) management tools. Although videos were viewed 2,150 times, only 9% of eligible patients watched them. IPV disclosure increased slightly (6%). Lack of internal champions, high turnover, increased patient load, and technological challenges hindered outcomes. Safety-net clinics need feasible methods to encourage IPV screening. Management champions and IT support are essential for video-based activities.
AllenN. E.LehrnerA.MattisonE.MilesT.RussellA. (2007). Promoting systems change in the health care response to domestic violence. Journal of Community Psychology, 35(1), 103–120.
2.
AndersonK. M.RennerL. M.DanisF. S. (2012). Recovery: Resilience and growth in the aftermath of domestic violence. Violence Against Women, 18, 1279–1299.
3.
Bair-MerrittM. H.Lewis-O’ConnorA.GoelS.AmatoP.IsmailjiT.JelleyM.LenahanP.CronholmP. (2014). Primary care–based interventions for intimate partner violence: A systematic review. American Journal of Preventive Medicine, 46(2), 188–194.
4.
BasileK. C.SmithS. G.BreidingM. J.BlackM. C.MahendraR. R. (2014). Sexual violence surveillance: Uniform definitions and recommended data elements (Version 2.0). National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
5.
BonomiA. E.AndersonM. L.ReidR. J.RivaraF. P.CarrellD.ThompsonR. S. (2009). Medical and psychosocial diagnoses in women with a history of intimate partner violence. Archives of Internal Medicine, 169, 1692–1697.
6.
BradleyF.SmithM.LongJ.O’DowdT. (2002). Reported frequency of domestic violence: Cross-sectional survey of women attending general practice. British Medical Journal, 324, 271–274.
7.
CampbellJ. C.CobenJ. H.McLoughlinE.DearwaterS.NahG.GlassN.LeeD.DurborowN. (2001). An evaluation of a system-change training model to improve emergency department response to battered women. Academic Emergency Medicine, 8(2), 131–138.
8.
CavanaughC. E.MessingJ. T.Del-ColleM.O’SullivanC.CampbellJ. C. (2011). Prevalence and correlates of suicidal behavior among adult female victims of intimate partner violence. Suicide and Life-Threatening Behavior, 41(4), 372–383.
9.
ColarossiL.BreitbartV.BetancourtG. (2010). Barriers to screening for intimate partner violence: A mixed-methods study of providers in family planning clinics. Perspectives on Sexual and Reproductive Health, 42(4), 236–243.
10.
EllsbergM.JansenH. A.HeiseL.WattsC. H.Garcia-MorenoC., & WHO Multi-country Study on Women’s Health and Domestic Violence Against Women Study Team. (2008). Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: An observational study. Lancet, 371(9619), 1165–1172.
11.
EvansM.FederG. (2014). Help-seeking amongst women survivors of domestic violence: A qualitative study of pathways towards formal and informal support. Health Expectations, 19, 62–73. https://doi.org/10.1111/hex.12330
12.
FederG.Agnew-DaviesR.BairdK.DunneD.EldridgeS.GriffithsC.GregoryA.HowellA.JohnsonM.RamsayJ.RutterfordC.SharpD. (2011). Identification and referral to improve safety (IRIS) of women experiencing domestic violence with a primary care training and support programme: A cluster randomised controlled trial. Lancet, 378, 1788–1795.
13.
FederG.RamsayJ.DunneD.RoseM.ArseneC.NormanR. (2009). How far does screening women for domestic (partner) violence in different health-care settings meeting the UK National Screening Committee criteria for a screening programme in terms of condition, screening method and intervention? Systematic reviews of nine UK National Screening Committee criteria. Health Technology Assessment, 13(16), 1–113.
14.
FoleyK. A.SheltonJ.RichardsonE.SmartN.Smart-McMillanC.MustakemO. S.YoungA.DavisD.FrayneD. (2019). Primary care women’s health screening: A case study of a community engaged human centered design approach to enhancing the screening process. Maternal and Child Health Journal, 23(11), 1446–1458.
15.
GutmanisI.BeynonC.TuttyL.WathenC. N.MacMillanH. L. (2007). Factors influencing identification of and response to intimate partner violence: A survey of physicians and nurses. BMC Public Health, 7, Article 12.
16.
HinyardL. J.KreuterM. W. (2007). Using narrative communication as a tool for health behavior change: A conceptual, theoretical and empirical overview. Health Education and Behavior, 34(5), 777–792.
17.
HumphreysJ.TsohJ. Y.KohnM. A.GerbertB. (2011). Increasing discussions of intimate partner violence in prenatal care using video doctor plus provider cueing: A randomized controlled trial. Women’s Health Issues, 21(2), 136–144.
18.
LoveG. D.MouttapaM.TanjasiriS. P. (2009). Everybody’s talking: Using entertainment-education video to reduce barriers to discussion of cervical cancer screening among Thai women. Health Education Research, 25(5), 829–838.
19.
LylesC. R.AulakhV.JamesonW.SchillingerD.YeeH.SarkarU. (2014). Innovation and transformation in California’s safety-net healthcare settings: An inside perspective. American Journal of Medical Quality, 29(6), 538–545.
20.
McCawB.BermanW. H.SymeS. L.HunkelerE. F. (2001). Beyond screening for domestic violence: A systems model approach in a managed care setting. American Journal of Preventive Medicine, 21(3), 170–176.
21.
McKibbinA.Gill-HoppleK. (2018). Intimate partner violence: What health care providers should know. Nursing Clinics of North America, 53, 177–118.
22.
MillerE.McCawB.HumphreysB. L.MitchellC. (2015). Integrating intimate partner violence assessment and intervention into healthcare in the United States: A systems approach. Journal of Women’s Health, 24(1), 92–99.
23.
Minsky-KellyD.HambergerL. K.PapeD. A.WolffM. (2005). ‘We’ve had training, now what?’ Qualitative analysis of barriers to domestic violence screening and referral in a health care setting. Journal of Interpersonal Violence, 20(10), 1288–1309.
24.
MooreS. L.FischerI.HavranekE. P. (2016). Translating health services research into practice in the safety net. Health Services Research, 51(1), 16–31.
25.
O’CampoP.KirstM.TsamisC.ChambersC.AhmadF. (2011). Implementing successful intimate partner violence screening programs in health care settings: Evidence generated from a realist-informed systematic review. Social Science and Medicine, 72(6), 855–866.
26.
O’DohertyL.HegartyK.RamsayJ.DavidsonL. L.FederG.TaftA. (2015). Screening women for intimate partner violence in healthcare settings (review). Cochrane Database of Systematic Reviews, 7, CD007007.
27.
PhelanM. B. (2007). Screening for intimate partner violence in medical settings. Trauma, Violence, & Abuse, 8(2), 199–213.
28.
PlichtaS. B. (2007). Interactions between victims of intimate partner violence against women and the health care system: Policy and practice implications. Trauma, Violence, & Abuse, 8(2), 226–239.
29.
ProsmanG. J.LoFoWongS. H.Lagro-JanssenA. L. (2014). Why abused women do not seek professional help: A qualitative study. Scandinavian Journal of Caring Sciences, 28(1), 3–11.
30.
RamsayJ.RichardsonJ.CarterY. H.DavidsonL. L.FederG. (2002). Should health professionals screen women for domestic violence: Systematic review. British Medical Journal, 325(7359), 314.
31.
RhodesK. V.DichterM. E.SmithK. L. (2018). Challenges and opportunities for studying routine screening for abuse. Journal of the American Medical Association, 320(16), 1645–1647.
32.
RivaraF. P.AndersonM. L.FishmanP.BonomiA. E.ReidR. J.CarrellD.ThompsonR. S. (2007). Healthcare utilization costs for women with a history of intimate partner violence. American Journal of Preventive Medicine, 32, 89–96.
33.
SethP.RaifordJ. L.RobinsonL. S.WingoodG. M.DiclementeR. J. (2010). Intimate partner violence and other partner-related factors: Correlates of sexually transmissible infections and risky sexual behaviours among young adult African American women. Sexual Health, 7(1), 25–30.
34.
SinghV.PetersenK.SinghS. R. (2014). Intimate partner violence victimization: Identification and response in primary care. Primary Care, 41(2), 261–281.
35.
SpragueS.MaddenK.SimunovicN.GodinK.PhamN. K.BhandariM.GoslingsJ. C. (2012). Barriers to screening for intimate partner violence. Women & Health, 52, 587–605.
36.
StaytonC. D.DuncanM. M. (2005). Mutable influences on intimate partner abuse screening in health care settings: A synthesis of the literature. Trauma, Violence, & Abuse, 6(4), 271–285.
37.
StithS. M.RosenK. H.McCollumE. E. (2003, July). Effectiveness of couples treatment for spouse abuse. Journal of Marital and Family Therapy, 29(3), 407–426. https://doi.org/10.1111/j.1752-0606.2003.tb01215.x
38.
SutherlandM. A.HutchinsonM. K. (2019). Organizational influences on the intimate partner violence and sexual violence screening practices of college health care providers. Research in Nursing & Health, 42(4), 284–295.
39.
SweeneyA. C.WeitlaufJ. C.ManningE. A.SzeJ. A.WaldropA. E.HasserC. (2013). Intimate partner violence: Perspectives on universal screening for women in VHA primary care. Women’s Health Issues, 23(2), Article e73-6.
40.
SylaskaK. M.EdwardsK. M. (2014). Disclosure of intimate partner violence to informal social support network members: A review of the literature. Trauma, Violence, & Abuse, 15, 3–21.
41.
TavrowP.BloomB. E.WithersM. H. (2017). Intimate partner violence screening practices in California after passage of the affordable care act. Violence Against Women, 23(7), 871–886.
42.
ThurstonW.TuttyL.EisenerA.LalondeL.BelenkyC.OsborneB. (2009). Implementation of universal screening for domestic violence in an urgent care community health center. Health Promotion Practice, 10(4), 517–526.
43.
TodahlJ.WaltersE. (2011). Universal screening for intimate partner violence: A systematic review. Journal of Marital & Family Therapy, 37(3), 355–369.
44.
TrautmanD. E.McCarthyM. L.MillerN.CampbellJ. C.KelenG. D. (2007). Intimate partner violence and emergency department screening: Computerized screening versus usual care. Annals of Emergency Medicine, 49(4), 526–535.
45.
TrevillionK.HowardL. M.MorganC.FederG.WoodallA.RoseD. (2012). The response of mental health services to domestic violence: A qualitative study of service users’ and professionals’ experiences. Journal of the American Psychiatric Nurses Association, 18(6), 326–336.
46.
TuongW.LarsenE. R.ArmstrongA. W. (2014). Videos to influence: A systematic review of effectiveness of video-based education in modifying health behaviors. Journal of Behavioral Medicine, 37(2), 218–233.
47.
UlrichY. C.CainK. C.SuggN. K.RivaraF. P.RubanowiceD. M.ThompsonR. S. (2003). Medical care utilization patterns in women with diagnosed domestic violence. American Journal of Preventive Medicine, 24(1), 9–15.
48.
WaalenJ.GoodwinM. M.SpitzA. M.PetersenR.SaltzmanL. E. (2000). Screening for intimate partner violence by health providers: Barriers and interventions. American Journal of Preventive Medicine, 19(4), 230–237.
Young-WolffK. C.KotzK.McCawB. (2016). Transforming the health care response to intimate partner violence: Addressing “wicked problems.”Journal of the American Medical Association, 315(23), 2517–2518.
51.
ZinkT.ElderN.JacobsonJ. (2003). How children affect the mother/victim’s process in intimate partner violence. Archives of Pediatrics and Adolescent Medicine, 157, 587–592.
52.
ZinkT.ReganS.GoldenharL.PabstS.RintoB. (2004). Intimate partner violence: What are physicians’ perceptions?Journal of the American Board of Family Practice, 17, 332–340.
