Citation

Decker MR, Flessa S, Pillai RV, Dick RN, Quam J, Cheng D, McDonald-Mosley R, Alexander KA, Holliday CN, Miller E. J. Womens Health (Larchmont) 2017; 26(9): 957-965.

Affiliation

5 Division of Adolescent and Young Adult Medicine and Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

10.1089/jwh.2016.6093

PMID

28375750

Abstract

OBJECTIVE: Intimate partner violence (IPV) and reproductive coercion (RC) are associated with poor reproductive health. Little is known about how family planning clinics implement brief IPV/RC assessment interventions in practice. We describe the uptake and impact of a brief, trauma-informed, universal IPV/RC assessment and education intervention.

METHODS: Intervention implementation was evaluated via a mixed methods study among women ages 18 and up receiving care at one of two family planning clinics in greater Baltimore, MD. This mixed methods study entailed a quasi-experimental, single group pretest-posttest study with family planning clinic patients (baseline and exit survey n = 132; 3-month retention n = 68; retention rate = 52%), coupled with qualitative interviews with providers and patients (total n = 35).

RESULTS: Two thirds (65%) of women reported receiving at least one element of the intervention on their exit survey immediately following the clinic-visit. Patients reported that clinic-based IPV assessment is helpful, irrespective of IPV history. Relative to those who reported neither, participants who received either intervention element reported greater perceived caring from providers, confidence in provider response to abusive relationships, and knowledge of IPV-related resources at follow-up. Providers and patients alike described the educational card as a valuable tool. Participants described trade-offs of paper versus in-person, electronic medical record-facilitated screening, and patient reluctance to disclose current situations of abuse.

CONCLUSION: In real-world family planning clinic settings, a brief assessment and support intervention was successful in communicating provider caring and increasing knowledge of violence-related resources, endpoints previously deemed valuable by IPV survivors.

RESULTS emphasize the merit of universal education in IPV/RC clinical interventions over seeking IPV disclosure.

Language: en

Keywords

clinical intervention; implementation science; intimate partner violence; reproductive coercion; screening; trauma-informed care