Abstract
BackgroundProviders face increasing demands to screen for various health issues. Family medicine, primary care, and obstetric providers are encouraged to screen women universally for intimate partner violence, which could be challenging without comprehensive screening tools. The screening expectations and demands motivated providers and staff in south-central Appalachia (U.S.) to engage community members in streamlining women’s health screening tools, and integrating intimate partner violence screening questions, through a Human-Centered Design (HCD) process. The objective of this article is to present participants’ experiences with and perceptions of the HCD process for developing screening tools for women’s health.MethodsThis was a qualitative, phenomenological study conducted with community members (n = 4) and providers and staff (n = 7) who participated in the HCD process. Sampling was purposive and opportunistic. An experienced qualitative researcher conducted open-ended, semi-structured interviews with participants. Interviews were transcribed and coded for thematic analysis.ResultsCommunity members reported that in the HCD sessions they wanted clinicians to understand the importance of timing and trust in health screening. They focused on the importance of taking time to build trust before asking about intimate partner violence; not over-focusing on body weight as this can preclude trust and disclosure of other issues; and understanding the role of historical oppression and racial discrimination in contributing to healthcare mistrust. Providers and staff reported that they recognized the importance of these concerns during the HCD process.ConclusionsCommunity members provided critical feedback for designing appropriate tools for screening for women’s health. The findings suggest that co-designing screening tools for use in clinical settings can facilitate communication of core values. How, when, and how often screening questions are asked are as important as what is asked—especially as related to intimate partner violence and weight.
Highlights
Providers face increasing demands to screen for various health issues
All participating community members involved in the women’s health screening tool redesign process reported three ideas they had wanted health providers and staff to hear: (1) that screening for intimate partner violence (IPV) requires spending time and earning trust; (2) a person’s weight should not be the focus of every medical visit and that making it the focus can create a barrier to earning trust; and (3) that their (African-American) community’s prior history of discrimination and distrust in medical settings interferes with effective health screening
The desire for trust to be gained over time and over multiple visits was described by community member participants purely in terms of not wanting to talk with providers and staff about something as personal, and literally, intimate as intimate partner violence in a setting that they perceived as a clinician checking a box to complete a required screening
Summary
Providers face increasing demands to screen for various health issues. The screening expectations and demands motivated providers and staff in south-central Appalachia (U.S.) to engage community members in streamlining women’s health screening tools, and integrating intimate partner violence screening questions, through a Human-Centered Design (HCD) process. The objective of this article is to present participants’ experiences with and perceptions of the HCD process for developing screening tools for women’s health. Clinicians are keenly aware of increasing pressures and expectations to implement various screening tools in primary care and women’s health. A growing body of literature describes healthcare products and processes resulting from such patient engagement [12] and examines its utility for improving provider-patient communication and treatment plan development, visit attendance, and satisfaction [6, 8, 9]. This study contributes to filling this gap in the literature
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