Abstract
BackgroundIntimate partner violence (IPV) against women is a global health problem that is a substantial source of human suffering. Within the United States (US), women veterans are at high risk for experiencing IPV. There is an urgent need for feasible, acceptable, and patient-centered IPV counseling interventions for the growing number of women treated in the US’s largest integrated healthcare system, the Veterans Health Administration (VHA). Implementation science and user-centered-design (UCD) can play an important role in accelerating the research-to-practice pipeline. Recovering from IPV through Strengths and Empowerment (RISE) is a flexible, patient-centered, modular-based program that holds promise as a brief counseling intervention for women veterans treated in VHA. We utilized a UCD approach to develop and refine RISE (prior to formal effectiveness evaluations) by soliciting early feedback from the providers where the intervention will ultimately be implemented. The current study reports on the feedback from VHA providers that was used to tailor and refine RISE.MethodWe conducted and analyzed semi-structured, key-informant interviews with VHA providers working in clinics relevant to the delivery of IPV interventions (n = 23) at two large medical centers in the US. Participants’ mean age was 42.6 years (SD = 11.6), they were predominately female (91.3%) and from a variety of relevant disciplines (39.1% psychologists, 21.7% social workers, 17.4% physicians, 8.7% registered nurses, 4.3% psychiatrists, 4.3% licensed marriage and family therapists, 4.3% peer specialists). We conducted rapid content analysis using a hybrid inductive-deductive approach.ResultsProviders perceived RISE as highly acceptable and feasible, noting strengths including RISE’s structure, patient-centered agenda, and facilitation of provider comfort in addressing IPV. Researchers identified themes related to content and context modifications, including requests for additional safety check-ins, structure for goal-setting, and suggestions for how to develop and implement RISE-specific trainings.ConclusionsThese findings have guided refinements to RISE prior to formal effectiveness testing in VHA. We discuss implications for the use of UCD in intervention development and refinement for interventions addressing IPV and other trauma in health care settings globally.Trial registrationClinicalTrials.gov identifier: NCT03261700; Date of registration: 8/25/2017, date of enrollment of first participant in trial: 10/22/2018. Unique Protocol ID: IIR 16–062.
Highlights
Intimate partner violence (IPV) against women is a global health problem that is a substantial source of human suffering
While this study focused on providers working with veterans in the United States (US)’s largest integrated healthcare system, findings may be broadly applicable to other countries that provide healthcare to former service members and veterans, such as the Veterans Affairs Canada, the Department of Veterans Affairs in Australia, and the Service Personnel and Veterans Agency in the United Kingdom [55]
There remains a need to develop and evaluate interventions to address IPV, especially among vulnerable population such as women who have served in the military
Summary
Intimate partner violence (IPV) against women is a global health problem that is a substantial source of human suffering. There is an urgent need for feasible, acceptable, and patient-centered IPV counseling interventions for the growing number of women treated in the US’s largest integrated healthcare system, the Veterans Health Administration (VHA). By and large the majority of countries can improve on their healthcare responses and policy [20] and methods for psychological intervention [23], despite that many private and public service settings, including the VHA in the US, have implemented or are in the process of implementing routine screening protocols to identify women who experience IPV. The current sub-study is part of a larger multi-phase study that seeks to help address this issue by determining the preliminary effectiveness of an intervention for women veterans experiencing IPV [24], which – should it prove to be effective – could help to bridge the gap in healthcare response following IPV disclosure
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