Intimate Partner Violence Screening Research Articles

Imaging Findings on Head Computed Tomography Scans in Victims of Intimate Partner Violence.

The aim of the study is to analyze the imaging findings and injury patterns seen on head computed tomography (CT) examinations performed on survivors of intimate partner violence (IPV). An institutional review board-approved retrospective analysis of 668 patients reporting IPV to our institution's violence intervention and prevention program between January 2013 and June 2018 identified 40 unique patients with radiological findings visible on head CT. All injuries visible on head CT were analyzed based on the anatomic location and injury type. Demographics, IPV screening at the time of injury, concomitant, prior, and subsequent injuries to the index head injury were also recorded. Our study cohort had 36 women and 4 men with a mean age at presentation of 43 ± 13 years (mean ± SD), 91 unique injuries with 57 (62.6%) isolated soft tissue injuries, 4 (3.2%) fractures, 13 (14.3%) intra-axial, and 17 (18.7%) extra-axial injuries. Soft tissue injuries and intra-axial injuries occurred most commonly in the frontal region (45.6% and 38.5%), followed by the parietal region (22.8% and 23.1%), while most extra-axial injuries were subdural hematomas (41.2%). Left-sided injuries accounted for 49% (45/91) with 29/91 right-sided (32%) and 17/91 bilateral (19%) injuries. The IPV screening occurred in 44% of injury visits (22/50). Concomitant injuries were seen in 14/50 injury visits (28%), most commonly being in the lower extremity (6/14, 42.9% [% of visits with concomitant injuries]) followed by the upper extremity (5/14, 35.7%), while 52% of visits (26/50) were preceded by prior injuries and 68% of events (34/50) were followed by subsequent injuries. Isolated soft tissue swelling is the most common manifestation of IPV on head CT scans with frontoparietal region being the most common site. Synchronous and metachronous injuries are frequent.

Lifetime history of interpersonal partner violence is associated with insomnia among midlife women veterans.

Over a third of women in the United States report a lifetime history of intimate partner violence. Although a recent review found that intimate partner violence is related to poor subjective sleep, the majority of studies involved reproductive-aged women and used suboptimal measures of interpersonal violence and/or insomnia. We examined the relationship between lifetime intimate partner violence and current clinical insomnia in a cross-sectional sample of midlife women veterans. Cross-sectional data were drawn from the Midlife Women Veterans Health Survey. Women Veterans (N = 232) aged 45 to 64 years enrolled in Department of Veterans Affairs health care in Northern California completed an adapted version of the Extended-Hurt, Insult, Threaten, Scream to assess lifetime history of intimate partner violence (screening threshold score and any physical, sexual, and psychological intimate partner violence) and the Insomnia Severity Index to assess current insomnia. In multivariable analyses, lifetime history of intimate partner violence was associated with twofold to fourfold odds of current clinical insomnia, including overall intimate partner violence (odds ratio, 3.24; 95% confidence interval, 1.57-6.69), physical intimate partner violence (odds ratio, 2.01; 95% confidence interval, 1.09-3.70), psychological intimate partner violence (odds ratio, 3.98; 95% confidence interval, 2.06-7.71), and sexual intimate partner violence (odds ratio, 2.09; 95% confidence interval, 1.08-4.07). Lifetime history of intimate partner violence is common and may be associated with clinical insomnia during midlife. Findings highlight the importance of screening midlife women for intimate partner violence and recognizing the potential role of this traumatic exposure on women's health.

Intimate Partner Violence and Health Outcomes Among Women Living With HIV/AIDS in Ghana: A Cross-Sectional Study.

Intimate partner violence (IPV) is known to have negative health consequences for victims. For women living with HIV/AIDS, whose health may be compromised, exposure to IPV can be devastating. Yet few (if any) studies have explored the health implications of exposure to IPV among HIV-positive women. We begin to fill this gap by examining the effects of various dimensions of IPV (physical, sexual, psychological/emotional, and economic) on the cardiovascular, psychosocial, and sexual reproductive health outcomes of HIV-positive women in Ghana. Data were collected from a cross-section of 538 HIV-positive women aged 18 years and older in the Lower Manya Krobo District in the Eastern Region. We used logit models to explore relationships between IPV and health. The findings indicate high prevalence of IPV in our sample: physical violence (61%), sexual violence (50.9%), emotional/psychological violence (79.6%), and economic violence (66.8%). Generally, participants with experiences of IPV reported cardiovascular health problems, unwanted pregnancies and pregnancy loss, and poor psychosocial health. Our findings suggest the importance of screening for IPV as part of HIV care in Ghana.

Screening for and Experiences of Intimate Partner Violence in the United States Before, During, and After Pregnancy, 2016-2019.

Objectives. To measure rates of intimate partner violence (IPV) screening during the perinatal period among people experiencing physical violence in the United States. Methods. We used 2016-2019 Pregnancy Risk Assessment Monitoring System data (n = 158 338) to describe the incidence of physical IPV before or during pregnancy. We then assessed the prevalence of IPV screening before, during, or after pregnancy and predictors of receiving screening among those reporting violence. Results. Among the 3.5% (n = 6259) of respondents experiencing violence, 58.7%, 26.9%, and 48.3% were not screened before, during, or after pregnancy, respectively. Those reporting Medicaid or no insurance at birth, American Indian/Alaska Native people, and Spanish-speaking Hispanic people faced increased risk of not having a health care visit during which screening might occur. Among those attending a health care visit, privately insured people, rural residents, and non-Hispanic White respondents faced increased risk of not being screened. Conclusions. Among birthing people reporting physical IPV, nearly half were not screened for IPV before or after pregnancy. Public health efforts to improve maternal health must address both access to care and universal screening for IPV. (Am J Public Health. 2023;113(3):297-305. https://doi.org/10.2105/10.2105/AJPH.2022.307195).

Australian women’s perspectives of routine enquiry into domestic violence before and after birth

BackgroundPeripartum women are vulnerable to experiencing intimate partner violence (IPV). Interactions with health practitioners during maternity care provide a unique opportunity to detect and respond to women who are experiencing IPV. The aim of this study was to explore women’s experiences of IPV screening at an Australian maternity service.MethodsQualitative methodology was used in this cross-sectional study. In-depth semi-structured interviews were conducted with women with IPV who attended an Australian maternity service. Thematic analysis was used to identify codes and themes.ResultsThe nine women expressed three major themes, and six sub-themes, surrounding clinician approaches (communication and support, asking about IPV, and following disclosure), system considerations (fear of child safety involvement, continuity of care, and environmental considerations), and education. All participants supported screening and highlighted beneficial or detrimental approaches to screening and care, and recommendations for improvement.ConclusionThis research points to the benefit of trauma-informed frameworks in hospitals to support women experiencing IPV.

Intimate Partner Violence Screening Instruments: A Protocol for a COSMIN-Based Systematic Review.

Intimate partner violence (IPV) is a major public health problem resulting in a significant impediment to equal participation, quality of life, and personal, social, and economic development. At present, a variety of screening instruments for IPV have emerged in developed countries, and some of them have been adapted to the language and culture of different countries, such as Hurt, Insult, Threaten, Scream (HITS) and the Abuse Assessment Screen (AAS). The selection of the most appropriate IPV screening instrument for the target population and context from among those instruments has become difficult for researchers when intending to start screening. Therefore, a systemic review of IPV screening instruments is needed. This protocol describes a COSMIN-based systematic review of the measurement properties of these instruments. The aims of the systematic review are to (1) evaluate the methodological quality of studies on the measurement properties including the validity, reliability, and internal consistency of these IPV screening instruments, and (2) provide suggestions for relevant researchers in their local context for using the IPV screening instruments.

Intimate partner violence among HIV-positive women in discordant relationships attending care and treatment clinics in Dar es Salaam, Tanzania.

Intimate partner violence (IPV) toward women is a public health concern affecting many countries across the world. Globally, 30% of women experience lifetime physical, sexual, or psychological harm. HIV-positive women in discordant relationships are at higher risk of experiencing IPV than other women. This study aimed to determine the magnitude and factors associated with intimate partner violence among HIV-positive women in discordant relationships attending HIV care and treatment clinics in Dar es Salaam, Tanzania. An analytical cross-sectional study was conducted among 411 HIV-positive women who were in discordant relationships attending HIV care and treatment clinics in eight selected healthcare facilities in Dar es Salaam from June 2021 to July 2021. A questionnaire with structured questions on social-demographic information and factors associated with intimate partner violence was used. Data were collected electronically using the Open Data Kit (ODK) system, cleaned, and stored. Descriptive analysis was done and presented in frequency distribution and cross-tabulation. A chi-square was used to determine the differences in variables, and the modified Poisson regression model was used to estimate adjusted prevalence risk ratios (APRRs) with 95% CI for factors associated with IPV. Variables were considered statistically significant at 95% CI and p < 0.05. All statistical analyses were conducted using STATA version 15. The mean age of the participants was 36.2 (standard deviation [SD] ±7.8). The majority of women had attained primary education, i.e., 237 (57.7%). Over 65.7% of HIV-positive women in discordant relationships had ever experienced IPV. Women whose partners had primary and secondary education, were alcohol users, and were solely decision-makers in the family were strongly associated with IPV. Close to two-thirds of HIV-positive women who were in discordant relationships attending HIV care and treatment clinics in selected healthcare facilities in Dar es Salaam had ever experienced at least one form of IPV. Low level of education of the partner, alcohol use, and power relation in decision-making were significantly associated with IPV. We recommend routine screening of IPV for HIV-positive women who are in discordant relationships attending HIV care and treatment clinics. Joint efforts are needed in addressing the factors associated with IPV in discordant couples.

Knowledge, Attitude, and Practice of Intimate Partner Violence and Its Determinants Among Female Nursing Students in Abakaliki, Southeast Nigeria

To assess the knowledge, attitude, practice, and determinants of intimate partner violence (IPV) among nursing female student in a tertiary hospital in Abakaliki. A cross-sectional descriptive study was done in a tertiary hospital in Abakaliki between 1st March 2018 and 31st August 2018 among 450 nursing female student. They were interviewed using a Composite Abuse Scale (CAS) version 2013. Analysis was done using IBM SPSS Statistic version 20. The prevalence of any type of IPV among respondents was 47.8%. The majority (70.9%) were aware of IPV and the commonest mode of information was mass media (60.0%). Majority of the respondent would resort to prayer following IPV and only 15.5% would report to police. The most common form of abuse reported was emotional &amp;or harassment abuse (26.6%). Student’s age (OR = 0.42; 95% CI [0.41, 0.92]), social class (OR = 0.60; 95% CI [0.40, 0.90]), level of study (OR = 0.45; 95% CI [0.29, 0.68]), and partner’s level of education (OR = 0.60; 95% CI [0.42, 0.88]) were determinant of respondent experiencing IPV. Less than 50% of the respondent were aware of legislation against IPV. The study shows a high level of IPV among the studied group. Screening for IPV is advocated among the students’ population especially among the young adolescent. Efforts should also be made by the government to increase awareness about Nigerian law against IPV.

Is Intimate Partner Violence More Common Among HIV-Positive Pregnant Women? A Comparative Study in Oyo State, Nigeria.

Introduction: Intimate partner violence (IPV) is the most common form of violence against women. Pregnant women are also not exempted from the menace of IPV which has dire consequences for both the mother and child. There is an established link between HIV and IPV and both have a synergistic effect. This study is aimed at comparing the prevalence, pattern, and determinants of IPV among pregnant women living with HIV and HIV-negative pregnant women attending antenatal clinics in Oyo state. Methodology: This is a descriptive cross-sectional study carried out among women attending antenatal clinics in Oyo state using a multistage sampling technique. The study spanned through March and September 2019. The data collection was conducted using a semi-structured questionnaire and the analysis was done using Statistical Package for Social Sciences version 22. The pattern and prevalence of IPV were measured using the Composite Abuse Scale, a 30-item validated interviewer-administered research instrument. It measured 4 dimensions of abuse: physical, emotional, severe, combined, and sexual harassment. A preliminary cut-off score of 7 was used to divide respondents into the presence or absence of IPV. A Chi-square test was used to test for an association between IPV and socio-demographic characteristics and a logistic regression was used at the multivariate level to identify the determinants of IPV. The P-value was set at <.05. Results: Out of the 240 booked pregnant women, 44.2% of HIV-negative respondents and 47.5% of women living with HIV reported being abused in the index pregnancy. Severe combined abuse was the most common type of abuse, 110 (75.1%), followed by emotional abuse, 70 (40.2%), physical abuse, 68 (39.3%), and sexual harassment, 67 (38.1%). Respondents living with HIV reported suffering more physical abuse than their HIV-negative counterparts. Occupation of respondents and duration of marriage determinants of IPV among HIV-positive participants are statistically significant while the duration of marriage was not statistically significant for IPV among HIV-negative respondents. Conclusion: This study recorded a high prevalence of IPV among pregnant women living with HIV and HIV-negative pregnant women with a slight increase in the group living with HIV. It is therefore recommended that IPV screening programs and intervention strategies should be developed for every pregnant woman, irrespective of their HIV status.

Abused and Rejected: The Link Between Intimate Partner Violence and Parental Alienation

Previous studies have demonstrated a connection between intimate partner violence (IPV) and a child’s alienation from the abused parent, but little is known about the relationships between the type of IPV, aspects, and severity of a child’s alienation, and the target parent’s gender. This study assessed the presence of an IPV history (verbal and physical aspects) among parents who identify as targets of their children’s unreasonable rejection. Also investigated were associations between the form of IPV and manifestations of a child’s alienated behavior, parent’s gender and type of IPV, and parents’ gender and degree of the child’s alienation. Self-identified alienated parents (n= 842) completed an online survey that included an IPV screening measurement (Hurts, Insults, Screams, Threatens screening tool) and a measure of the parent’s perception of their child’s alienated behaviors (Rowlands Parental Alienation Scale). The majority identified as IPV victims and reported a higher level of verbal than physical abuse. More mothers than fathers identified themselves as IPV victims. As a group, IPV victims rated their child as more severely alienated than did non-IPV alienated parents. Mothers were more likely than fathers to report physical aggression by the other parent and more likely than fathers to assess their child’s alienated behaviors as more severe. Victims of physical violence reported their children were less likely to withhold positive affection from them. This knowledge may assist in earlier identification of the alienation process and greater recognition, legitimacy, funding, and opportunities for enhanced collaboration among stakeholders. This, in turn, may lead to improvements in prevention, intervention, and accountability, thus helping to interrupt alienation processes.

Domestic violence against pregnant women is a potential risk factor for low birthweight in full-term neonates: A population-based retrospective cohort study.

Domestic violence's most frequently reported outcomes are preterm delivery and low birthweight, both of which are the strongest correlates of mortality and morbidity. Several studies have shown that pregnant women with domestic violence during pregnancy were more likely to deliver low-birthweight and preterm neonates. However, there has been no consensus on associations between domestic violence and low-birthweight and preterm delivery. To examine the impact of domestic violence on birthweight stratified by preterm or full-term delivery, a population-based retrospective cohort study was conducted that linked four national databases in Taiwan. A total of 1,322 subjects associated with a report of domestic violence during pregnancy were compared with 485,981 subjects without any record of reported domestic violence. The percentage of low birthweight in the group exposed to domestic violence was significantly higher than in the unexposed group with full-term delivery (4.9% vs. 3.3%, p = 0.001). Multivariable logistic regression analysis showed that pregnant women exposed to domestic violence had an OR of 1.37 (95% CI 1.05, 1.79) for low birthweight in full-term delivery. However, domestic violence was not significantly associated with low birthweight in preterm delivery. Screening for intimate partner violence in the perinatal health care system should be seen as especially important for women who have had full-term low-birthweight neonates.

Predicting intention of intimate partner violence screening among Thai nursing students: A cross-sectional study.

Using the theory of planned behaviour, the aim of this study was to examine predictors of intention to screen patients for intimate partner violence among Thai nursing students. We employed a cross-sectional, anonymous online survey study with convenience sampling of senior nursing students from across Thailand in April 2019. We administered the Intimate Partner Violence Screening Intention, Nursing Students, a 36-item tool, and analysed relationships between students' intentions and attitudes, subjective norms and perceived behavioural control towards intimate partner violence screening. PROCESS was used to test mediation analyses. Of N=639 respondents. Most (90%) reported intention to screen patients for intimate partner violence. Approximately 41% reported having no intimate partner violence training in their nursing school. Results of the multiple logistic analysis showed that attitudes (OR: 8.5; 95% CI 1.2-4.6) and subjective norms (OR: 4.4; 95% CI 1.4-4.6) significantly predicted intention, whereas perceived behavioural control (OR: 1.7; 95% CI 0.5-4.9) did not. Moreover, attitudes and subjective norm significantly mediated the association between providing a screening tool at clinical sites, and intention. Attitudes and subjective norms were significant predictors of intention of intimate partner violence screening. However, participants lacked adequate role models and training. Future research should improve the predictive power of the framework by integrating additional constructs such as the availability of screening tools, the presence of role models, to design and evaluate effective training and support for future nurses to address intimate partner violence in practice. It is time to seriously consider integrating intimate partner violence content and training into the Thai nursing curriculum, and address the policies, guidelines, and practice culture. The study was designed to examine predictors of intention to screen patients for intimate partner violence. Thai senior nursing students were contributed in the design and conduct of the study. However, the study did not include input from the public or the intended participants.

Implementation of a Trauma-Informed Care Elective in Medical Education

Background: Education about the harm trauma does to one’s health is lacking in traditional medical school curricula. The goal of our elective extracurricular course on trauma-informed care (TIC) was to provide students with experience, knowledge, and resources to care for future patients who may have lived through traumatic experiences. Methods: We created a semester-long elective TIC course for first year medical students at a large, public medical school. We developed one - and one retrospective /post-course survey for studentsusing a mix of sliding scale and free text responses to capture student evaluations of the course. ANOVA was used for statistical analysis. Results: Of the 11 students who completed the retrospective - and post- surveys, there was a significant increase in student’s rating of their knowledge regarding impact of trauma on health by the end of the course (retro : 45.55+24.73, post: 81.64+11.79). Importantly, the group felt significantly more comfortable screening for intimate partner violence (retro : 34.09+31.05, post: 77.00+23.81), performing a physical exam for patient’s experiencing intimate partner violence (retro : 17.55+22.17, post: 67.27+18.35), accessing resources for patients experiencing addiction and recovery (retro : 35.00+32.25, post: 76.82+17.79), and caring for patients who have had adverse childhood experiences (retro : 28.27+32.18, post: 66.36+21.46). Discussion: This study is limited in a small sample size and the biases that accompany survey-based qualitative studies. It can only be interpreted in the context of a large public medical school in the southern United States. Conclusion: An elective course on TIC can be a way to make medical students feel more comfortable providing trauma-informed care. Additional research is needed to evaluate the long-term influence of a TIC course on medical students’ patient interactions.

Intimate Partner Violence and Pregnancy: Nationwide Analysis of Injury Patterns and Risk Factors.

Intimate partner violence (IPV) is a significant cause of injury, and in pregnant patients (PIPV) poses a risk to both mother and fetus. Characteristics and outcomes for PIPV patients have not been well described. We hypothesize that PIPV patients have higher admission rates and mortality than non-IPV pregnant trauma (PT) patients and nonpregnant female IPV patients of childbearing age. We also hypothesize differences exist between PIPV and PT patient injury patterns, allowing for targeted IPV screening. The Nationwide Emergency Department Sample database was queried from 2010 to 2014 to identify IPV in adult women patients by injury code E967.3. Patients were compared in 2 ways, PIPV vs PT and PIPV vs nonpregnant female IPV patients. Demographics, injury mechanisms, and National Trauma Data Standard injury diagnoses were surveyed. Primary outcomes were hospital admissions and mortality. Logistic regression was used to estimate risk factors of the outcomes of hospitalization and IPV victimization in pregnant injured patients. There were 556 PIPV patients, 73,970 PT patients, and 56,543 nonpregnant female IPV patients. When comparing PIPV to PT, more PIPV patients had Medicaid coverage or were self-pay. Suffocation, head injuries, face/neck/scalp contusions, multiple contusions, and abrasions/friction burns were more prevalent in PIPV patients. Mortality and hospital admissions were scarce among all cohorts. Predictors of IPV victimization among injured pregnant patients include multiple injuries, head injuries, face/neck/scalp contusions, abrasions/friction burns, contusions of multiple sites, and those with Medicaid or self-pay coverage. Among injured pregnant patients, those with multiple injuries, head injuries, contusions of the face/neck/scalp, abrasions/friction burns, and multiple contusions should undergo IPV screening. Admissions and mortality are low; therefore, prevention measures should be implemented in the emergency department to reduce repeat victimization.

General dentists' readiness and barriers in intimate partner violence screening: a cross-sectional study in Jeddah City.

Intimate partner violence (IPV) has varying prevalence rates and risk factors based on cultural, social, and economic backgrounds. However, it is common for IPV victims to be seen in dental settings on a regular basis. Identifying IPV victims in dental settings might help address this overlooked global dilemma. This study was conducted to evaluate general dentists' readiness and potential barriers to performing IPV screening in a dental setting. A cross-sectional study was conducted using the Domestic Violence Healthcare Providers Survey (DVHPS). This validated and structured questionnaire was adopted, modified, and self-administered to evaluate general dentists' readiness and barriers to IPV screening. General dentists were recruited for the study population from 5 administrative territorial regions in Jeddah, Saudi Arabia. The questionnaire consists of 7 domains that assess general dentists' readiness and barriers to performing IPV screening for all dental patients. Out of the 273 dentists approached, a total of 200 participated in the study, with a total response rate of 73.3%. The percentages of female and male dentists were 54% and 46%, respectively. Almost 73% of the study population believed they could identify IPV in a dental setting. The multiple linear regression model indicated a substantial decrease in general dentists' readiness to perform IPV screening due to fear of offending patients, an increased number of patients treated per day, and professional role resistance. The current study suggests the high readiness of general dentists to perform IPV screening for all patients. However, prominent barriers to implementing IPV screening for all patients include fear of offending patients, an increased number of patients treated per day, and professional role resistance. Postgraduate continuous education is encouraged to re-enforce the importance of IPV screening in dental settings.

"Are You Safe at Home?": Clinician's Assessments for Intimate Partner Violence at the Initial Obstetric Visit.

Few studies have empirically examined patient-clinician conversations to assess how intimate partner violence (IPV) screening is performed. Our study sought to examine audio-recorded first obstetric encounters' IPV screening conversations to describe and categorize communication approaches and explore associations with patient disclosure. We analyzed 247 patient encounters with 47 providers. IPV screening occurred in 95% of visits: 57% used direct questions, 25% used indirect questions, 17% repeated IPV screening later in the visit, 11% framed questions with a reason for asking, and 10% described IPV types. Patients disclosed IPV in 71 (28.7%) visits. There were no associations between disclosure and any categories of IPV screening.

Experience of introducing screening for intimate partner violence and reproductive coercion in an urban sexual health clinic

BackgroundIntimate partner violence (IPV) and reproductive coercion (RC) can result in serious psychological, social and physical harm. Screening patients for IPV/RC has the potential to identify and assist patients who may not otherwise discuss this with a health practitioner. Targeted screening for those with a range of specific presentations including many sexual and reproductive health issues has been recommended, but universal screening has not. MethodsThe implementation and evaluation of a screening program for IPV and RC in an urban sexual and reproductive health clinic is described. ResultsThe program enabled patients who had been exposed to IPV and/or RC to receive assistance and support. Screening was highly acceptable to patients, and the reception and clinical staff became both highly supportive of screening and increasingly confident to assist patients who were exposed to IPV and/or RC. Conclusion and implications for public healthThis program could be adapted for use in a number of healthcare settings and lead to positive health outcomes.

Intimate partner violence screening during pregnancy: midwives’ perspective

ABSTRACT Violence during pregnancy has serious health consequences. Several scientific societies recommend introducing domestic violence screening in clinical practice, but it is poorly employed. This study aimed to explore midwives’ perspective regarding how, where, and when to conduct intimate partner violence screening during pregnancy to increase its clinical application. We performed a qualitative study using a hermeneutic phenomenological approach. Eleven midwives were recruited, and semi-structured interviews were conducted. The interviews were audio recorded and transcribed verbatim. Content analysis was conducted. Six main themes emerged: “the healthcare providers involved,” “the best place to investigate,” “the best time to ask,” “how to investigate,” “what facilitates investigations and women’s disclosure,” and “what hinders investigations and women’s disclosure.” Most interviewees believed that midwives are the most suitable healthcare providers to investigate violent situations during pregnancy because the continuity of midwifery care can facilitate women’s disclosure. Midwives emphasized the importance of an environment where women’s privacy is respected. Midwives did not consider it appropriate to ask about domestic violence at the first antenatal appointment. Most believed that the best way to investigate domestic violence depends on the context and the woman’s personal history.

‘It is a hard decision’: a qualitative study of perinatal intimate partner violence disclosure

BackgroundPerinatal intimate partner violence is a hidden under reported and difficult to identify problem which has negative effects on mother and child. The present study aimed to explore barriers and facilitators of perinatal intimate partner violence disclosure.MethodsThis qualitative study was carried out from October 2019 to January 2021 in Mashhad, Iran. Participants included 23 abused women (11 pregnant and 12 after birth) which were selected via purposive sampling. Semi-structured in-depth interviews and focus group discussion were conducted until the data saturation was achieved. The data analysis was performed based on conventional content analysis adopted by Graneheim & Lundman.ResultsThe main themes “barriers to disclosure” and “facilitators of disclosure” were emerged as the result of data analysis. Barriers to disclosure included negative disclosure consequences and protection of family privacy. Facilitators of disclosure included maternal self-efficacy, threats to security, and formal and informal supportive networks.ConclusionsMost abused women did not disclose violence despite routine screening for perinatal intimate partner violence in antenatal care. Recognizing the barriers to and facilitators of violence disclosure play an important role in eliminating barriers, strengthening facilitators, providing effective supportive services for abused women, and reducing perinatal violence. Focus on the barriers to and the facilitators of disclosure will be useful to policymakers, health program planners, and health care providers to identify and manage intimate partner violence, appropriately.

Evidence of Help-Seeking Behaviors Among Black Women Under Community Supervision in New York City: A Plea for Culturally Tailored Intimate Partner Violence Interventions.

Black women involved in the legal system disproportionately experience intimate partner violence (IPV); however, current research does not satisfactorily describe the risk and protective factors associated with IPV among Black women under community supervision. We conducted a subgroup analysis of Black women (N = 128) using data from a randomized controlled trial that evaluated the feasibility and efficacy of two IPV screening and prevention programs for women under community supervision. Participants in the original study were randomized into two IPV prevention conditions-computerized or case manager Women Initiating New Goals of Safety (WINGS). In this study, we examine the effects of that study's two conditions on linkage to IPV services and secondary outcomes, specifically among Black participants who experienced physical, sexual, and psychological IPV. Both conditions showed significant reductions in days of substance use abstinence over the 3-month period among Black women who experienced sexual or verbal IPV. Participants in the case manager arm were 14 times more likely to receive IPV services in the past 90 days-from baseline to the 3-month follow-up (adjusted odds ratio = 14.45, 95% confidence interval [CI] = 1.25 to 166.51, p = 0.032). Participants in the computerized arm were significantly more likely to report receiving social support from baseline to the 3-month follow-up assessment (regression coefficient [b] = 2.27, 95% CI = 0.43 to 4.11, p = 0.015). Although both conditions showed significant reductions in the number of days of abstinence from substance use among this subgroup of Black women, the findings showed differential effectiveness between the computerized WINGS arm and the case manager WINGS arm in improving social support and linkage to services. These findings may indicate that different modalities of WINGS may work better for specific activities and point to the need for a hybrid format that optimizes the use of distinct modalities for delivering activities.