Domestic Violence Screening Research Articles

WITHDRAWN: Domestic violence screening and intervention programmes for adults with dental or facial injury.

Domestic violence exists in all communities across the world. Healthcare services have a pivotal role in the identification, assessment and response to domestic violence. As the face is a common target in assault, dentists and oral and maxillofacial surgeons are in a unique position to screen for domestic violence in the context of presentation of dental and facial injury. Owing to lack of training, dentists and oral and maxillofacial surgeons may not be the best persons to give advice to someone experiencing domestic violence. Improper advice such as encouragement to leave an abusive relationship may escalate the frequency of violence. It may be more appropriate to refer to specialist agencies for intervention and support. It would, therefore be useful to know whether screening and intervention programmes are effective.(1) To assess the benefits and harms of intervention programmes employed to reduce and or prevent domestic violence in adults with dental and/or facial injuries.(2) To assess the benefits and harms of screening and the use of different screening tools in the detection of the proportion of adult victims of domestic violence who present with dental and/or facial injury.We searched the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO and Lilacs databases. No language restrictions were applied. Personal contacts were used and international domestic violence organisations were contacted to identify any unpublished trials. Last search was done February 2004.Randomised controlled trials involving adults aged 16 years and over presenting with dental and/or facial injury relating to domestic violence in any healthcare setting.Screening of eligible studies was conducted in duplicate and independently by two reviewers. Results were to be expressed as random effects models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence interval. Heterogeneity was to be investigated including both clinical and methodological factors.No eligible randomised controlled trials (RCTs) were identified.There is no evidence to support or refute that screening for domestic violence in adults with dental or facial injury is beneficial nor that it causes harm. Screening tools to detect domestic violence exist but no RCTs have specifically evaluated their effectiveness for patients presenting with facial and or dental injuries. There is also lack of evidence that intervention programmes are effective at reducing frequency of physical assaults and at reducing the severity of facial injuries.

Intimate Partner Violence Experienced by Physicians: A Review.

Physicians play a significant role in screening for domestic violence. However, little information is available about the prevalence of physicians who experience intimate partner violence (IPV) or the implications for their clinical practice. National surveys indicate a potential prevalence of 16% for sexual abuse and 32% for abuse by an intimate partner. This extrapolates to more than 395,000 potential physician victims, the majority of which are women. We conducted a systematic review of IPV and physician victims from 1990 to 2014 that included peer-reviewed journals, trade books, and dissertations that referenced physician victims. We identified 17 publications; nine quantitative studies, four first-person accounts, one qualitative study, and a qualitative dissertation that included two physician subjects. Two case studies of victimized physicians were identified in trade books. Quantitative results noted that women reported higher prevalence for all experiences of violence [childhood exposure (6%-32%), adult IPV exposure (7%-24%)] than men (6%-10%). This review highlights the need for improved understanding of physician experience with IPV, and development of physician-sensitive resources and treatment approaches. Contributions and limitations are provided for each publication. IPV exposure impacts clinical practice, including reticence to consistently screen patients. Lower reported prevalence may be related to extreme stigma among physicians that may prevent their reporting and help seeking, but more research is needed. We provide recommendations for clinical practice, education, and future research.

Validity and Reliability of the Spanish Version of the "Abuse Assessment Screen" among Pregnant Women.

To assess the reliability, accuracy, and construct validity of the SpanishAbuse Assessment Screen (AAS) among pregnant women using the Spanish version of Indexof Spouse Abuse (ISA) as a reference standard. Cross-sectional survey. A total of 1,329 pregnant women were selected in nine primary care centers during 2008-2009. The Spanish ISA was self-administered first, followed by the AAS, administered by the midwife. Sensitivity, specificity, and predictive values of the Spanish AAS were compared with the Spanish version of the ISA as a reference standard. Percentage of agreement between initial and retest administration of the Spanish AAS was high, from 96.4% to 100%. Specificity was for all types of abuse above 97%, but sensitivity values were much lower (33.3%, 22.9%, 6.9%, for severe physical abuse, minor psychological abuse, and minor physical abuse, respectively). The sensitivity of severe psychological abuse was perfect. Construct validity was good. The Spanish AAS has good test-retest reliability, specificity, and construct validity. The sensitivity was good for severe psychological abuse and moderate for severe physical abuse. Further formal psychometric evaluations, in other languages from countries with low prevalence of abuse, remains a priority for clinical and research efforts in pregnancy domestic violence screening.

The Family Court–Based Stepping Stones Model of Triage: Some Concerns About Safety, Process, and Objectives*

This article critically evaluates the recommendation that family court–based mandatory mediation incorporated in a tiered service delivery model be replaced by a mandatory screening process incorporated in a stepping stones triage model in which couples are matched with an appropriate conflict resolution proceeding. My conclusion is that implementation of this recommendation should be made contingent upon the willingness of its advocates to address concerns with the safety, process, and objectives as described herein. Key Points for the Family Court Community: Domestic violence screening should be incorporated in the larger triadic process of screening–risk assessment–risk management. A Safety First Rule should be followed in screening couples into or out of conflict resolution proceedings. Screening decisions must be grounded in an empirically validated method of matching couples with appropriate conflict resolution proceedings. Causal mechanisms must be included as items in any risk assessment instrument used in family courts.

Domestic Violence Awareness.

Domestic or intimate partner violence is alarmingly prevalent, and, for victims, a major contributor to depression, anxiety, and other forms of mental illness. Psychological problemsandpsychiatric syndromesoften are the antecedents of domestic violence for the perpetrator and also can be risk factors for becoming a victim. Remarkably, the two dominant mental health fields, psychiatry and clinical psychology—the ones charged with investigating and attending to the mind, brain, andbehavior—are largelyabsent fromdomestic violence research and intervention. More than one in three women and at least one in four men have been the victim of rape, physical violence, or stalking by an intimate partner (1). However, women are far more likely than men to experience severe sexual and physical violence from apartnerortobekilledbyone(1,2). IntheUnitedStates, intimate partnerhomicidesmakeupbetween40%and50%ofallmurders of women (3). Domestic violence crosses geographic and socioeconomic stratification, although studies indicate that lowerincomewomen in rural communities experience higher rates of violence and, specifically, sexual abuse (4, 5). Victims suffer from dramatic rates of depression, anxiety, and posttraumatic stress disorder,aswellassubstanceabuseandsuicidality(6–8).Arecent study based on a representativeU.S. sample ofmore than 25,000 adults indicatedthatnewonsetsofmajormentalhealthproblems were more than twice as common among those exposed to domestic violence in the past year than among nonvictims (9). Millionsofchildren—asmanyas 15million, according to some estimates—witness domestic violence each year (10). For male children there is a 1,000% greater risk of reproducing this violence in their own spousal relationships (11). A recent epidemiologic study found prior domestic violence victimization to bemore strongly associatedwith domestic violence perpetration than any other factor (12). Despite its prevalence in the general population, domestic violence is underrepresented in our consulting rooms in part because victims, and especially perpetrators, rarely voluntarily self-identifyorseektreatment(8, 13, 14).Shame,guilt, anddenial are obvious deterrents. These factors are often compounded by a sense of futility resulting from learned helplessness, and a profound unraveling of self-esteem (15). More practical considerations include fears for personal security, economic codependence, and the concerns that disclosure will trigger social services engagement, particularly child protection (8). Finally, disclosure represents a potential threat to the continuance of a romantic relationship, which, though abusive, involves emotional investment. Without experience handling domestic violence situations, clinicians can feel ill-prepared and deskilled, lacking knowledge about referral sources, emergent threats of bodily harm, and the accompanying legal and ethical obligations. This lack of presentation in clinical settings contributes to a “don’t ask” scenario (8). Since 1986, numerous medical institutions have advocated for domestic violence screening inroutinemedicalcare(16, 17); in2001, theAmerican Psychiatric Association followed suit. That same year, the AmericanPsychologicalAssociation’s IntimatePartner Abuse and Relationship Violence Working Group launched a curriculumon domestic violence but appears to have done little to foster relevant training in clinical interventions. Domestic violence is an exceptionally challenging clinical situation. Those in domestic violence relationships areat risk for repeating this experience, and likely have abuse or exposure to it in their backgrounds (11, 18), adding immense complexity to treatment. Thework presents unique challenges, including safety planning and patients’minimization of abuse, which may induce feelings of helplessness in the context of significant urgency anddanger (19–21). There noware targeted treatments for domestic violence intervention, such as Seeking Safety (22) and Child-Parent Psychotherapy (23), though few psychologists and psychiatrists are trained in them. Of course the question of how clinically to respond to perpetrators is a complicated one, independentof thenecessary legal consequences.However, treatment and prevention programs are emerging, such as the Melissa Institute for Violence Prevention and Treatment. Beyond the “professional counter-transference” is possibly a more personal one. Aggression is a fundamental human impulse, and violence a socially unacceptable manifestation of it. Underlying any violent interaction is the universal human struggle with aggression and its myriad complex antecedents: family and developmental history; self-esteem; power dynamics; fear of abandonment and humiliation; emotional regulation; impulse control; and the capacity for empathy, guilt, and remorse. The possibility that domestic

Screening for antepartum anxiety and depression and their association with domestic violence among Egyptian pregnant women

Greater attention has been paid recently to prenatal mental disorders and their association with exposure to domestic violence (DV) as both have serious reproductive consequences. The aim of this study was to screen for anxiety and/or depression among pregnant women, as well as identify the frequency and association of exposure to DV. This cross-sectional study was conducted in 2013 and included a systematic random sample of 376 pregnant women attending the antenatal care outpatient clinic at the largest university hospital in Egypt. Participants were interviewed using a structured questionnaire including three components: sociodemographic characteristics of the participants, the Hospital Anxiety and Depression Scale questionnaire (HADS), and the Hurt, Insulted, Threaten, Scream (HITS) inventory for screening for DV. Women who expressed simultaneous anxiety and depressive manifestations accounted for 63%, whereas 11.4% and 10.4% of them expressed only anxiety and only depression, respectively. Exposure to DV was detected in 30.6% of all participants, of whom 25.2% were physically hit by their husbands often to most of the time. Simultaneous anxiety and depression was independently associated with lifetime exposure to DV (odds ratio=3.27, 95% confidence interval: 1.28-8.34, P=0.013), whereas having a university-graduated husband was a protective factor from DV (odds ratio=0.22, 95% confidence interval: 0.64-0.75, P=0.01). Symptoms of anxiety and depression were highly reported among this sample of pregnant Egyptian women and were significantly associated with exposure to intimate partner violence. Screening of pregnant women for mental disorders associated with exposure to DV with provision of supportive mental health services, as well as interventions to reduce exposure to DV, should be considered for integration into antenatal care services.

Chronic Victims, Risky Women: Domestic Violence Advocacy and the Medicalization of Abuse

Critical literature on the antiviolence movement has largely overlooked the role of biomedical institutions in depoliticizing domestic violence advocacy. Additionally, studies of medicalization have largely failed to attend to domestic violence screening and diagnosis as key technologies through which gendered biomedical surveillance has expanded. Based on interviews with domestic violence medical advocates and health-care providers, I show how domestic violence is being transformed into a chronic disease category, thereby reconfiguring the historical relationship between feminist-based advocacy and medical expertise. What follows is a scientized and degendered transformation of causal explanations for domestic violence: rather than patriarchy, advocates now explain domestic violence using the language of risk. I argue that haunting this construction of women as at high risk for abuse is a reconstituted gender essentialism that casts women victims as passive recipients of their partners’ abusive actions.

Maternal and child health nurse screening and care for mothers experiencing domestic violence (MOVE): a cluster randomised trial.

BackgroundMothers are at risk of domestic violence (DV) and its harmful consequences postpartum. There is no evidence to date for sustainability of DV screening in primary care settings. We aimed to test whether a theory-informed, maternal and child health (MCH) nurse-designed model increased and sustained DV screening, disclosure, safety planning and referrals compared with usual care.MethodsCluster randomised controlled trial of 12 month MCH DV screening and care intervention with 24 month follow-up.The study was set in community-based MCH nurse teams (91 centres, 163 nurses) in north-west Melbourne, Australia.Eight eligible teams were recruited. Team randomisation occurred at a public meeting using opaque envelopes. Teams were unable to be blinded.The intervention was informed by Normalisation Process Theory, the nurse-designed good practice model incorporated nurse mentors, strengthened relationships with DV services, nurse safety, a self-completion maternal health screening checklist at three or four month consultations and DV clinical guidelines. Usual care involved government mandated face-to-face DV screening at four weeks postpartum and follow-up as required.Primary outcomes were MCH team screening, disclosure, safety planning and referral rates from routine government data and a postal survey sent to 10,472 women with babies ≤ 12 months in study areas. Secondary outcomes included DV prevalence (Composite Abuse Scale, CAS) and harm measures (postal survey).ResultsNo significant differences were found in routine screening at four months (IG 2,330/6,381 consultations (36.5 %) versus CG 1,792/7,638 consultations (23.5 %), RR = 1.56 CI 0.96–2.52) but data from maternal health checklists (n = 2,771) at three month IG consultations showed average screening rates of 63.1 %. Two years post-intervention, IG safety planning rates had increased from three (RR 2.95, CI 1.11–7.82) to four times those of CG (RR 4.22 CI 1.64–10.9). Referrals remained low in both intervention groups (IGs) and comparison groups (CGs) (<1 %).2,621/10,472 mothers (25 %) returned surveys. No difference was found between arms in preference or comfort with being asked about DV or feelings about self.ConclusionA nurse-designed screening and care model did not increase routine screening or referrals, but achieved significantly increased safety planning over 36 months among postpartum women. Self-completion DV screening was welcomed by nurses and women and contributed to sustainability.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12609000424202, 10/03/2009

If We Build It, They Will Come: Exploring Policy and Practice Implications of Public Support for Couple and Relationship Education for Lower Income and Relationally Distressed Couples.

Over the past decade, public funding for Couple and Relationship Education programs has expanded. As program administrators have been able to extend their reach to low-income individuals and couples using this support, it has become apparent that greater numbers of relationally distressed couples are attending classes than previously anticipated. Because psychoeducational programs for couples have traditionally served less distressed couples, this dynamic highlights the need to examine the policy and practice implications of more distressed couples accessing these services. This paper reviews some of the most immediate issues, including screening for domestic violence and couple needs, pedagogical considerations, and the potential integration of therapy and education services. We also make suggestions for future research that can inform policy and practice efforts.

Feasibility of routine screening for domestic violence among women attending an urban health center in Puducherry, India

Background: Women facing domestic violence are likely to seek medical care but are likely not to report the cause as domestic violence. Objective: To find out the yield of screening for domestic violence among ever-married adult women visiting an urban primary health-care center and to understand the health consequences and perception of women affected by domestic violence regarding selected aspects of the same. Materials and Methods: This hospital-based, cross-sectional study was conducted in an urban health center attached to a tertiary care institution in Puducherry during October and November 2014. All adult women who had married at least once in their lifetime, and visited the outpatient department of the urban health center during the study period, either as patients or as patients’ attenders, were included in the study. Anonymized data were collected using a pretested semi-structured questionnaire. Questions assessed whether participants had ever faced or currently facing any physical, emotional, or sexual violence after marriage. Results: Reportedly, 133 (57.3%) participants have experienced some form of domestic violence after marriage; of which, 68 (51.1%) had faced it in the last 1 year. Physical, emotional, and sexual violence was reported by 105 (45.3%), 110 (47.4%), and 26 (11.2%) participants, respectively. Both physical and emotional violence were faced by 89 (38%) women. Arguing with husband was perceived by most women as the most common cause of violence (about 43%). About 34.4% women cited the reason for not speaking about violence to someone else as not being helpful. Conclusion: Screening for domestic violence was feasible in urban health center, the yield being high.

Domestic violence screening in pregnancy: Discussing evidence and developing a practice tool kit

Domestic violence screening in pregnancy: Discussing evidence and developing a practice tool kit

Prediction of domestic violence against married women in southwestern Turkey

ObjectiveTo determine the prevalence of, and independent risk factors for various domestic violence categories among married women of reproductive age in southwestern Turkey. MethodsThe present cross-sectional study included 260 randomly selected women registered to a family physician in the district of Gönen, Isparta. During home visits between October 1 and December 31, 2012, the women completed a questionnaire that included between four and eight questions for each violence category (physical, verbal, economic, emotional, and sexual) to assess the lifetime presence of domestic violence. Logistic regression models with backward elimination were constructed to define independent risk factors for domestic violence. ResultsIn total, 176 (67.7%) women reported any type of domestic violence at least once in their lifetime. Verbal/psychological abuse was the most frequent type (reported by 121 [46.5%] women). Living in a village, young age (19–29 years) of the husband, adolescent age (<19years) of the husband at marriage, and problem alcohol use or problem gambling in the partner were independent predictors of domestic violence. ConclusionAttention should be given to area of residence, age of both partners at marriage, adolescent marriage, and husband characteristics during screening for domestic violence.

Recent violence in a community-based sample of homeless and unstably housed women with high levels of psychiatric comorbidity.

We determined associations between co-occurring psychiatric conditions and violence against homeless and unstably housed women. Between 2008 and 2010, we interviewed homeless and unstably housed women recruited from community venues about violence, socioeconomic factors, and psychiatric conditions. We used multivariable logistic regression to determine independent correlates of violence. Among 291 women, 97% screened positive for 1 or more psychiatric conditions. Types of violence perpetrated by primary partners and persons who were not primary partners (non-primary partners) included emotional violence (24% vs 50%; P < .01), physical violence (11% vs 19%; P < .01), and sexual violence (7% vs 22%; P < .01). The odds of primary partner and non-primary partner violence increased with each additional psychiatric diagnosis and decreasing levels of social isolation. All types of violence were more commonly perpetrated by non-primary partners, suggesting that an exclusive focus on domestic violence screening in health care or social service settings will miss most of the violence in this population. Contrary to some previous studies, the odds of violence decreased as social isolation increased, suggesting that social isolation may be protective in homeless and unstably housed communities with high levels of comorbidity and limited options.

At Cliff's Edge: Judicial Dispute Resolution in Domestic Violence Cases

The article endeavors, from a point of view informed by domestic violence (DV) research, to provide information, options, and tools that may help judicial (and nonjudicial) mediators make settlement processes equitable and safe. While opinions about the use of mediation and judicial dispute resolution in domestic violence cases are polarized, the reality is that the vast majority of these cases are settled by lawyers prior to trial, by judges in dispute resolution processes, by mediators, or by intimate (and formerly intimate) partners themselves. Thus the ultimate goal of this article is not to weigh the merits of settlement against litigation; instead the goal is to support the work of judges and mediators in making settlement processes equitable and safe. Key Points for the Family Court Community Judicial dispute resolution (JDR) is a recognized component of judicial practice Some JDR cases will involve intimate partner violence Identifying and responding to domestic violence violence by type Screening for domestic violence Pre‐dispute‐resolution assessments: of risk, of parties, and of process Options to enhance due process and safety

Domestic violence as a risk factor for maternal depression and neonatal outcomes: a hospital-based cohort study.

Objectives:This study attempted to follow up a cohort of women who presented to a tertiary hospital to investigate the effect of domestic violence on maternal and neonatal outcomes.Materials and Methods:Women, between 26-34 weeks of gestation, attending the obstetrics outpatient department, were recruited and followed up until delivery. They were assessed at recruitment and after delivery using the Edinburgh Postnatal Depression Scale, the Abuse Assessment Screen, and a pro forma to assess socio-demographic and clinical characteristics. Bivariate and multivariate statistics were employed to assess statistical significance.Results:One hundred and fifty women were recruited, 132 delivered in the hospital and were followed up. Domestic violence was associated with antenatal and postnatal depression, spouse's insistence of a boy baby, medical complications during pregnancy, preterm delivery, and lower birth-weight.Conclusion:Domestic violence has a significant impact on maternal and neonatal outcomes. Screening for domestic violence and interventions should be part of all antenatal programs. India should also employ public health approaches to change its patriarchal culture.

Development of a scale for determining violence against infertile women: a scale development study

BackgroundTo develop a scale to evaluate violence experienced among infertile women.MethodThree steps were followed in the development of the scale: Literature review and deep interviews to generate item pool, content validity testing, and administration of draft. Content validity was evaluated by experts. The draft scale was pilot-tested with a convenience sample of 30 women during their treatment. After the pilot-test, 166 infertile females filled the scale in the infertility clinic of a university hospital in Istanbul.ResultsFor evaluation of construct validity, Kaiser-Mayer Olkin was 0.91. Bartlett test was statistically significant (p = 0.00). According to the results of analysis, 5 domains were determined: “domestic violence”, “social pressure”, “punishment”, “exposure to traditional practices” and “exclusion”. The values of correlation of item were between 0.50 and 0.82. Item-total and subscale-total correlation varied between 0.57-0.91. The scale had good internal reliability, with Cronbach’s Alpha coefficient of 0.96. The other coefficients of subscales varied between 0.80-0.94.ConclusionsThe scale called “Infertile Women’s Exposure to Violence Determination Scale” indicates high reliability, good content and construct validity. Routine screening for domestic violence in infertility clinics is necessary to give affected women an opportunity to access appropriate health care and support services. On the other hand, common use of Infertile Women’s Exposure to Violence Determination Scale in infertility clinics provides increased sensitivity and awareness by caregivers.

Intimate Partner Violence Risk Assessment: A Primer for Social Workers

Socialworkersarelikelytoencounterintimatepartnerviolence(IPV)survivorsand/orperpetrators within their practice due to the prevalence of this social issue and the negative health and mental health consequences resulting from it. IPV risk assessments can be utilised by social workers in multiple service settings. A recent meta-analysis provided information on the IPV risk assessment instruments with the greatest predictive accuracy, but social workers need to know the most appropriate IPV risk assessment tools for use in their particular practice settings. Therefore, this paper provides social workers with summary information on the four risk assessment instruments that have the highest predictive accuracy—the Danger Assessment, the Spousal Assault Risk Assessment, the Ontario Domestic Assault Risk Assessment, and the Domestic Violence Screening Inventory. For social workers unable to use validated risk assessments, a summary of the risk factors is provided with a focus on opportunities for change within violent relationships. Finally, recommendations for which IPVrisk assessment to use in various social work practice settings are outlined. The use of IPVrisk assessment should be situated within an evidence-based practice framework, taking into account the best evidence of risk for future harm, clinical expertise and client self-determination.

Predicting Family Violence Recidivism Using the DVSI-R

Recent published predictive validation studies of risk assessment instruments commonly used the explanatory power of Receiver Operating Characteristics (ROC) analysis. The present study also tested the predictive validity of the Revised Domestic Violence Screening Instrument (DVSI-R) by conducting a ROC analysis of 18-month follow-up data post assessment from the entire state of Connecticut between January 1, 2010, and May 31, 2012. With a sample of 29,317, the analysis examined rearrests for new family violence incidents and new violations of protective or restraining orders. The sample was predominantly male (70%), with an average age of 34 years, and equally split between non-Latino White and minority perpetrators. Moving beyond the explanatory power of ROC analysis, the Kaplan–Meier (KM) estimator of the survival function was used to examine the cumulative probability of rearrest during the time at-risk period. In addition to determining the survival functions of perpetrators based on their level of risk as identified by their DVSI-R total numeric risk scores, the analysis examined differences by characteristics of perpetrators, an issue given scant attention in prior research. Survival analyses identified critical times after intake assessments when those who reoffended were at greatest risk and significant differences in timing of reoffending by gender and ethnicity. Implications for intervention are discussed.

Readiness to Screen for Domestic Violence against Women in Healthcare Uganda: Associations with Demographic, Professional and Work Environmental Factors

Aim: We assessed demographic, professional and work environmental determinants of readiness to screen for Intimate Partner Violence among healthcare practitioners in healthcare Uganda. Methods: The Domestic Violence Healthcare Provider Survey Scale and the Demand-Control-Support questionnaire was administered to a random sample of 376 health care providers (n = 279 valid responses) from Gulu, Anaka, Lacor and Iganga hospital situated in northern and eastern Uganda. Correlation tests, t-tests, ANOVA and Multiple Linear regression were used to analyse the data. Results: Male care providers were more likely than female peers to blame the victim for the occurrence of Intimate Partner Violence in a relationship. Participants from Lacorhospital graded a lower self-efficacy and a poorer support network with regard to screening for Intimate partner violence, and a higher propensity to blame the victim when contrasted with other hospitals. Doctors experienced a lower self-efficacy with regard to IPV screening than other professions. Blaming the victim for abuse was associated with a high work load and low support at work. In addition, with increasing work control and support, participants’ appraisal of system support and self-efficacy increased. Conclusion: Gender, profession, facility of work, work demand, control and support are important determinants of the readiness to screen for IPV in healthcare Uganda, and should inform strategy for the introduction and implementation of routine IPV inquiry in healthcare Uganda.

Urban density, deprivation and road safety: A small area study in the eThekwini metropolitan area, South Africa

The aim of this policy brief is to provide an evidence-informed answer to the question: ‘What is the role and scope of pre-hospital emergency care providers to domestic violence (DV) intervention as a form of gender-based violence prevention?’ The answer is intended to determine the theoretical and clinical best practice to inform the emergency care community and policy development by critically appraising the evidence that considers the responsiveness of Emergency Medical Services to the health needs of DV victims. Evidence-informed Decision Making methods are employed. The evidence appraised was based on electronic searches using the Cape Peninsula University of Technology database. Research and non-research publications were considered with publication dates mostly from 1999 to 2011. Upon screening 164 articles for content relevance, 53 were critically appraised against predetermined criteria for relevance of the evidence, robust nature of the evidence and presence of bias. A thematic/narrative analysis ensued in terms of strength of evidence and frequency of findings. Early recognition and intervention is seen as one of the most effective methods of DV prevention. This finding is nuanced if it is male caregivers doing so. There is an ethical obligation to implement a comprehensive health approach to manage domestic violence victims. The strong, majority findings are that educational intervention/s increases the health care provider’s understanding of DV and improves screening for DV. The research supports the development and use of screening tools/guidelines/ procedures for DV as they are found to improve DV intervention. The evidence supports an integrated effort of the health system in achieving its goal of DV prevention by promoting the participation of pre-hospital emergency care providers as critical stakeholders. Key words : Domestic Violence (DV) management and prevention, Emergency Care Providers (ECP’s), Gender-based violence (GBV) prevention, Evidence-informed Decision Making (EiDM), Emergency Medical Service