Screening For Partner Violence Research Articles

Health insurance coverage and experiences of intimate partner violence and postpartum abuse screening among rural US residents who gave birth 2016-2020.

Intimate partner violence (IPV) is elevated among rural residents and contributes to maternal morbidity and mortality. Postpartum health insurance expansion efforts could address multiple causes of maternal morbidity and mortality, including IPV. The objective of this study was to describe the relationship between perinatal health insurance, IPV, and postpartum abuse screening among rural US residents. Using 2016-2020 data on rural residents from the Pregnancy Risk Assessment Monitoring System, we assessed self-report of experiencing physical violence by an intimate partner and rates of abuse screening at postpartum visits. Health insurance at childbirth and postpartum was categorized as private, Medicaid, or uninsured. We also measured insurance transitions from childbirth to postpartum (continuous private, continuous Medicaid, Medicaid to private, and Medicaid to uninsured). IPV rates varied by health insurance status at childbirth, with the highest rates among Medicaid beneficiaries (7.7%), compared to those who were uninsured (1.6%) or privately insured (1.6%). When measured by insurance transitions, the highest IPV rates were reported by those with continuous Medicaid coverage (8.6%), followed by those who transitioned from Medicaid at childbirth to private insurance (5.3%) or no insurance (5.9%) postpartum. Nearly half (48.1%) of rural residents lacked postpartum abuse screening, with the highest proportion among rural residents who were uninsured at childbirth (66.1%) or postpartum (52.1%). Rural residents who are insured by Medicaid before or after childbirth are at elevated risk for IPV. Medicaid policy efforts to improve maternal health should focus on improving detection and screening for IPV among rural residents.

Barriers to routine screening for intimate partner violence during pregnancy in Nigeria

BackgroundThe benefits of routine screening for intimate partner violence (IPV) among pregnant women include early identification, prompt management, referral of IPV victims, and creating awareness about IPV. Despite these benefits, the practice of routine screening of IPV remains limited in midwifery settings in low-income countries. The purpose of this study is to identify and describe midwives’ perspectives of the barriers in conducting routine screening of IPV for pregnant women in northern Nigeria. MethodsA case study qualitative descriptive design was used to collect data from ten midwives in the antenatal clinic of a tertiary hospital. Non-participant observation and individual face-to-face semi-structured interviews were used as data collection methods. Thematic data analysis was carried out using Yin's five stage analytical cycle. FindingsThree themes, with related subthemes, emerged from the data: (i) The theme of “Internal” barriers to IPV screening has four subthemes; midwives' personal discomfort in asking IPV- related questions, perceived mistrust of midwives by pregnant women, midwives' own perceptions of IPV as a personal matter, and midwives’ lack of skills to screen for IPV. (ii) “External” barriers to IPV screening subsumes three subthemes: antenatal card related barriers, workload related barriers, and protocol barriers. (iii) “Structural” barriers to IPV screening have two subthemes: lack of space for privacy and lack of resources for managing pregnant women who have experienced IPV. ConclusionKnowing the barriers to midwives’ screening practices is important because it may help in the development of contextually relevant and acceptable screening guidelines for midwives in Nigeria. Education and training of midwives will eliminate the internal barriers while the external barriers will need the intervention of hospital authorities and government to eliminate their effects on screening.

Healthcare providers' perceived barriers and facilitators to screening for intimate partner violence in pregnant women attending prenatal clinics.

To examine healthcare providers' extent of and perceived barriers and facilitators to screening for intimate partner violence in pregnant women attending prenatal clinics. Cross-sectional descriptive design was used to collect data from 130 healthcare providers. Seventeen healthcare providers from 17 prenatal clinics in Kanungu district, Uganda, were recruited via convenience sampling to participate in an online survey implementing a modified Normalization Measure Development instrument. Data were collected between February 2023 and March 2023 (02/8/2023 to 03/12/2023) and analysed using descriptive and Mann-Whitney U test and chi-square tests. Slightly more than half (56%) of healthcare providers report screening pregnant women for intimate partner violence. There was a statistically significant relationship between healthcare providers screening for intimate partner violence and having previous training on intimate partner violence screening. The only barrier to screening identified was a lack of understanding of how intimate partner violence screening affects the nature of participant's own work. There were numerous potential facilitators identified for healthcare providers' intimate partner violence screening. Although higher-than-expected number of healthcare providers reported screening of pregnant women for intimate partner violence, the extent of screening is still suboptimal. The barrier to screening identified needs to be addressed and facilitators promoted. Receiving training among healthcare providers on intimate partner violence screening was associated with higher levels of screening; thus, this needs to be enhanced to optimize screening rates. Future studies should assess screening practices objectively and implement interventions to improve healthcare providers' intimate partner violence screening rates. Screening for intimate partner violence should be part of standard care provided by healthcare providers to all pregnant women during prenatal clinic visits. The study supports the need for more training for healthcare providers in aspects related to intimate partner violence screening in order to ensure prompt diagnosis and treatment of those affected, identify those at risk and increase awareness. There is a need to enhance healthcare providers' capacity for intimate partner violence screening through education by integrating intimate partner violence screening pre- and post-registration courses and preparation programs or curriculum. Intimate partner violence (IPV) in pregnancy is a global health problem. Screening for IPV by healthcare providers is suboptimal. This study found that only 56% of healthcare providers were routinely screening for IPV in Ugandan prenatal clinics. This study identified the main facilitators and one barrier to IPV screening. This study has adhered to the relevant EQUATOR guidelines for quantitative studies. No patient was involved in this study.

Intimate Partner Violence and Human Trafficking Screening and Services in Primary Care Across Underserved Communities in the United States-Initial Examination of Trends, 2020-2021.

The Health Resources and Services Administration (HRSA) began collecting data on intimate partner violence (IPV) and human trafficking (HT) in the 2020 Uniform Data System (UDS). We examined patients affected by IPV and HT served by HRSA-funded health centers in medically underserved US communities during the COVID-19 pandemic. We established a baseline and measured trends in patient care by analyzing data from the 2020 (N = 28 590 897) and 2021 (N = 30 193 278) UDS. We conducted longitudinal ordinal logistic regression analyses to assess the association of care trends and organization-level and patient characteristics using proportional odds ratios (PORs) and 95% CIs. The number of clinical visits for patients affected by IPV and HT decreased by 29.4% and 88.3%, respectively, from 2020 to 2021. Health centers serving a higher (vs lower) percentage of pediatric patients were more likely to continuously serve patients affected by IPV (POR = 2.58; 95% CI, 1.01-6.61) and HT (POR = 6.14; 95% CI, 2.06-18.29). Health centers serving (vs not serving) patients affected by IPV were associated with a higher percentage of patients who had limited English proficiency (POR = 1.77; 95% CI, 1.02-3.05) and Medicaid beneficiaries (POR = 2.88; 95% CI, 1.48-5.62), whereas health centers serving (vs not serving) patients affected by HT were associated with a higher percentage of female patients of reproductive age (POR = 15.89; 95% CI, 1.61-157.38) and urban settings (POR = 1.74; 95% CI, 1.26-2.37). The number of clinical visits for patients affected by IPV and HT during the COVID-19 pandemic declined. Delayed care will pose challenges for future health care needs of these populations.

Physical Intimate Partner Violence Against Pregnant Women in Türkiye: A Population Based Study

This study’s main objective was to determine the factors that led to Turkish women being physically abused by their husbands or partners during pregnancy. The National Research on Domestic Violence against Women in Turkey conducted in 2014 was utilized in our study. We analyzed the survey data using the binary logistic regression method. A pregnant woman who graduated from high school was less likely to encounter physical abuse than an illiterate woman. Those who made more money for the family than their husband or partner were more likely to experience physical abuse. Pregnant women with alcoholic husbands/partners were more likely to experience physical abuse. By supporting the prevention of other potential outcomes for maternal and infant health, implementing screening for partner violence and childbirth phobia in obstetrics and gynecology clinics, and offering comprehensive information about pregnancy labour, we can enhance family and social health.

Mediation for Misdemeanor Assault

ABSTRACT Crime reduction strategies over the past 30 years have greatly expanded the criminalization of a wide variety of minor offenses, especially in communities of color, even as violence continues to damage individuals, families, and communities. Solutions that reduce both violence and over-criminalization are urgently needed. Community-based mediation for diversion of misdemeanor assault cases has been practiced since the 1970s, but little is known about its ability to prevent further violence between participants or reduce assault recidivism. From a state judiciary’s quasi-experimental longitudinal comparison group study of criminal court mediation recidivism, assault cases (n = 162) were isolated and analyzed using bivariate tests and logistic regression with inverse proportion of treatment weighting. Misdemeanor assault cases handled with community-based mediation had a small and statistically non-significant association with return to court at 6 months versus cases handled with usual court processes. Had assaults between couples been excluded, recidivism for mediation cases would have been one-third the rate of those treated as usual. Mediation centers and local prosecutors’ offices could improve screening for intimate partner violence and divert more cases earlier via police and court commissioners. Research with a dependent variable of self-reported violence would be best suited to understanding the ability of community mediation to meet its founding mission of community-created peace.

On Your Mark, Get Set, Go: A Descriptive Study of Initial Implementation of Universal Intimate Partner Violence Screening at a Veterans Health Administration Facility

Intimate partner violence (IPV) negatively impacts mental, physical, and social health, and veterans are at a greater risk for experiencing lifetime IPV than civilians. Prior research has identified facilitators and barriers to sustained implementation of IPV screening but has often focused solely on screening reproductive-aged women or screening within a single clinical setting. In contrast, the Veterans Health Administration (VHA) IPV Assistance Program has recently developed a comprehensive plan for universal training and education of all staff and universal screening and intervention for all veterans, which, to our knowledge, is the first such large-scale IPV program. This program evaluation project examines the plan’s initial implementation across multiple clinical settings at one VHA site following a concerted training effort of 422 interdisciplinary staff. Over 17 months, clinicians completed 2,596 screenings out of 4,128 screening opportunities utilizing the Hurt, Insult, Threaten, and Scream tool. Eighteen percent of veterans screened positive for past-year IPV experience; of those, 29% screened positive on a secondary screen for acute safety needs and risk for lethality. Female veterans were screened more frequently than male veterans (χ2= 119,p< .001) and younger veterans more frequently than older veterans (effect of age strata ≤47, 48–64, or ≥65: χ2= 107,p< .001), but all age strata and genders had clinically important rates of positive screens. In addition to establishing local baseline prevalence, data on screening outcomes by sex, age, deferred screening opportunities, clinics where screening occurred, and interventions utilized offer insights on the impact of training, specific barriers, and future directions for enhancing and expanding training and screening efforts.

Sex Workers’ Experiences of Screening for Intimate Partner Violence

ObjectiveTo examine experiences of intimate partner violence (IPV) screening among women who sell sex. DesignA qualitative descriptive study. SettingTelephone interviews during the COVID-19 pandemic (June 2020 to October 2020). ParticipantsWomen aged 18 to 49 years who sold or traded sex for food, drugs, money, or shelter at least three times during the past 3 months before recruitment (N = 22). MethodsWe used individual, semistructured telephone interviews to collect data about participants’ experiences with IPV and IPV screening during health care encounters. We used reflexive thematic analysis to examine these data. ResultsWe identified two overarching themes related to IPV screening experiences: Preferences for IPV Screening and Barriers to Disclosure of IPV Experiences. Participants described a preference for IPV screening done face-to-face with providers who show a genuine interest in their responses. Stigma was a barrier of IPV disclosure. ConclusionHealth care providers are a trusted safety net for disclosure of IPV experiences. Providing screening in a trauma-informed, nonstigmatizing manner may facilitate disclosure of IPV by women who sell sex. Future research among marginalized populations is needed to examine ways to address IPV in clinical settings with a harm reduction empowerment lens.

Intimate Partner Violence and Depression Screening of Mothers with Infants in the Neonatal Intensive Care Unit.

This study aimed to determine the prevalence of partner violence and depression in neonatal intensive care unit (NICU) mothers. This was a descriptive study. Mothers were screened in a safe room away from their partner with the Edinburgh Postnatal Depression Scale (EPDS) and the Abuse Assessment Screen Tool (AAS) within 2 days of the newborn's admission. The EPDS was administered again 2 weeks later and then at discharge. Nearly 20% of mothers reported on the AAS that they had experienced physical abuse since pregnancy. Abuse significantly predicted baseline depression 48 hours after delivery. A significant relationship emerged between depression and past year partner violence, with 100% experiencing abuse in the past year after pregnancy. Regular hospital intake questions underreported NICU mothers' partner violence experience and feelings of depression. There was a marked difference between what mothers reported in their health history at admission versus evidence-based surveys in a private setting. These results challenge assumptions that accurate screening happens at hospital admission. It is imperative to use evidence-based scales after delivery to improve outcomes. · Intake questions undermeasure partner violence and depression.. · Clinical depression emerges by 2 weeks postdelivery.. · Screening is optimal postdelivery, rather than at admission..

Correlation Between Intimate Partner Violence During Pregnancy and Parental Acceptance by Primiparous Mothers.

Pregnancy and the transition to parenthood are periods in parents' lives that require tremendous adjustment. The physical and mental health of mothers during these periods is significantly associated with maternal acceptance. The present study aimed to evaluate the correlation between intimate partner violence (IPV) during pregnancy and parental acceptance by primiparous mothers in Isfahan, Iran. A cross-sectional descriptive and correlational study was conducted from September 2021 to February 2022 in Isfahan, Iran. The target population was primiparous mothers in the postpartum period referred to nine different health centers across Isfahan. The participants (n=308) completed three questionnaires, namely demographic, Tabrizi intimate partner violence screening, and parental acceptance questionnaire. Data were analyzed using descriptive and inferential statistics with SPSS software (version 22.0). P<0.05 was considered statistically significant. The mean score of total IPV was 40.45±28.94. Domestic violence during pregnancy was reported by 59 (19.2%) mothers. The most common types were psychological violence (74.4%), followed by financial abuse (35.1%), sexual violence (17.2%), and physical violence (14.9%). The mean score of parental acceptance was 115.77±12.58. There was a significant inverse correlation between parental acceptance and IPV score (r=-0.15, P=0.005). The number of siblings and birth order had a significant inverse correlation with parental acceptance (r=-0.13, P=0.002; r=-0.13, P=0.002, respectively). Moreover, the age difference between the mothers and their next siblings had a significant direct correlation with parental acceptance (r=0.12, P=0.003). Primiparous mothers subjected to IPV during pregnancy had lower parental acceptance after delivery.

Screening for Intimate Partner Violence in Trauma: Results of a Quality Improvement Project

IntroductionIntimate partner violence (IPV) is common, especially among patients presenting with traumatic injury. We implemented an IPV screening program for patients admitted after trauma. We sought to determine whether specific demographic or clinical characteristics were associated with being screened or not screened for IPV and with IPV screen results. MethodsRetrospective cohort study evaluating all patients admitted after trauma from July 2020-July 2022 in an Adult Level 1 Trauma Center. ResultsThere were 4147 admissions following traumatic injury, of which 70% were men and 30% were women. The cohort was 46% White, 20% Asian, 15% Black, and 17% other races. Twenty-three percent were Hispanic or Latino/a. Seventy-seven percent were admitted for blunt injuries and 16% for penetrating injuries. Thirteen percent (n = 559) of the cohort was successfully screened for IPV. Screening rates did not differ by gender, race, or ethnicity. After adjustment for demographic and clinical factors, patients admitted to the intensive care unit were significantly less likely to be screened. Of the screened patients, 30% (165) screened positive. These patients were more commonly Hispanic or Latino/a, insured by Medicaid and presented with a penetrating injury. There were no differences in injury severity in patients who screened positive versus those who screened negative. ConclusionsThere are significant barriers to universal screening for IPV, including injury acuity, in patients admitted following trauma. However, the 30% rate of positive screens for IPV in patients admitted following trauma highlights the urgent need to understand and address barriers to screening in trauma settings to enable universal screening.

Intimate partner violence screening for separating or divorcing parents: An introduction to the Mediator's Assessment of Safety Issues and Concerns‐Short (MASIC‐S)

AbstractIntimate partner violence (IPV) is a leading cause of separation and/or divorce. IPV may not stop after separation, as parents who use IPV can continue intruding in the lives of parents who experience IPV due to unsafe parenting arrangements that allow continued frequent contact and thus risk further abuse. Therefore, it is critical that separating/divorcing parents be assessed for IPV and ongoing safety concerns. Parenting arrangements (e.g., physical and legal custody, parenting time) may not include the appropriate protections if IPV has not been uncovered and/or considered. Unfortunately, many existing IPV screens for family court processes have limitations. The Mediator's Assessment of Safety Issues and Concerns‐Short (MASIC‐S) was designed to address these limitations. Results from the MASIC‐S may be used to inform and create parenting arrangements in the best interest of the child. We provide recommendations on how MASIC‐S results can guide family court practitioners in parenting arrangement disputes. These recommendations are based on the existing literature and guidelines regarding the relationship between parenting arrangements and child‐wellbeing following separation/divorce in the context of IPV. We also discuss areas in which additional research is needed to help determine parenting arrangements most suitable for separating/divorcing parents with a history of IPV.

Inequalities in intimate partner violence screening and receiving information among diverse groups of women: an online survey during COVID-19 lockdowns

BackgroundResearch shows violence against women likely increases during emergencies. COVID-19’s emergence exacerbated intimate partner violence (IPV), suggesting that healthcare services (HCS) should have increased IPV screening efforts and referrals of...

Patterns and Predictors of Intimate Partner Violence among Pregnant Women Attending Healthcare Centers in Obio-Akpor, Rivers State

Intimate partner violence though not consistent with our cultural and traditional values and beliefs as a people, is becoming rampant and this is a misnomer. Intimate partner violence (IPV) especially among women is a global phenomenon and has become a major public health concern. The researcher adopted a descriptive cross-sectional study design to assess patterns and predictors of intimate partner violence among pregnant mothers attending healthcare Centre’s in Obio/Akpor L.G.A., River’s state. A self-structured survey was utilized to gather information from 416 systematically selected pregnant mothers with a response rate of 412(99%). Data was evaluated utilizing descriptive and inferential statistics at a 5% degree of significance. Findings showed that many of the respondents ages 23 – 31years, married, with tertiary education, of Christian faith, were into business and had two children. The prevalence of IPV before pregnancy was 21.4% while in current pregnancy it was 20.1%. The most common violence act was physical 83(20.1%), followed by verbal violence 79(19.2%), emotional violence accounted for 76(18.4%), psychological violence 68(16.5%) while the least reported was sexual violence with about 57(13.8%). Domestic and financial issues were the cause of most violent experiences accounting for 19.9% and 19.4%. Statistical analysis using multinomial logistic regression showed that educational attainment (p; 0.000) and lifestyle of the husband (p = 0.000) were the socioeconomic and sociodemographic factors respectively associated with IPV. It is recommended that screening for intimate partner violence among pregnant women should be provided as uniform care during antenatal visits.

Preliminary Pilot-Testing of Intimate Partner Violence Screening for Transgender and Gender Diverse (TGD) Individuals in Med-Peds and Family Medicine.

Transgender and gender diverse (TGD) individuals, comprised of those whose gender identity does not correspond with the sex they were assigned at birth, represent approximately 1.4 million people in the U.S., with a higher prevalence among those 18-24 years old. TGD individuals experience high levels of intimate partner violence (IPV), which leads to disproportionately negative mental and physical health outcomes for this population. As a result, there is a resounding need to connect TGD populations to health-promoting services, supports and resources. Med-Peds and Family Medicine clinics may be particularly well-positioned to support these efforts due to physicians' focus on transitional-aged youth and young adults under 30. The current manuscript reports on processes and outcomes related to a quality improvement (QI) initiative that aimed to test the feasibility and acceptability of implementing IPV screening within both a Med-Peds and a Family Medicine specialty clinic serving TGD populations in Los Angeles, CA. This QI initiative included screeners that capture IPV in cisgender/non-TGD populations (Humiliation, Afraid, Rape, Kick [HARK]) as well as in TGD populations specifically (IPV-T). We utilized a mixed-methods approach to both quantify and qualify responses to existing IPV screening as well as informal feedback from clinic "champions" in each clinic. Quantitative and qualitative findings from this QI initiative, featuring both general and TGD-specific IPV screening measures with 140 TGD individuals, elucidated several important processes that can support effective IPV screening and referral to supports and services. These include the importance of interdisciplinary teams, the utility of an iterative approach to screener roll-out, and the essential role of solidifying a referral process in these efforts. This project additionally shed light on the potential utility and challenges of implementing both general and TGD-specific IPV screening measures. Our pilot test did not support the necessity of a TGD-specific IPV screener for identifying and responding to IPV in this population, yet additional data is critical to generate more conclusive recommendations. We recommend larger-scale data collection efforts to evaluate the utility of integrating general and TGD-specific screeners into clinic workflows to ensure optimal health promotion for the TGD population in Med-Peds and Family Medicine clinics.

Rural/urban differences in rates and predictors of intimate partner violence and abuse screening among pregnant and postpartum United States residents.

To describe rates and predictors of perinatal intimate partner violence (IPV) and rates and predictors of not being screened for abuse among rural and urban IPV victims who gave birth. This analysis utilized 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 45 states and three jurisdictions. This is a retrospective, cross-sectional study using multistate survey data. This analysis included 201,413 survey respondents who gave birth in 2016-2020 (n = 42,193 rural and 159,220 urban respondents). We used survey-weighted multivariable logistic regression models, stratified by rural/urban residence, to estimate adjusted predicted probabilities and 95% confidence intervals (CIs) for two outcomes: (1) self-reported experiences of IPV (physical violence by a current or former intimate partner) and (2) not receiving abuse screening at health care visits before, during, or after pregnancy. Rural residents had a higher prevalence of perinatal IPV (4.6%) than urban residents (3.2%). Rural respondents who were Medicaid beneficiaries, 18-35 years old, non-Hispanic white, Hispanic (English-speaking), or American Indian/Alaska Native had significantly higher predicted probabilities of experiencing perinatal IPV compared with their urban counterparts. Among respondents who experienced perinatal IPV, predicted probabilities of not receiving abuse screening were 21.3% for rural and 16.5% for urban residents. Predicted probabilities of not being screened for abuse were elevated for rural IPV victims who were Medicaid beneficiaries, 18-24 years old, or unmarried, compared to urban IPV victims with those same characteristics. IPV is more common among rural birthing people, and rural IPV victims are at higher risk of not being screened for abuse compared with their urban peers. IPV prevention and support interventions are needed in rural communities and should focus on universal abuse screening during health care visits and targeted support for those at greatest risk of perinatal IPV.

Examining Cases of Child Physical Abuse Evaluations to Identify Opportunities to Improve Intimate Partner Violence Screening in Pediatric Emergency Departments.

The association between child maltreatment and intimate partner violence (IPV) is well supported. Universal IPV screening has been recommended by the American Academy of Pediatrics and the United States Preventative Task Force, and many children's hospitals have established screening protocols. However, the yield and best screening method in families undergoing a child physical abuse (PA) evaluation have not been fully explored. To determine if there is a discrepancy in IPV disclosures between universal IPV screening completed during pediatric emergency department (PED) triage ("triage screening") and IPV screening by a social worker ("social work screening") in families of children who were evaluated for PA. Caregivers of children who presented to an urban tertiary PED and underwent an evaluation for PA via a child abuse pediatrics consult. A retrospective chart review was completed. Data collection included: caregiver responses to both triage screening and social work screening, interview setting details and participants, the child's injuries, and details of the family's reported IPV experiences. Our study (N = 329) revealed that social work screening produced significantly more positive IPV disclosures than triage screening (14.0% vs. 4.3%, p < .001). Additionally, non-IPV violence concerns were identified in 35.7% (n = 5) of the positive triage screens, whereas social work screens had none. These results highlight the benefits of IPV screening by social work in high-risk scenarios, such as child PA evaluations, regardless of universal IPV screening results. Exploring differences between the two screening methods can inform decisions about screening protocols to improve IPV identification in high-risk populations.

Intimate Partner Violence among women living in families with children under the poverty line and its association with common mental disorders during COVID-19 pandemics in Ceará, Brazil

BackgroundIntimate partner violence (IPV) is a pervasive public health issue that affects millions of women worldwide. Women living below the poverty line experience higher rates of violence and fewer resources to escape or cope with the abuse, and the COVID-19 pandemic has significantly impacted women’s economic well-being worldwide. We conducted a cross-sectional study in Ceará, Brazil, on women in families with children living below the poverty line at the peak of the second wave of COVID to assess the prevalence of IPV and its association with common mental disorders(CMD).MethodsThe study population comprised families with children up to six years of age who participated in the cash transfer program “Mais Infância”. The families selected to participate in this program must meet a poverty criterion: families must live in rural areas, in addition to a monthly per capita income of less than US$16.50 per month. We applied specific instruments to evaluate IPV and CMD. To access IPV, we used the Partner Violence Screen (PVS). The Self-Reporting Questionnaire (SRQ-20) was used to assess CMD. To verify the association between IPV and the other evaluated factors with CMD, simple and hierarchical multiple logistic models were used.ResultsOf the 479 participant women, 22% were positively screened for IPV (95% CI 18.2–26.2). After multivariate adjustment, the chances of CMD are 2.32 higher in women exposed to IPV than in those not exposed to IPV ((95%CI 1.30–4.13), p value = 0.004). CMD was also associated with job loss during the COVID-19 pandemic (ORa 2.13 (95% CI 1.09–4.35), p-value 0.029). In addition to these, separate or single marital status, as well as non-presence of the father at home and food insecurity were associated with CMD.ConclusionWe conclude that the prevalence of intimate partner violence in families with children up to six years of age living below the poverty line in Ceará is high and is associated with greater chances of common mental disorders in mothers. Also, job loss and reduced access to food caused by the Covid 19 pandemic exacerbated both phenomena, constituting a double burden generator factor on mothers.

Implementing intimate partner violence (IPV) screening within emergency departments – Barriers, challenges and enablers experienced by intimate partner violence practice change champions

AimTo identify the barriers, challenges, and enablers that clinical champions experience whilst implementing Intimate Partner Violence (IPV) screening within Emergency Departments (EDs). BackgroundChampions support the introduction of IPV screening within EDs. This paper shares new knowledge about IPV practice change champions: barriers, challenges and enablers they experienced in their efforts. DesignBetween 2017-2019, semi structured qualitative interviews were conducted with 23 individuals who identified as champions, working to introduce routine IPV in two rural tertiary hospital Emergency Departments. An interpretive framework and process of constant comparison was used to thematically analyse data from transcribed interviews. ResultsChampions identified barriers, challenges, and enablers that they experienced. Enablers included: support for the work of champions; champion leadership and collegiality; and training for the champion role. Challenges and Barriers included: resistance to a change in the focus of practice; and workflow and workload. Conclusions and implicationsNurse champions can effectively support IPV practice change but face certain barriers, challenges and enablers. Nurse managers can use this information to support champions to undertake their role effectively in order to better meet the needs of individuals experiencing IPV.

Patient-Centered Intimate Partner Violence Screening, Brief Intervention, and Referral to Treatment

ObjectiveTo increase rates of screening for intimate partner violence (IPV), education, and follow-up of women being seen at a private obstetrics and gynecology clinic to 52% in 90 days. DesignQuality improvement project. Setting/Local ProblemIPV screening was not the standard of care at a private suburban obstetric and gynecologic practice. MethodsThis project used an evidence-backed model for improvement that incorporated plan–do–study–act cycles to implement four core interventions. InterventionsThe Hurt, Insult, Threaten, Scream (HITS) screening tool, the investigator-developed Duluth model tool, a case management log, and a team engagement plan were implemented. ResultsImplementation of the HITS screening tool was associated with an increase in IPV screening to 94.7% from a baseline of 2.5%. In addition, the IPV disclosure rate increased 7.5% over the course of the initiative. The majority of staff (64%) participated in IPV educational offerings, and an increase in IPV knowledge was noted in team surveys, on which scores increased from 68% to 76.9%. ConclusionThe combined use of the HITS screening tool and the Duluth model tool were associated with increased rates of IPV screening. Women who screened positive for IPV were referred to appropriate resources. These findings can be used as a guide for clinics to implement IPV screening into practice.