Screening For Violence Research Articles

The acceptability of intimate partner violence screening and response among refugee women accessing Australian resettlement services.

Screening and response for intimate partner violence (IPV) is recommended for women in priority populations and is implemented in health services across diverse jurisdictions. Most women experiencing IPV strongly support screening, however this is untested with refugee women in resettlement contexts. Around one third of refugee women in Australia experience IPV and face multiple post-migration challenges. SAHAR (Safety and Health after Arrival) tested IPV screening using the ACTS tool, brief intervention, and referral with women accessing four settlement support services. Women attending sites during the study period were invited to participate in a three month follow up survey with participation by 321/375 women recruited (86%). Acceptability of IPV screening was assessed against (i) levels of comfort with the IPV screening questions and (ii) strength of agreement/disagreement with settlement services asking women about being frightened, controlled or hurt by their partners. Of participants who recalled the screening, 93% reported being very or moderately comfortable with being asked the questions (89% who had experienced IPV; 94% of those with no IPV identified). For all participants, 84% strongly or somewhat agreed with services asking the questions, with no significant difference in agreement between disclosing and non-disclosing groups. Those with no recall of the questions had lower overall agreement and higher disagreement than those who recalled the questions (88% and 10%). Acceptability was not associated with age, country of origin, household composition, time since arrival or number of prior service visits. Participants identified 'care shown by the worker', 'talking to someone in my own language', 'trust in the privacy of the service', and 'talking to a female worker' as the factors most important for encouraging discussion of IPV. High acceptance of IPV screening by refugee women supports consideration of implementation across settlement services, a key access point for refugee women with diverse needs.

Development and implementation of a firearm safety intervention by medical and physician assistant students in an adult primary care setting

Firearm ownership is associated with an increased risk of adverse health outcomes, including violence, suicide, and accidental firearm injury. Numerous medical governing bodies have placed emphasis on firearm screening and counseling within the healthcare setting. However, few physicians discuss firearm ownership and safety with patients, likely due to limited physician familiarity with firearms or perceived risk to the doctor-patient relationship, among other barriers. Clinical trainees have the capability to confidentially screen for unsafe firearm practices and potentially prevent fatal injury. In this study, we provide one of the first reports of a universal firearm screening and safety intervention developed and implemented by medical and physician assistant students in an adult primary care clinic as part of a longitudinal clerkship experience. Students learned the basics of firearm ownership and storage, developed interview skills for sensitive topics, developed a screening tool for safe firearm storage, and gained a better understanding of firearm safety in the community. Through partnership with the Chicago Police Department, students offered firearm cable locks to all patients who screened positive for unsafe firearm storage practices. Overall, this study aimed to assess the feasibility of a universal firearm safety screening tool and intervention in a primary care clinic. We conclude that such a tool is feasible in a student-led primary care clinic, provides unique educational opportunities for students, and can be adopted in numerous healthcare teaching settings. Future steps may include evaluating other ways to promote firearm safety, such as screening for intimate partner violence and/or concomitant mental illness.

Physical, sexual and overall reported interpersonal violence against adult out-patients with severe mental illness under remission, receiving healthcare at Butabika hospital: A cross-sectional study

Interpersonal violence is a significant public health and human rights concern. People living with severe mental illness are especially vulnerable. The Sustainable Development Goals 2030 Agenda aims to end violence. To this end, we gathered information on the prevalence and factors associated with interpersonal violence among one of the most impacted groups: individuals with severe mental illness at Butabika Hospital in Kampala, Uganda. We conducted a cross-sectional study in 2020, including individuals 18 years or older. Data was collected through a socio-demographics questionnaire and nine questions from the modified My Exposure to Community Violence Questionnaire. The assessment evaluated physical or sexual violence experience, frequency, and perpetrator identity. The data was analyzed using STATA version 12 through simple logistic regression to determine the correlation between a single exposure and the outcome of interest, with a significance level of 5%. Among 385 participants, the past year prevalence of overall reported interpersonal violence was about 34%, while physical and sexual reported interpersonal violence were approximately 29% and 11%, respectively. Participants who had perpetrated physical violence had higher odds of experiencing reported interpersonal violence. With increasing age, the odds of experiencing reported interpersonal violence decreased; compared to those aged 18–24 years, those aged 35–44 years had AOR = 0.31 (95% CI: 0.14–0.70, p = 0.005), and those aged 45 years and above had AOR = 0.34 (95% CI: 0.15–0.80, p = 0.013). Reported interpersonal violence was high among the participants. While individuals of older age had lower odds of reporting interpersonal violence, those who had perpetrated physical violence in the past year had higher odds. Screening for interpersonal violence among young patients is recommended. Psycho-education on preventing physical violence should be provided, especially to younger adults. The Ministry of Health should address violence against individuals with mental illness through mass sensitization. A prospective study could investigate risk and protective factors.

The Risk for Violence Screening Tool: A Psychometric Validation and Reliability Study

BackgroundThere is a lack of high-quality evidence to support the recommendation of an instrument to screen emergency department patients for their risk for violence. ObjectiveTo demonstrate the content and predictive validity and reliability of the novel Risk for Violence Screening Tool to identify patients at risk for violence. Design and SettingThis retrospective risk screening study was conducted at a 100-bed emergency department in an urban, academic, safety net trauma center in Southern California. ParticipantsNine subject matter expert employees and 22,583 non-critical adult emergency patients. MethodsSubject matter experts rated the relevance of 30 risk items and 10 domains comprising the Risk for Violence Screening Tool. Content Validity Index/Average Content Validity and Universal Agreement analyses determined the tool's content validity. Predictive validity, analyzed with logistic regression, used data from a patient incidence of violence registry (an incident occurred or did not occur), compared with the Risk for Violence Screening Tool screening result (positive or negative). Response agreement among three nurses who independently utilized the Risk for Violence Screening Tool to assess the same patients upon their arrival at the emergency department determined inter-rater reliability. ResultsThe overall Content Validity Index was 0.84, and the item-level Content Validity Index and the universal agreement scores were 1.00, indicating perfect agreement on item relevance and a unanimous consensus among experts. Patients who screened positive on the Risk of Violence Screening Tool, indicating a high probability of violence, were 27.55 times more likely to commit an act of violence compared to those who screened negative (95% CI = 24.73 to 30.70). The logistic regression model was statistically significant, (χ2(1) = 1140.29, p < .0001), explaining a range from 4.9% (Cox & Snell R2) to 37.3% (Nagelkerke R2) of the variance and indicating that the Risk for Violence Screening Tool successfully predicted violent incidents. The calculated area under the curve of 0.843 (95% confidence interval, 0.812-0.873, p< 0.001) affirmed the Risk for Violence Screening Tool's discriminatory ability to distinguish between individuals with and without a risk for violent behavior. Cohen's Kappa statistic yielded a value of 0.86 (p < 0.001). ConclusionsThe Risk for Violence Screening Tool is valid and reliable. This standardized tool can be used in emergency departments as part of a robust violence prevention program, creating a safer workplace for both staff and patients. Tweetable abstractThe Risk for Violence Screening Tool (RVST) is a valid and reliable brief screener to identify emergency department patients at risk for violence. @dhs.lacounty @ijn2024

Nonuse of Contraception at Conception Due to Partner Objection and Pregnancy-Related Health Care Utilization, Postpartum Health, and Infant Birth Outcomes.

Objective: Reproductive coercion has been associated with adverse reproductive health experiences. This study examined the relationship between nonuse of contraception due to partner objection, one aspect of reproductive coercion, and selected pregnancy-related outcomes. Methods: We used 2016-2020 data from the Pregnancy Risk Assessment Monitoring System in 22 jurisdictions to assess the prevalence of nonuse of contraception due to a partner objection by select characteristics among individuals with a recent live birth who reported an unintended pregnancy. We calculated adjusted prevalence ratios (aPRs) to understand associations with health care utilization, postpartum behaviors and experiences, postpartum contraceptive use, and infant birth outcomes. Results: Among people with a recent live birth in the study jurisdictions (n = 29,071), approximately 5% reported nonuse of contraception due to a partner objection and unintended pregnancy. This experience was associated with lower prevalence of attending a health care visit before pregnancy (aPR 0.8, 95% confidence interval [CI] 0.7-0.9), first trimester prenatal care, and attending a postpartum checkup (aPR 0.7, 95% CI 0.6-0.9 for both). Higher prevalence was observed for postpartum depressive symptoms (aPR 1.3, 95% CI 1.1-1.6) and partner objecting to using birth control postpartum (aPR 2.8, 95% CI 2.1-3.9). Conclusions: Nonuse of contraception due to a partner objection at conception was associated with poor mental health and lower health care utilization around the time of pregnancy. Prevention efforts may include strategies that ensure provider screening for intimate partner violence, and evidence-based approaches that teach about healthy relationships, enhance self-efficacy, and address underlying drivers of violence.

Evaluation of the measurement properties of intimate partner violence screening instruments for the general population: A COSMIN-based international systematic review.

To systematically appraise, compare, and summarize the measurement properties of intimate partner violence screening instruments for the general population and provide recommendations. We searched PubMed, Embase, Web of Science, ProQuest Dissertations & Theses Global and EBSCO Psychology Behavioral Sciences Collection from their establishment to March 2024 using systematic search strategies. The methodological quality of the instruments that met the inclusion criteria and their measurement properties were assessed using the COSMIN methodology, and the COSMIN recommendations were followed. We reported this study using PRISMA 2020 checklist. A total of 23 studies were eventually included, and 18 instruments were identified. The evaluation of the methodological quality indicates poor content validity but good structural validity; however, that of the criterion validity in most of the studies was inadequate. Measurement error and responsiveness were not assessed. Four screening instruments could be used in the interim. The remaining 14 instruments were not recommended for use. The overall methodological quality of most of the assessed instruments was insufficient. A rigorous intimate partner violence screening instrument with good measurement properties is urgently required to identify and screen for intimate partner violence in the general population. CRD42022365247.

An assessment of the content of antenatal care provided by obstetricians in Lebanon: A cross-sectional study.

Quality and timely antenatal care is a vital component of pregnancy care for the well-being of mothers and babies. The aim of this study of to assess self-reported obstetricians' adherence to national and international antenatal care guidelines in Lebanon. This cross-sectional study approached all obstetricians registered with the Lebanese Society of Obstetrics and Gynecology and the Lebanese Order of Physicians to participate in an online and telephone-based survey. The study tool included all of the items from the World Health Organization and national guidelines for antenatal care. Obstetricians' self-reported adherence was assessed across five modules including dietary interventions, dietary supplements, antenatal care assessment, fetal growth assessment, and antenatal care preventive measures. A total of 134 obstetricians completed the survey. Overall, adherence was high for most antenatal care guidelines except for providing nutrition services to undernourished pregnant women, screening for intimate partner violence, and providing tetanus vaccines. The number of recommended antenatal care visits (≥8 vs. <8 visits) was higher among obstetricians in Mount Lebanon or Beirut compared to other areas in Lebanon (72.7%vs.48.6%; p-value <0.01). Provision of tetanus or diphtheria, tetanus, and pertussis (DTP) vaccination was lower for obstetricians who provide care for women who pay out-of-pocket compared to obstetricians who provide care to women who use other payment methods (25.3%vs.45.7%; p-value = 0.024). Group B streptococcus screening test and the provision of at least five ultrasounds were higher among obstetricians who provide care in private clinics or clinics in private hospitals compared to clinics in public hospitals or primary healthcare centers (88.8%vs.66.7%; p-value = 0.023) and (83.6%vs.55.6%; p-value = 0.011), respectively. Reinforcing the adherence to all antenatal care guidelines by continuous monitoring of health facilities is crucial for best practice. Subsidies for essential services may be required for those who are unable to afford components of antenatal care.

Investigating the impact of Cognitive Processing Therapy (CPT) on Post-Traumatic Stress Disorder (PTSD), depression, and anxiety symptoms in female victims of domestic violence.

This study aimed to investigate the effects of CPT on PTSD, depression, and anxiety symptoms in female victims of domestic violence. A two-arm randomized clinical trial was conducted in Bandar-Abbas involving 62 female victims of domestic violence referred from private gynecology and obstetrics clinics. Initial screening for domestic violence was based on the World Health Organization violence questionnaire. Participants were randomly assigned to either a control group (n=32) or an intervention group (n=28) for a study duration of six months in 2022. Twelve group CPT sessions were conducted. The domestic violence questionnaire, Beck's Depression Inventory, Beck's Anxiety Inventory, and the Impact of Event Scale-Revised were completed in three time points: pre-test, post-test, and follow-up. There was a statistically significant difference in the mean scores of depression, PTSD, and domestic violence (P less than .001) between the two groups; however, no significant difference was found in anxiety scores (P greater than .050). CPT is recommended for female victims of domestic violence to reduce symptoms of depression, PTSD, and domestic violence.

Is domestic violence during COVID-19 in lactating women related to infantile colic? An important question

BackgroundPsychosocial factors such as maternal stress in lactating women were shown to be related to an increased risk of infantile colic because the infants can be affected through breast milk. Therefore, domestic violence against lactating mothers can be effective on the infants’ health. It is also demonstrated that domestic violence against women has increased following the COVID-19 pandemic and quarantine. Therefore, this study aims to assess the relationship between domestic violence against breastfeeding women during COVID-19 and the incidence of infantile colic.MethodsThis was a case-control study that was conducted on 356 lactating mothers who attended Bentolhoda Hospital in Bojnoord-Iran from November 2021 to August 2022. The participants were exclusively breastfeeding mothers who were under 6 months infants. Mothers with and without infantile colic infants were considered the case and control groups, respectively. Two questionnaires were used for data collection including a demographic questionnaire, and a questionnaire to assess domestic violence against women during the quarantine period of Corona pandemic. The data was analyzed using SPSS-V22 and Pearson Spearman correlation and linear regression tests.ResultsThe results showed that women in the case group had a significantly higher score for “sexual violence and restraint” than women in the control group [0.59 ± 0.34 versus 0.62 ± 0.25 (Mean ± SD), respectively] (P < 0.05). The chance of infantile colic was higher among the infants of mothers who experienced domestic violence, but it was not statistically significant (OR = 1.236, P = 0.573). Significant relationships were found between the infantile colic and the history of abortion (OR = 1.430, P = 0.028) and cesarean section (OR = 1.723, P = 0.044).ConclusionDomestic violence during pregnancy can potentially increase infant colic through breast milk. Although our findings need more investigation, it can be recommended to plan the direction of screening for domestic violence and providing the necessary care and counseling to the parents in perinatal care services to prevent infantile colic and improve the infant’s health.

Relation Between Intimate Partner Violence During Pregnancy and Postpartum Mother Psychological Wellbeing

Background: Intimate partner violence (IPV) may be physical violence, psychological or sexual abuse by a current or former intimate partner. It is an avoidable global public health problem. IPV in pregnancy, despite being a common problem but remains a neglected condition (1). The severity of violence from a partner during pregnancy was reported to be greater than violence before pregnancy due to possibly change in a couple’s relationship and lifestyle accompanying pregnancy (2).Numerous studies revealed that experiencing IPV during pregnancy negatively affects both mothers and infants during the post- partum period(3).Objectives: to assess prevalence of postpartum depression and anxiety and assess possible relation between partner violence during pregnancy and postpartum psychological health. Design: prospective cohort study Method: This study was carried out on 176 pregnant women attending antenatal care to explore the possible relation between intimate partner violence and postpartum depression and anxiety. The assessment was done during the second trimester by screening the sociodemographic factors, screening of intimate partner violence was done using the Arabic version of the Composite Abuse Scale. Postpartum assessment by screening of maternal depression was done by the Arabic version of the Edinburgh post-partum depression scale, and screening of anxiety using the Arabic version of Perinatal Anxiety Screening Scale. Results: the prevalence of intimate partner violence during pregnancy was 19.3%. Near half of participants suffered from postpartum depressive illness and around one quarter suffered from possible depression. More than half of participants suffered from mild to moderate postpartum anxiety. Partner violence had also significant relation with depression during pregnancy and post-partum with p-value &lt;0.001 for both. Conclusions: intimate partner violence may be a risk factor for postpartum depression and anxiety.so, we should screen for it and learn how to deal with this problem.

Uptake of gynecological consultation following domestic or sexual violence: A case-control study in the context of induced abortion

ObjectiveThe aim of this study was to determine the prevalence of domestic and sexual violence and to characterize the association between exposure to domestic and sexual violence and low uptake of gynecological care, in the context of induced abortion.Study design.We conducted a case-control study among women seeking abortion care, in mother and child centers and sexual health centers in the Paris, France area (April 2022-March 2023). ResultsA total of 103 women were included in the study during induced abortion care. Physical, psychological or sexual domestic violence was reported by 48.5 % and sexual violence, whoever the perpetrator, was reported by 23.3 %. In the bivariate analysis, a history of physical, psychological or sexual domestic violence was not associated with the absence of a gynecological consultation in the past two years, compared with no history of intimate partner violence (p = 0.09). After adjustment for regular pelvic pain, dysmenorrhea, vulvodynia and dyspareunia, there was no association between a history of sexual violence and the absence of a gynecological consultation in the past two years (OR 1.05; CI95% 0.27–4.13, p = 0.93). ConclusionViolence was a common finding among women seeking abortion care. We did not find any association between a history of sexual violence and the absence of a gynecological consultation in the past two years. We suggest investigating multiple or frequent use of gynecological care following violence. The combination of ethical, moral, and psychological constraints associated with violence screening and abortion care is a challenge to patient recruitment in future studies.

Rising to the challenge: The motivation to champion routine intimate partner violence screening in rural emergency departments.

To understand the motivations of champions who worked to bring about system and practice change that supported routine screening for intimate partner violence (IPV) in two rural emergency departments (EDs). Practice changes are required to achieve routine and effective identification and response to IPV. Nurses play a significant role in affecting such practice change. This paper identifies the motivations of champions in the ED setting who successfully brought about such change. The EDs of two Level 5 tertiary hospitals within a rural Local Health District (LHD) of New South Wales, Australia. Twenty-three individuals who identified as champions and worked to introduce routine IPV screening in two rural hospital EDs. Qualitative longitudinal semi-structured interviews employing a process of constant comparison and an interpretive framework to analyse data thematically. Interviews were carried out between June and August 2017 and again between July and August 2019. Over the period of the study, routine screening was established, and screening rates steadily increased from a low baseline to a significantly higher rate. Three aspects of champion motivation emerged from the analysis: formation of an identity as a champion, making a difference to a significant social justice issue and providing quality and community-relevant care. This study is the first study to report on champions and their motivation as they supported IPV practice change in the ED. The findings highlight the capacity for innovation in rural health services, with important implications for other settings looking to translate similar programs. Understanding motivating factors may assist in improved utilisation and support for champions. This is vital if champions are to bring about required practice change within their service and ensure the needs of individuals experiencing IPV are effectively met.

Untold Stories of Displaced Rohingya Pregnant Women Exposed to Intimate Partner Violence in Camp Settings

Intimate partner violence (IPV) strongly impacts the physical, sexual, social, and reproductive health of women, causing an array of psychological and behavioural problems. During pregnancy, the detrimental effects of violence extend to both the mother and the child. Rates of IPV are frequently higher among those in conflict‐affected and displaced communities, most of whom live in low and middle‐income countries. IPV against Rohingya women is common due to relocation, family breakups, patriarchal norms, and deep‐seated gender roles. Despite the high prevalence of IPV in Rohingya refugees in Bangladesh, the matter is often under‐examined. This qualitative study aims to explore and understand pregnant IPV victims’ unique experiences and hardships among the displaced population in a camp setting. A sample of six pregnant homemakers with no formal education was recruited from a healthcare service provider in Leda Camp 24, a remote camp in Cox’s Bazar, Bangladesh. Semi‐structured, in‐depth, face‐to‐face interviews were conducted. Participants reported diverse manifestations of IPV victimisation. Physical abuse, emotional abuse, economic abuse, sexual abuse, pregnancy‐related consequences, and impact on mental health were commonly experienced by participants of this study. The current research investigates the recurrent abuse experienced by this demography, providing detailed narrative information beyond quantitative descriptions of IPV experiences. This article contributes to the existing knowledge on the intersection of IPV, pregnancy, and mental health among displaced populations. Governmental and non‐governmental stakeholders must contextualise these findings in policies and practices by integrating IPV and violence screening, prevention, and treatment protocols into refugee camps and healthcare service providers.

Help-seeking behavior of male victims of intimate partner violence in Japan.

Intimate partner violence (IPV) is becoming a serious public health issue worldwide. This study sought to analyze factors affecting the help-seeking behavior of male victims of IPV using a web survey. Male IPV victims living in Japan were recruited to participate in a web-based questionnaire survey conducted on February 25 and 26, 2021. A total of 1466 men were divided into two groups: Group 1 (43 men) consisted of victims who sought help and Group 2 consisted of victims (1423 men) who had not sought help. The Domestic Violence Screening Inventory, a 20-item questionnaire regarding IPV exposure, and the Patient Health Questionnaire-9 were used, along with the questions regarding help-seeking behaviors for Group 1. Of the 43 victims, 28 victims (65.1%) used exclusively informal supports, eight victims (18.6%) used exclusively formal supports, and seven victims (16.3%) used both. Logistic regression analyses revealed that only physical violence was significantly associated with help-seeking behaviors among types of abuse/violence (odds ratio [OR] = 4.51, confidence interval [CI] = 1.95-10.50, P < .001). Of past experiences, "foregoing divorce to avoid adverse childhood experiences in their offspring" (OR = 3.14, CI = 1.45-6.82, P = .003) was the most significantly associated with help-seeking behaviors. In Japan, male IPV victims tend to seek help following physical violence, but males are less are likely to seek help for nonphysical victimization, highlighting the need for targeted support for victims of nonphysical abuse. To provide comprehensive aid to male IPV victims, consultation centers designed for men will be needed.

A Clinical Decision Support Tool for Intimate Partner Violence Screening Among Women Veterans: Development and Qualitative Evaluation of Provider Perspectives.

Women veterans, compared to civilian women, are especially at risk of experiencing intimate partner violence (IPV), pointing to the critical need for IPV screening and intervention in the Veterans Health Administration (VHA). However, implementing paper-based IPV screening and intervention in the VHA has revealed substantial barriers, including health care providers' inadequate IPV training, competing demands, time constraints, and discomfort addressing IPV and making decisions about the appropriate type or level of intervention. This study aimed to address IPV screening implementation barriers and hence developed and tested a novel IPV clinical decision support (CDS) tool for physicians in the Women's Health Clinic (WHC), a primary care clinic within the Veterans Affairs Palo Alto Health Care System. This tool provides intelligent, evidence-based, step-by-step guidance on how to conduct IPV screening and intervention. Informed by existing CDS development frameworks, developing the IPV CDS tool prototype involved six steps: (1) identifying the scope of the tool, (2) identifying IPV screening and intervention content, (3) incorporating IPV-related VHA and clinic resources, (4) identifying the tool's components, (5) designing the tool, and (6) conducting initial tool revisions. We obtained preliminary physician feedback on user experience and clinical utility of the CDS tool via the System Usability Scale (SUS) and semistructured interviews with 6 WHC physicians. SUS scores were examined using descriptive statistics. Interviews were analyzed using rapid qualitative analysis to extract actionable feedback to inform design updates and improvements. This study includes a detailed description of the IPV CDS tool. Findings indicated that the tool was generally well received by physicians, who indicated good tool usability (SUS score: mean 77.5, SD 12.75). They found the tool clinically useful, needed in their practice, and feasible to implement in primary care. They emphasized that it increased their confidence in managing patients reporting IPV but expressed concerns regarding its length, workflow integration, flexibility, and specificity of information. Several physicians, for example, found the tool too time consuming when encountering patients at high risk; they suggested multiple uses of the tool (eg, an educational tool for less-experienced health care providers and a checklist for more-experienced health care providers) and including more detailed information (eg, a list of local shelters). Physician feedback on the IPV CDS tool is encouraging and will be used to improve the tool. This study offers an example of an IPV CDS tool that clinics can adapt to potentially enhance the quality and efficiency of their IPV screening and intervention process. Additional research is needed to determine the tool's clinical utility in improving IPV screening and intervention rates and patient outcomes (eg, increased patient safety, reduced IPV risk, and increased referrals to mental health treatment).

Evaluation of intimate partner violence screening administration formats in a court-affiliated family mediation program.

Evaluation of intimate partner violence screening administration formats in a court-affiliated family mediation program.

Risk of adverse perinatal outcomes with violence in pregnancy.

To examine the association between physical, sexual, or physiological harm in pregnancy and perinatal outcomes in a large, contemporary birth cohort. This retrospective cohort study used California-linked vital statistics and hospital discharge data from 2016 to 2020. We included singleton, non-anomalous births with a gestational age of 23-42weeks. Violence in pregnancy was identified using International Classification of Disease, Tenth Revision (ICD-10) codes. Chi-square tests and multivariable Poisson regression models were used to evaluate associations of violence in pregnancy with perinatal outcomes. A total of 1,728,478 pregnancies met inclusion criteria, of which 3,457 (0.2%) had reported violence in pregnancy. Compared to those without violence in pregnancy, individuals who experienced violence had an increased risk of non-severe hypertensive disorders (aRR = 1.36, 95% CI 1.22, 1.51), preeclampsia with severe features (aRR = 1.34; 95% CI 1.11, 1.61), chorioamnionitis (aRR = 1.68; 95% CI 1.48, 1.91), anemia (aRR = 1.59; 95% CI 1.50, 1.68), antepartum hemorrhage (aRR = 2.17; 95% CI 1.19, 3.95), and postpartum hemorrhage (aRR = 1.65; 95% CI 1.48, 1.85). Violence in pregnancy was also associated with increased risk of Apgar score < 7 at 5 min (aRR = 1.37; 95% CI 1.11, 1.71) and neonatal hypoglycemia (aRR = 1.26; 95% CI 1.07, 1.48). Violence experienced in pregnancy is associated with an increased risk of adverse perinatal outcomes. Understanding how universal screening and early recognition of violence in pregnancy may reduce disparities in maternal morbidity for this understudied population is critical.

Domestic and Family Violence Screening and Response: A Prospective, Cross-Sectional, Mixed Methods Survey in Private Mental Health Clients.

Most domestic and family violence (DFV) research has focused on establishing prevalence and screening rates in public health and community samples. This study sought to address a gap in the literature by evaluating DFV screening and response practices in a private mental healthcare inpatient service and determining if clients of the service had unmet DFV needs. A prospective, convenience sample, mixed methods, cross-sectional survey of adult inpatient mental health consumers was employed. Sixty-two participants completed the Royal Melbourne Hospital Patient Family Violence Survey. Quantitative Likert-type and categorical responses were collated and analysed descriptively (count and percentage). Free-text responses were analysed using qualitative description within a content analysis framework. Sixty-five percent of participants had been screened for at least one DFV issue, on at least one occasion, with 35% not being screened, to their recall. Twenty-three percent reported disclosing DFV concerns, 82% felt very supported by the clinician's response to their disclosure, and 86% were provided with information they found helpful. Unmet needs were identified in 13% of participants, who had wanted to disclose DFV concerns but not feel comfortable to do so. No unscreened respondents disclosed DFV concerns, highlighting the need to uphold best practice guidelines for direct enquiry. Most disclosing clients were positive about the support they received. Indicated areas for improvement were screening rates, active follow-up, increasing psychology support levels and safety planning.

Screening college athletes for sexual violence: athletes’ experiences and opinions on best practices

ObjectivesCollege athletes are at elevated risk for sexual violence, yet few formally report it and screening for sexual violence is uncommon. This study aimed to evaluate the nature of screening...

Implementation and Impact of Intimate Partner Violence Screening Expansion in the Veterans Health Administration: Protocol for a Mixed Methods Evaluation.

Intimate partner violence (IPV) is a significant public health problem with far-reaching consequences. The health care system plays an integral role in the detection of and response to IPV. Historically, the majority of IPV screening initiatives have targeted women of reproductive age, with little known about men's IPV screening experiences or the impact of screening on men's health care. The Veterans Health Administration (VHA) has called for an expansion of IPV screening, providing a unique opportunity for a large-scale evaluation of IPV screening and response across all patient populations. In this protocol paper, we describe the recently funded Partnered Evaluation of Relationship Health Innovations and Services through Mixed Methods (PRISM) initiative, aiming to evaluate the implementation and impact of the VHA's IPV screening and response expansion, with a particular focus on identifying potential gender differences. The PRISM Initiative is guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) and Consolidated Framework for Implementation Research (CFIR 2.0) frameworks. We will use mixed methods data from 139 VHA facilities to evaluate the IPV screening expansion, including electronic health record data and qualitative interviews with patients, clinicians, and national IPV program leadership. Quantitative data will be analyzed using a longitudinal observational design with repeated measurement periods at baseline (T0), year 1 (T1), and year 2 (T2). Qualitative interviews will focus on identifying multilevel factors, including potential implementation barriers and facilitators critical to IPV screening and response expansion, and examining the impact of screening on patients and clinicians. The PRISM initiative was funded in October 2023. We have developed the qualitative interview guides, obtained institutional review board approval, extracted quantitative data for baseline analyses, and began recruitment for qualitative interviews. Reports of progress and results will be made available to evaluation partners and funders through quarterly and end-of-year reports. All data collection and analyses across time points are expected to be completed in June 2026. Findings from this mixed methods evaluation will provide a comprehensive understanding of IPV screening expansion at the VHA, including the implementation and impact of screening and the scope of IPV detected in the VHA patient population. Moreover, data generated by this initiative have critical policy and clinical practice implications in a national health care system. PRR1-10.2196/59918.