Screening For Violence Research Articles

Implementation of a Trauma-Informed Care Elective in Medical Education

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

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

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

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

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

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

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

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

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

The risk of not knowing – A predictive validity study of the “Don't know” scores on a violence screen in acute psychiatry

Access to information about risk factors of violence for patients admitted to acute psychiatric wards may be sparse. This prospective study from three acute wards explored associations between items scored “Don't know” and violence during hospital stays ( N = 1435) and the first three months after discharge ( N = 461) when using a violence risk screening tool (Violence risk screening - 10; V-RISK-10). When V-RISK-10 was scored at admission and “Don't know” was weighted 0 or 1, the area under the curve of the receiver operating characteristics (AUC) was 0.79 and 0.82 for inpatient violence and 0.79 and 0.80 for post-discharge violence. “Don't know” scored at admission was significantly associated with inpatient violence for eight risk items and with violence after discharge for seven items. Numbers of “Don't know” scores decreased substantially at discharge. A substantial proportion of those scores seemed to change into “Maybe/moderate” or “Yes”. There were some differences in single items in the associations of “Don't know” with violence and the distribution of scores. Findings indicate that items scored “Don't know” at the time of admission may be associated with violence during hospital stay and after discharge. More research is needed to elaborate these findings. • Don't know scores on risk factors were significant for inpatient violence. • Risk screening at admission was significant for post-discharge violence. • Assessment and management of post-discharge violence risk may start at admission.

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

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

Intimate partner violence screening during pregnancy: midwives’ perspective

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

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

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

Evaluation of sexual violence among lesbian, bisexual, and heterosexual Hispanic women living in Puerto Rico.

To investigate the association between sexual orientation and sexual violence in Hispanic women living in Puerto Rico. Secondary data analysis of a cross-sectional study. An anonymous web-based questionnaire was distributed in Puerto Rico between February and April 2016. Variables included history of sexual violence, sexual orientation, and age of first sexual experiences. Data were analyzed using χ2 testing and a P value less than 0.05 was considered significant. Sociodemographic characteristics were similar between groups except for age in the 476 participants. The most common age of first sexual experiences was between 7 and 12 years, 13-18 years for penile vaginal and oral sex, and 22-29 years for penile anal sex in the overall population of the study. These did not differ except that more bisexual women 40 (71.4%) had their first oral sex experience at 13-18 years compared with 164 (50.7%) heterosexual and 35 (55.2%) lesbian women (P= 0.045). Of the 19.2% of participants who reported sexual violence, there were 50 (18.4%) heterosexual, 8 (12.2%) lesbian, and 17 (34.7%) bisexual women. Bisexual women were more likely to disclose sexual violence (P= 0.007). Most women stated having a sexual experience at a young age. Significant proportions reported sexual violence with bisexual women being the most likely. Screening for sexual violence must be routinely performed by health professionals.

Perinatal intimate partner violence and postpartum contraception timing among currently married women in Southern Ethiopia: A multilevel Weibull regression modeling.

Adopting contraception on time is a critical intervention for postpartum women, but violence exposure around pregnancy may interfere with postpartum contraceptive use behaviors. Hence, this study aimed to investigate the time duration of the first modern contraceptive adoption and its individual-and community-level predictors among postpartum women in the Wolaita zone, South Ethiopia. A community-based prospective follow-up study was conducted among 1,292 postpartum women nested in 38 "Kebles" (clusters) using multistage-clustered sampling techniques. A multilevel Weibull regression model was employed to investigate predictors of time-to-method initiation after childbirth using STATA Version 14. Kaplan-Meier curve and Wilcoxon log-rank test were used to estimate time-to-modern contraceptive use across different variables. All variables with p-values <0.05 were considered for multivariate analysis. Adjusted time ratios (ATR) with 95 % CI were computed using Weibull accelerated failure time models. Of the respondents, 62% (95% CI: 59.1-64.5) had started the first modern contraception within a year after childbirth. The restricted mean survival time-to-postpartum modern contraceptive use was 6.28 months. Being a rural dweller (aTR: 1.44; 95% CI: 1.06-1.99) and living in the middle household wealth quintiles (aTR: 1.10; 95% CI: 1.02-1.19) predicted longer time duration to adopt first modern contraception by 44 and 10%, respectively. The women from the community with a high early marriage (aTR: 1.14; 95% CI: 1.01-1.28) took longer time to initiate modern postpartum methods. Furthermore, women who had no history of perinatal abuse took less time than those who had a history of abuse to start postpartum contraception (aTR: 0.71; 95% CI: 0.66-0.78). Rural residence, poor household wealth status, history of perinatal abuse, and a high rate of early marriage in the community are predicted to lengthen the time duration to start modern postpartum contraception. Thus, community-level women's empowerment, particularly among rural women and integration of intimate partner violence screening into family planning counseling throughout the continuum of care will likely to improve postpartum contraception timing.

Domestic violence screening in a public mental health service: A qualitative examination of mental health clinician responses to DFV.

WHAT IS KNOWN ON THE SUBJECT?: Mental health clients experience higher estimated rates of domestic violence, yet mental health services are less likely to screen for domestic violence. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper qualitatively explores the perspectives and experiences of mental health practitioners in inpatient and community teams in a publicly funded hospital and health service (i.e. public mental health service). Mental health practitioners described a lack of domestic violence training, as well as a lack of knowledge of domestic violence and support mechanisms for victims, when domestic violence is disclosed by clients. The paper highlights the unique difficulties and barriers experienced by clinicians in screening for domestic violence while also dealing with clients suffering a mental health crisis. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The paper sheds more light on the issue of domestic violence in mental health in terms of screening, and identifies avenues for improvement in mental health services; particularly the need for staff training and education. ABSTRACT: Introduction Domestic violence is particularly prevalent within mental health client groups, though screening for domestic violence within mental health services is often overlooked. Aim To investigate the experiences and opinions of domestic violence screening by mental health clinicians in a publicly funded hospital and health service. Methods Semi-structured interviews were conducted with twelve clinicians working in publicly funded mental health services in Queensland, Australia. Transcripts were thematically analysed. Results Four main themes emerged from the data: staff training and experience; prioritizing domestic violence screening; attitudes to domestic violence; and victim support. Participants discussed a lack of training for, or expectations of, domestic violence screening in mental health services. They also highlighted a lack of resources enabling them to appropriately respond when domestic violence was identified. Discussion Education, attitudes and resources relating to domestic violence are major factors that should be addressed for the successful screening and treatment of clients in mental health. Implications for Practice This paper informs services of the gaps in knowledge and care around domestic violence and mental health. A less medicalized approach to the treatment of mental health should be adopted, and domestic violence training introduced for all healthcare practitioners, to improve client outcomes.

Intimate Partner Violence and Adverse Pregnancy Outcomes

Background Intimate partner violence (IPV) is an abuse or harm that occurs in a close relationship. The World Health Organization (WHO) estimated that, globally, 35% of women living in industrialized and developed countries have experienced exposure to intimate partner violence and during pregnancy it is associated with low birth weight, preterm birth, and even death of the baby.&#x0D; Objective To find out proportion of intimate partner violence and adverse pregnancy outcome among postnatal mothers who recently delivered their baby.&#x0D; Method A cross-sectional study was conducted among 220 postnatal mothers using a structured questionnaire based on 13-item WHO Violence against women instrument in Nepali language. Face-to-face interview technique was used to collect data using consecutive sampling technique at Kathmandu Medical College teaching Hospital. The data were analyzed using SPSS version 20.&#x0D; Result In recent pregnancy, 32.7% of women had experienced intimate partner violence at least once, which has been categorized as physical 28.6%, psychological 30.9%, and 22.7% sexual violence. Among them, 36% had low birth weight babies, 24% had preterm, 2.8% had dead baby, and 35% reported abortion in previous pregnancy. In the binary logistic regression, intimate partner violence was significantly associated with preterm baby (OR-1.143, 95% CI- 0.386-3.384, p=0.002), low-birth weight (OR- 0.237, 95% CI- 0.093-0.602, p ≤ 0.001), and abortion (OR-0.021, 95% CI- 0.003-0.175, p ≤ 0.001).&#x0D; Conclusion One in three women experienced intimate partner violence during their recent pregnancy and is associated with adverse pregnancy outcomes. Programs targeting screening of intimate partner violence against women should therefore be emphasized during reproductive health services such that adverse pregnancy outcomes can be prevented.

Integrating Gender-Based Violence Screening and Support into the Research Clinic Setting: Experiences from an HIV Prevention Open-Label Extension Trial in Sub-Saharan Africa

HIV and gender-based violence (GBV) are syndemic in sub-Saharan Africa and provision of support for participants who disclose GBV constitutes part of comprehensive care. Consequently, a process was undertaken to develop, implement, and evaluate standard operating procedures (SOPs) in MTN-025/HOPE, a study of the dapivirine vaginal ring for HIV prevention. The SOP was developed using needs assessment surveys in addition to World Health Organization (WHO) guidelines and other literature. Sites tailored and implemented the SOP through HOPE implementation. At study end, staff reported increased training 32/35 (91.43%); improved confidence (18/26; 69.23%); and improved vicarious trauma prevention onsite (17/28; 60.71%). Leadership reported increased staff competence in GBV response. Obstacles included limited referral organizations and time for follow-up, continued training needs, and cultural norms. Development and implementation of an SOP is a feasible strategy to build a GBV response to improve health systems and support sustained effective use of HIV prevention products.

Systematic screening of gender violence and domestic violence among HIV-positive patients: the VIHOLETA study

ABSTRACT We conducted a multicentre observational study in people living with HIV (PLHIV) on antiretroviral therapy in Alicante (Spain) from 2019 to 2020 aiming to analyse the prevalence of abuse and assess treatment adherence according to this variable. We used the Abuse Assessment Screen tool, the simplified medication adherence questionnaire and the medication possession ratio to assess outcomes.. Of the 161 included PLHIV, 53 (32.9%) had suffered abuse (27 emotional abuse, 6 physical abuse, 3 sexual abuse, 13 emotional and physical abuse, 4 unknown type). Seven (4.3%) had suffered abuse in the last year (5 emotional, 2 physical). Abuse had lasted a median of 48 months (interquartile range 12–81). HIV status was considered as a cause of violence by 9.4% of victims. In the multivariable analysis, only abuse was independently associated with non-adherence [adjusted odds ratio (aOR) 3.92; 95% confidence interval (CI) 1.80–8.84; p = 0.0007]. Abuse (aOR 6.14; 95% CI 1.63–27.70; p = 0.001) and previous incarceration (aOR 15.08 95% CI 2.71–104.71; p = 0.003) were associated with detectable viral load. In conclusion, the prevalence of abuse is high in PLHIV, hampering adherence and virological success. Abuse screening tools should be incorporated into routine HIV care.

Perceptions of women towards screening for intimate partner violence.

BackgroundIntimate partner violence (IPV) is an under-diagnosed public health problem affecting women with attendant negative bio-psycho-social ramifications, and unfortunately there is no universally agreed recommendation for routine hospital IPV screening currently.AimThis study was carried out to determine the prevalence of IPV among women and their perceptions towards screening.SettingThe study was carried out in a hospital in Southwest, Nigeria.MethodsThe study was a descriptive, cross-sectional study of 347 consenting women. Respondents were recruited using systematic random sampling. Data were collected using questionnaire adapted from the World Health Organization’s (WHO) Multi-Country Study Questionnaire on Women’s Health and Domestic Violence against women. Descriptive and inferential statistics were used and a p-value < 5% was considered significant.ResultsThe prevalence of IPV among the sample was 71.2%. The most common IPV pattern was controlling behaviour (49.6%) while sexual violence (19.6%) was the least. The majority (85.0%) of the respondents agreed that routine IPV screening should be done for women while 96.5% believed that it would enable doctors to help identify victims. The belief that it will help physicians in making a correct diagnosis, shared by 10.7% of the respondents, was statistically significant (odd ratio [OR] = 2.592, 95% confidence interval [CI] = 1.180–5.694, p-value = 0.018). A total of 37 respondents (10.7%) were about three times more likely to have experienced IPV than others.ConclusionThere was a high prevalence of IPV and the women are open to routine hospital IPV screening, with the belief that it will help physicians to make an accurate diagnosis of IPV.ContributionThis research was done by majority of family health specialists, in Nigeria, an African country. The focus of the research was distinctly with an African perspective, in the field of family medicine which has a public health implication and effect on the community.

Perinatal Care for Individuals With a History of Sexual Trauma

Many women and individuals assigned female at birth experience sexual assault or abuse in their lives leading to sexual trauma. In this article, we review the effects of sexual trauma and resulting chronic stress on the body and during the perinatal period. Maternal, fetal, and neonatal health implications are discussed. Routine screening for sexual assault and violence can assist with early identification and intervention. A variety of modalities and methods for managing the effects of sexual trauma have been identified, including pharmacologic treatment, psychotherapy, complementary and alternative medicine, and shared decision-making. Further research regarding different treatments is essential to find additional tools to aid clinicians providing care to this vulnerable population. When nurses care for individuals with a history of sexual trauma, incorporating trauma-informed care can help prevent retraumatization and promote a healthy perinatal experience.

Prevalence of Intimate Partner Violence and Endodontic Treatment Needs: Pilot Study.

ObjectiveThe aim of this study was to assess the prevalence and potential association between intimate partner violence (IPV) with traumatic dental injuries (TDIs) and the subsequent need for root canal treatment (RCT).MethodsA total of 100 subjects with TDIs presented at emergency or postgraduate restorative clinics at University Dental Hospital, King Abdulaziz University, Jeddah, Saudi Arabia post-TDI. All study subjects completed the Hurt-Insult-Threaten-Scream (HITS) domestic violence screening tool and were clinically and radiographically examined to determine the type of TDI they suffered along with the pulp and periapical status of affected teeth. Demographic data were also recorded. Based on the findings, management included regular follow-up, splinting, reattachment of broken tooth part, vital pulp therapy and/or RCT as seen appropriate.ResultsMean age of participants was 28.4±5.7 years. Prevalence of IPV among subjects presented with TDIs was 18%. Most of the IPV victims held a bachelor’s degree (67%) and were unemployed (61%). Most of TDI cases were crown fracture (84%) followed by luxation and avulsion (10% and 6%, respectively). Among all TDI cases, 73% required RCT. Crown fracture was the most prevalent TDI among IPV victims followed by luxation and avulsion with prevalence of 56%, 33%, and 11%, respectively. Out of a total of 73 patients requiring RCT, nine were IPV victims (12.3%) which indicated that one of each eight TDI cases requiring RCT might be a potential IPV victim. Half of the IPV victims required RCT to manage their TDIs.ConclusionPrevalence of IPV among TDIs was 18%. IPV screening should be included as routine assessment part for TDIs. Identification of IPV victims could be difficult, however, employment status, type of TDI, and RCT needs were suggested as potential predictors of positive IPV cases.

Opportunities to More Comprehensively Assess Sexual Violence Experience in Veterans Health Administration Medical Records Data

IntroductionExperience of sexual violence (SV) is prevalent among the Veteran population and associated with many negative mental and physical health outcomes including suicidal behavior, obesity, post-traumatic stress disorder, anxiety, depression, and poor sexual and reproductive functioning. Although Veterans of any gender may experience SV, women Veterans are particularly at risk. Research on SV among Veterans has focused primarily on the experience of SV during military service (military sexual trauma, MST), although Veterans may also experience SV prior to and following military service. The aim of the current study was to construct a more comprehensive method of identifying SV among Veterans Health Administration (VHA) patients as documented in medical records in a national cohort of 325,907 Veterans who used VHA care between 2000 and 2018 in order to inform future research in this area.MethodWe used three indicators to identify SV in VHA medical records: (a) the MST screen, (b) the sexual violence item of the intimate partner violence (IPV) screen, and (c) International Classification of Disorders (ICD) codes (versions 9 and 10) representing adult sexual abuse and assault. Univariate descriptive analyses were conducted to determine the exclusivity and overlap of the SV measures.ResultsThe universal MST screen was the most commonly identified indicator of SV in the data. However, including the IPV and ICD indicators identified an additional 5% of Veterans who had experienced SV, accounting for thousands of patients.DiscussionThe results of the current study indicate that using the three-pronged approach of SV collection is a more comprehensive method of identifying patient SV experience through VHA medical records and contributes uniquely to the methodology of studying social factors’ impact on health care. Clinical screening and documentation of SV allow for the assessment of health impacts and trends through examination of medical records data.

Intimate Partner Violence Screening for Veterans Accessing Homelessness Services

ABSTRACT To-date, there has been limited visibility into the prevalence of intimate partner violence (IPV) among veterans accessing Department of Veterans Affairs (VA) homeless services. A three-month screening pilot was implemented in early 2020 to explore IPV screening for participants of VA homeless veteran programs at five VA medical centers throughout Tennessee and Kentucky. VA IPV screening was administered to 577 veterans. Of those screened, 91 were positive for the primary screen. Of positive screens, 30 reported elevated risk on a secondary lethality screen. Rates of positive IPV screening appeared elevated among female and younger veterans; race was not related to IPV screening outcome. Implications for future research and implementation within VA homeless programs nationwide are discussed.