Results of a domestic violence training program offered to the staff of urban community health centers. Evaluation Committee of the Philadelphia Family Violence Working Group.
BACKGROUND
Domestic violence (DV) against women often goes unrecognized by health care providers due to multiple barriers. In an effort to increase screening, identification, and referral for services, the RADAR Training Project was created for the health care staff of 12 federally qualified community health centers (CHCs).


METHODS
A two-phase evaluation was conducted to assess the intervention. Phase one evaluated the health care providers' perceived knowledge and comfort pre-training, post-training, and at 3 months follow-up. The second phase included a medical chart review of 4 CHCs to assess the rates of screening, documentation of abuse, assessment of safety, and referrals for help at baseline (6 months pre-training) as compared to the intervention period (6 months post-training).


RESULTS
The health care providers' perceived level of knowledge and comfort increased significantly post-training and then later decreased at 3 months follow-up. The rate of screening for DV (25% vs. 5%), suspicion of DV (6% vs. 2%), completion of safety assessments (17% vs. 5%), and referrals (4% vs. 0%) increased significantly between the intervention and baseline periods. However, the rates of documentation of abuse did not change.


CONCLUSIONS
This intervention was successful in increasing provider perceived knowledge and comfort; however, comfort decreased at follow-up. Additionally, the rates of screening and referrals increased 6 months post-training. Health care provider training and support and integrated quality assurance mechanisms may be necessary to increase the overall rate of these activities, and to sustain this effort over time. Further study is needed to identify effective methods to increase provider comfort regarding DV screening.
Harwell
T S
TS
Department of Community and Preventive Medicine, Allegheny University of the Health Sciences, Philadelphia, Pennsylvania 19107, USA.
Casten
R J
RJ
Armstrong
K A
KA
Dempsey
S
S
Coons
H L
HL
Davis
M
M
D000293:Adolescent; D000328:Adult; D003151:Community Health Centers; D017579:Domestic Violence / Q000517:prevention & control; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008403:Mass Screening; D015143:Philadelphia; D012017:Referral and Consultation; D013179:Spouse Abuse / Q000175:diagnosis; D014505:Urban Population