Screening for intimate partner violence by health care providers. Barriers and interventions.
BACKGROUND
Routine screening for intimate partner violence (IPV) is endorsed by numerous health professional organizations. Screening rates in health care settings, however, remain low. In this article, we present a review of studies focusing on provider-specific barriers to screening for IPV and interventions designed to increase IPV screening in clinical settings.


METHODS
A review of published studies containing original research with a primary focus on screening for IPV by health professionals was completed.


RESULTS
Twelve studies identifying barriers to IPV screening as perceived by health care providers yielded similar lists; top provider-related barriers included lack of provider education regarding IPV, lack of time, and lack of effective interventions. Patient-related factors (e.g., patient nondisclosure, fear of offending the patient) were also frequently mentioned. Twelve additional studies evaluating interventions designed to increase IPV screening by providers revealed that interventions limited to education of providers had no significant effect on screening or identification rates. However, most interventions that incorporated strategies in addition to education (e.g., providing specific screening questions) were associated with significant increases in identification rates.


CONCLUSIONS
Barriers to screening for IPV are documented to be similar among health care providers across diverse specialties and settings. Interventions designed to overcome these barriers and increase IPV-screening rates in health care settings are likely to be more effective if they include strategies in addition to provider education.
Waalen
J
J
General Preventive Medicine Residency Program, University of California, San Diego/San Diego State University, San Diego, California 92182, USA. waalen@rohan.sdsu.edu
Goodwin
M M
MM
Spitz
A M
AM
Petersen
R
R
Saltzman
L E
LE
D018585:Battered Women / Q000706:statistics & numerical data; D017579:Domestic Violence / Q000517:prevention & control* / Q000706:statistics & numerical data*; D005069:Evaluation Studies as Topic; D005260:Female; D017408:Guidelines as Topic; D006282:Health Personnel / Q000592:standards* / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D019221:Mandatory Reporting; D008403:Mass Screening; D010819:Physician's Role; D012307:Risk Factors; D013179:Spouse Abuse / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology