Partner violence intervention in the busy primary care environment.
BACKGROUND
Few studies of intimate partner violence (IPV) interventions have been conducted in primary care settings. Based on recommendations, we implemented a multifaceted IPV intervention that included a sticker placed in medical charts listing screening questions, routine IPV screening by nursing staff, clinician follow-up for women screening positive, and referral to on-site services.


METHODS
A prospective cohort study compared multiple measures collected at the intervention site and a center providing usual care. Measures included self-reported IPV, documented IPV screening and IPV experiences, and quantity of IPV materials taken from the centers.


RESULTS
Of 746 charts reviewed in a random chart review conducted at the intervention site, 36.6% were tagged for IPV screening, and of those tagged, 86.1% had documentation of screening. Approximately 5% (11 of 235) of women screened positive for IPV; about half had documented clinician follow-up and referral to on-site services. Comparison of survey responses and medical record reviews (intervention site) indicated that the screening protocol primarily identified severely abused women (sensitivity 80%, specificity 98%), but rarely identified women experiencing low to moderate levels of abuse. IPV brochures were taken from the intervention site at a rate of 51 per 1000 visits versus 29 per 1000 visits taken from the control site.


CONCLUSIONS
Utilizing screening as the only gateway to on-site services limited access for many IPV victims. The removal of IPV brochures from examination rooms suggests that providing contact information for self-referral to on-site services may improve access.
McNutt
Louise Anne
LA
Department of Epidemiology, University at Albany, State University of New York, Albany, NY 12144, USA. lam08@health.state.ny.us
Carlson
Bonnie E
BE
Rose
Isabel M
IM
Robinson
David A
DA
D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D003419:Crisis Intervention; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D011322:Primary Prevention / Q000379:methods*; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D013179:Spouse Abuse / Q000517:prevention & control* / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014505:Urban Population