A practice-centered intervention to increase screening for domestic violence in primary care practices.
BACKGROUND
Interventions to change practice patterns among health care professionals have had mixed success. We tested the effectiveness of a practice centered intervention to increase screening for domestic violence in primary care practices.


METHODS
A multifaceted intervention was conducted among primary care practice in North Carolina. All practices designated two individuals to serve as domestic violence resources persons, underwent initial training on screening for domestic violence, and participated in 3 lunch and learn sessions. Within this framework, practices selected the screening instrument, patient educational material, and content best suited for their environment. Effectiveness was evaluated using a pre/post cross-sectional telephone survey of a random selection of female patients from each practice.


RESULTS
Seventeen practices were recruited and fifteen completed the study. Baseline screening for domestic violence was 16% with a range of 2% to 49%. An absolute increase in screening of 10% was achieved (range of increase 0 to 22%). After controlling for clustering by practice and other patient characteristics, female patients were 79% more likely to have been screened after the intervention (OR 1.79, 95% CI 1.43-2.23).


CONCLUSIONS
An intervention that allowed practices to tailor certain aspects to fit their needs increased screening for domestic violence. Further studies testing this technique using other outcomes are needed.
Bonds
Denise E
DE
Department of Epidemiology and Prevention, Division of Public Health Sciences, and Section of General Internal Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. dbonds@wfubmc.edu
Ellis
Shellie D
SD
Weeks
Erin
E
Palla
Shana L
SL
Lichstein
Peter
P
D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D017579:Domestic Violence / Q000517:prevention & control*; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education* / Q000379:methods / Q000592:standards; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009657:North Carolina; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D012737:Sex Factors; D011795:Surveys and Questionnaires