title: Intimate Partner Violence Detection and Care in the Veterans Health Administration: Patient and Provider Perspectives.
abstract: BACKGROUND
  Women veterans experience high rates of intimate partner violence (IPV), with associated negative health impacts. The Veterans Health Administration (VHA) has recently developed plans to implement routine IPV screening and provide IPV-related follow-up services for VHA patients. Previous research has examined barriers and facilitators to health care provider screening for IPV. The next step is to examine patients' disclosure of IPV experiences to health care providers and effective response to such disclosures. We sought to identify VHA patients' and providers' perspectives on how to facilitate effective IPV detection and care in VHA.
  
  
  METHODS
  We conducted semistructured, qualitative interviews with 25 female veteran patients and 15 VHA health care providers. We used an inductive approach to analyzing interview transcripts and identifying themes that constituted study findings.
  
  
  RESULTS
  Themes fell in to two broad categories: 1) barriers to disclosure and 2) barriers to an adequate response to disclosure and providing follow-up care. Barriers to disclosure of IPV to health care providers included lack of provider inquiry, lack of comfort, and concerns about the consequences of disclosure and lack of privacy. Patients and providers both indicated a need for expanded resources to respond to IPV in VHA.
  
  
  CONCLUSIONS
  Findings support current plans for IPV program implementation in VHA and point to recommendations for practice and implications for further research.
authors.affiliation: VA Center for Health Equity Research and Promotion, Philadelphia Pennsylvania. Electronic address: Melissa.Dichter@va.gov.
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Dichter
authors.affiliation: VA Center for Health Equity Research and Promotion, Philadelphia Pennsylvania.
authors.forename: Clara
authors.initials: C
authors.lastname: Wagner
authors.affiliation: VA Center for Health Equity Research and Promotion, Philadelphia Pennsylvania.
authors.forename: Erica B
authors.initials: EB
authors.lastname: Goldberg
authors.affiliation: National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Iverson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D030881:Disclosure; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D000066511:Intimate Partner Violence; D008403:Mass Screening; D036301:Qualitative Research; D013179:Spouse Abuse / Q000175:diagnosis* / Q000523:psychology; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*; D058014:Veterans Health