title: Implementing Trauma-Informed Partner Violence Assessment in Family Planning Clinics.
abstract: Intimate partner violence (IPV) and reproductive coercion (RC) are associated with poor reproductive health. Little is known about how family planning clinics implement brief IPV/RC assessment interventions in practice. We describe the uptake and impact of a brief, trauma-informed, universal IPV/RC assessment and education intervention.
  
  
  
  Intervention implementation was evaluated via a mixed methods study among women ages 18 and up receiving care at one of two family planning clinics in greater Baltimore, MD. This mixed methods study entailed a quasi-experimental, single group pretest-posttest study with family planning clinic patients (baseline and exit survey n = 132; 3-month retention n = 68; retention rate = 52%), coupled with qualitative interviews with providers and patients (total n = 35).
  
  
  
  Two thirds (65%) of women reported receiving at least one element of the intervention on their exit survey immediately following the clinic-visit. Patients reported that clinic-based IPV assessment is helpful, irrespective of IPV history. Relative to those who reported neither, participants who received either intervention element reported greater perceived caring from providers, confidence in provider response to abusive relationships, and knowledge of IPV-related resources at follow-up. Providers and patients alike described the educational card as a valuable tool. Participants described trade-offs of paper versus in-person, electronic medical record-facilitated screening, and patient reluctance to disclose current situations of abuse.
  
  
  
  In real-world family planning clinic settings, a brief assessment and support intervention was successful in communicating provider caring and increasing knowledge of violence-related resources, endpoints previously deemed valuable by IPV survivors. Results emphasize the merit of universal education in IPV/RC clinical interventions over seeking IPV disclosure.
authors.affiliation: 1 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.|2 Department of Women's Health & Rights Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Michele R
authors.initials: MR
authors.lastname: Decker
authors.affiliation: 3 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Flessa
authors.affiliation: 4 Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Ruchita V
authors.initials: RV
authors.lastname: Pillai
authors.affiliation: 5 Division of Adolescent and Young Adult Medicine and Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Dick
authors.affiliation: 1 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Jamie
authors.initials: J
authors.lastname: Quam
authors.affiliation: 6 Maryland Department of Health and Mental Hygiene, Baltimore, Maryland.
authors.forename: Diana
authors.initials: D
authors.lastname: Cheng
authors.affiliation: 7 Planned Parenthood of Maryland, Baltimore, Maryland.
authors.forename: Raegan
authors.initials: R
authors.lastname: McDonald-Mosley
authors.affiliation: 8 Department of Community Public Health Nursing, John Hopkins School of Nursing , Baltimore, Maryland.
authors.forename: Kamila A
authors.initials: KA
authors.lastname: Alexander
authors.affiliation: 1 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Charvonne N
authors.initials: CN
authors.lastname: Holliday
authors.affiliation: 5 Division of Adolescent and Young Adult Medicine and Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D015142:Baltimore; D003068:Coercion; D003376:Counseling / Q000379:methods*; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006801:Humans; D000066511:Intimate Partner Violence / Q000517:prevention & control* / Q000523:psychology; D011247:Pregnancy; D015397:Program Evaluation; D060728:Reproductive Health; D012747:Sexual Partners / Q000523:psychology*; D013179:Spouse Abuse / Q000517:prevention & control* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: clinical intervention; implementation science; intimate partner violence; reproductive coercion; screening; trauma-informed care