Domestic Violence Clinical Trial
Official title:
Evaluation of an Intimate Partner Violence Screening-Intervention
The purpose of the study is to evaluate a multi-faceted intimate partner violence (IPV)
screening/intervention targeting abused women who are seen for prenatal care in
obstetrics-gynecology clinics or general medical care in internal medicine clinics. The
intervention is based on our clinical experience and review of the literature which suggests:
1) IPV can vary and no one pattern exists for all women; 2) recovery from abuse usually
occurs over time and not necessarily immediately after it is first detected; 3) women have
gone down many different paths leading to an abusive relationship and there is no single path
to recovery; 4) for screening/interventions to be credible and ultimately disseminated they
must respond to the complexity of the patient stories clinicians see everyday when caring for
women experiencing IPV and 5) busy obstetricians/internists/clinicians are unlikely to
effectively screen and treat women experiencing IPV unless they are supported by other
personnel trained to address IPV as well.
The intervention also is based on recommendations of IPV experts and on the theory of chronic
disease management that recognizes that the best outcomes are achieved when: 1) patients are
educated and given the support and skills to set their own goals and make their own choices;
2) multidisciplinary teams work better than programs focused only on physician behavior; 3)
active monitoring of progress is essential; 4) active coping styles using a range of
therapeutic modalities are available and 5) a stepped approach is utilized with those not
making progress or with more severe problems receiving the greatest intensity of services.
The screening/intervention will be available to each abused woman for approximately three to
six months. Patients in the evaluation study will be surveyed at the following time points:
baseline, 1 week, 1 month, 3 months, 6 months, and for the partial cohort that starts early,
9 months. Additionally, a sample of nonabused women will be surveyed at baseline to serve as
a referent group.
Our primary hypotheses are, that compared to usual care, abused women receiving the
intervention will have a reduction in levels of IPV, decreases in depression and nonspecific
physical symptoms, increase in functional health status, increase in safety behaviors,
increase in help seeking for issues related to IPV, and reduction of general medical
services.
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