Barriers to Domestic Violence Screening in the Pediatric Setting

Erickson, Mary J.; Hill, Teresa D.; Siegel, Robert

doi:10.1542/peds.108.1.98

Cited by 125 publications

(108 citation statements)

References 27 publications

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“…Although several obstacles exist for intimate partner violence screening in the ED, including fear of offending the patient, patient nondisclosure, 14 lack of resources, 15 lack of education of medical personnel, lack of specific treatment protocols, time constraints, and lack of support staff (eg, social workers), 16 our research demonstrates that universal intimate partner violence screening in the ED is possible and resulted in utilization of resources and safety measures. Moreover, in this large cohort of screened patients there was no evidence of any harm related to intimate partner violence screening and referral.…”

Section: Discussionmentioning

confidence: 80%

Does Screening in the Emergency Department Hurt or Help Victims of Intimate Partner Violence?

Houry

Kaslow

Kemball

et al. 2008

Annals of Emergency Medicine

108

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Study objective: Recent systematic reviews have noted a lack of evidence that screening for intimate partner violence does more good than harm. We assess whether patients screened for intimate partner violence on a computer kiosk in the emergency department (ED) experienced any adverse events during or subsequent to the ED visit and whether computer kiosk identification and referral of intimate partner violence in the ED setting resulted in safety behaviors or contact with referrals.Methods: We conducted a prospective, observational study in which a convenience sample of male and female ED patients triaged to the waiting room who screened positive (on a computer kiosk-based questionnaire) for intimate partner violence in the past year were provided with resources and information and invited to participate in a series of follow-up interviews. At 1-week and 3-month follow-up visits, we assessed intimate partner violence, safety issues, and use of resources. In addition, to obtain an objective measure of safety, we assessed the number of violence-related 911 calls to participant addresses within a call district 6 months before and 6 months after the index ED visit.Results: Of the 2,134 participants in a relationship in the last year, 548 (25.7%) screened positive for intimate partner violence. No safety issues, such as calling security or a partner's interference with the screening, occurred during the ED visit for any patient who disclosed intimate partner violence. Of the 216 intimate partner violence victims interviewed in person and 65 contacted by telephone 1 week later, no intimate partner violence victims reported any injuries or increased intimate partner violence resulting from participating in the study. For the sample in the local police district, there was no increase in the number of intimate partner violence victims who called 911 in the 6 months after the ED visit. Finally, 35% (n131) reported they had contacted community resources during the 3-month follow-up period.Conclusion: Among patients screening positive for intimate partner violence, there were no identified adverse events related to screening, and many had contacted community resources. Study objective: Recent systematic reviews have noted a lack of evidence that screening for intimate partner violence does more good than harm. We assess whether patients screened for intimate partner violence on a computer kiosk in the emergency department (ED) experienced any adverse events during or subsequent to the ED visit and whether computer kiosk identification and referral of intimate partner violence in the ED setting resulted in safety behaviors or contact with referrals. Comments Postprint version. Published inMethods: We conducted a prospective, observational study in which a convenience sample of male and female ED patients triaged to the waiting room who screened positive (on a computer kioskbased questionnaire) for intimate partner violence in the past year were provided with resources and information and invited to participate in a ...

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Section: Discussionmentioning

confidence: 80%

Does Screening in the Emergency Department Hurt or Help Victims of Intimate Partner Violence?

Houry

Kaslow

Kemball

et al. 2008

Annals of Emergency Medicine

108

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“…Similarly, there is clearly resistance to screening for parental domestic violence among pediatricians. One recent survey of Midwestern practitioners found that only 8.5% routinely screened [33]; a nationwide survey found the overall self-reported prevalence at 5%, with little improvement among recent cohorts [34]. The cited reasons are similar to those for practitioners treating adults: feelings of inadequate education and too little time, and concern about offending patients [34,35].…”

Section: Discussionmentioning

confidence: 99%

Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety

Rhodes

Iwashyna

2007

Matern Child Health J

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Objective: In several populations, maternal depression has been associated with reduced child safety. In an urban pediatric Emergency Department, we examined the relationship between parental depression, social support, and domestic conflict and child safety behaviors.Methods: We studied consecutive patients in an Emergency Department. Trained interviewers used a structured instrument to assess patient, primary caregiver, and household demographics, socio-economic status, psychosocial factors, child safety behaviors (whether a gun was in the home, poisons were locked, a functioning smoke detector was present, and use of carseats or seatbelts), and whether the home was smokefree. 1,116 patients provided adequate data.Results: Depression was associated with a modest and not statistically significant reduction in child safety behaviors in this population. Lack of social support and the presence of domestic conflict were robustly, independently, and statistically significantly associated with less safe homes. Domestic conflict was associated with more smoking in the home.Conclusion: In our population, child safety was associated less with depression and more with parental lack of social support and domestic conflict. These can be assessed in a Emergency Department and may be amenable to intervention. Abstract Objective: In several populations, maternal depression has been associated with reduced child safety. In an urban pediatric Emergency Department, we examined the relationship between parental depression, social support, and domestic conflict and child safety behaviors.Methods: We studied consecutive patients in an Emergency Department. Trained interviewers used a structured instrument to assess patient, primary caregiver, and household demographics, socio-economic status, psychosocial factors, child safety behaviors (whether a gun was in the home, poisons were locked, a functioning smoke detector was present, and use of carseats or seatbelts), and whether the home was smoke-free. 1,116 patients provided adequate data.Results: Depression was associated with a modest and not statistically significant reduction in child safety behaviors in this population. Lack of social support and the presence of domestic conflict were robustly, independently, and statistically significantly associated with less safe homes. Domestic conflict was associated with more smoking in the home.Conclusion: In our population, child safety was associated less with depression and more with parental lack of social support and domestic conflict. These can be assessed in a Emergency Department and may be amenable to intervention.

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“…16,63,64 Health providers report, however, that they often are unfamiliar with resources and do not know what to do if a patient discloses IPV to them. 12,28,51,[65][66][67][68] Unfortunately, little guidance exists on how to build these connections with victim-advocacy services, how to strengthen local connections, and how to nurture a collaborative relationship.…”

Section: Health Information Technology and Ipv Screening And Counselingmentioning

confidence: 99%

Integrating Intimate Partner Violence Assessment and Intervention into Healthcare in the United States: A Systems Approach

Miller

McCaw

Humphreys

et al. 2015

Journal of Women's Health

152

116

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The Institute of Medicine, United States Preventive Services Task Force (USPSTF), and national healthcare organizations recommend screening and counseling for intimate partner violence (IPV) within the US healthcare setting. The Affordable Care Act includes screening and brief counseling for IPV as part of required free preventive services for women. Thus, IPV screening and counseling must be implemented safely and effectively throughout the healthcare delivery system. Health professional education is one strategy for increasing screening and counseling in healthcare settings, but studies on improving screening and counseling for other health conditions highlight the critical role of making changes within the healthcare delivery system to drive desired improvements in clinician screening practices and health outcomes.This article outlines a systems approach to the implementation of IPV screening and counseling, with a focus on integrated health and advocacy service delivery to support identification and interventions, use of electronic health record (EHR) tools, and cross-sector partnerships. Practice and policy recommendations include (1) ensuring staff and clinician training in effective, client-centered IPV assessment that connects patients to support and services regardless of disclosure; (2) supporting enhancement of EHRs to prompt appropriate clinical care for IPV and facilitate capturing more detailed and standardized IPV data; and (3) integrating IPV care into quality and meaningful use measures. Research directions include studies across various health settings and populations, development of quality measures and patient-centered outcomes, and tests of multilevel approaches to improve the uptake and consistent implementation of evidence-informed IPV screening and counseling guidelines.

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Barriers to Domestic Violence Screening in the Pediatric Setting

Cited by 125 publications

References 27 publications

Does Screening in the Emergency Department Hurt or Help Victims of Intimate Partner Violence?

Does Screening in the Emergency Department Hurt or Help Victims of Intimate Partner Violence?

Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety

Integrating Intimate Partner Violence Assessment and Intervention into Healthcare in the United States: A Systems Approach

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