Responding to intimate partner violence: Healthcare providers' current practices and views on integrating a safety decision aid into primary care settings

Abstract

Supportive care for survivors of intimate partner violence (IPV) remains limited in primary care settings. Low-income and Spanish-speaking survivors of IPV are even more disadvantaged, given the dearth of linguistically and culturally appropriate interventions for IPV. We conducted semi-structured individual interviews with 17 healthcare workers, including physicians, nurses, and social workers, to describe how healthcare workers serving primarily low-income, Latina populations are currently screening and responding to IPV disclosure, and to explore the acceptability of integrating an interactive, personalized safety decision aid application-myPlan app-into the clinic setting. Despite recognition of IPV as a problem, none of the clinical sites had a protocol to guide screening and response to IPV disclosure. Screening practices varied across the sites, sometimes conducted by medical assistants prior to the provider visit and other times by the physician or nurse provider. When IPV was disclosed, it was often during assessment for a presenting problem such as poor sleep or anxiety. Most healthcare workers felt that clinical and community resources were limited for their patients experiencing IPV. The "warm hand-off" to a social worker was the most common response strategy when possible; otherwise, women were given information about available resources such as hotlines and safe houses. We discuss structural, family, and individual barriers to accessing safety resources for underserved women and review how an easily accessible safety decision app, such as myPlan, could be a resource for women to safely tailor an action plan for her situation.

Implementing Goal Mama: Barriers and Facilitators to Introducing Mobile Health Technology in a Public Health Nurse Home-Visiting Program

“…interpersonal violence) via mobile app underscores the critical need for developers to create data protection policies and infrastructure that uphold the rigorous protection of health information. Previous research on intimate partner violence has found mobile apps designed with safety and privacy in mind to be an acceptable and feasible supplement to in-person health care visits, providing a rapid way to disclose and engage in safety planning ( Alvarez et al, 2018 ; Tarzia et al, 2017 ). Developers and researchers alike must continue to simultaneously consider how a mobile app can facilitate enhanced communication between patients and providers, while also ensuring said communication remains confidential to the appropriate security standards (e.g.…”

Adolescent Perceptions of an Interactive Mobile Application to Respond to Teen Dating Violence

“…Although such programs are important to primary and secondary prevention of TDV, several studies show that curriculum-based programs often do not account for variations in gender, dating history, experiences with TDV, and readiness to use skills to remain violence free or extricate themselves from present violent relationships (Fellmeth, Heffernan, Nurse, Habibula, & Sethi, 2013; Levesque, Johnson, & Prochaska, 2017). Ultimately, TDV interventions are most effective when adolescents find the interventions relevant and their implementation is sustainable (Alvarez, Debnam, Clough, Alexander, & Glass, 2018; Levesque et al, 2017).…”

“…Another method of preventing partner violence can be found in mobile applications (apps). There are currently apps available addressing adult intimate partner violence (Alvarez et al, 2018; Glass et al, 2015; Google Play, 2018). Although numerous apps target women or health care providers seeking resources for their clients, it is not clear that the apps target teens or the unique issues this population experiences in TDV.…”

Intimate partner violence screening intention instrument for Thai nursing students: A principal component analysis

“…Identifying IPV survivors in clinical practice may help them connect with needed support and safety services, thereby potentially reducing exposures to violence (Ali & McGarry, 2018;Anderzen-Carlsson et al, 2018;Ferranti et al, 2018). However, research has consistently demonstrated many frontline healthcare providers are uncomfortable in screening and counselling patients for IPV (Alvarez et al, 2017(Alvarez et al, , 2018Rees et al, 2014). Similarly, despite the high prevalence of IPV in Thailand and its substantial impact on health, researchers have found that Thai healthcare providers rarely ask their patients about IPV (Boonnate et al, 2015;Thananowan & Heidrich, 2008; Thananowan & Vongsirimas, 2014).…”