Effect of face-to-face interview versus computer-assisted self-interview on disclosure of intimate partner violence among African American women in WIC clinics

Background: African American women in the United States report intimate partner violence (IPV) more often than the general population of women. Still, women often under-report IPV because of shame, embarrassment, fear of retribution, or low expectation of legal support. African American women may be especially unlikely to report IPV because of poverty, low social support, and past experiences of discrimination. Purpose: To determine the context in which low-income African American women disclose IPV. Methods: Consenting African American women receiving Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services in WIC clinics were randomized to complete an IPV screening (Revised Conflict Tactics Scales, Short-Form) via computer-assisted self-interview (CASI) or face-to-face interview (FTFI). Results: Women (n=368) reported high rates of lifetime and prior year verbal (48%, 34%), physical (12%, 7%), sexual (10%, 7%), and any (49%, 36%) IPV, as well as IPV-related injury (13%, 7%). Mode of screening, but not interviewer race, affected disclosure. Women screened via FTFI reported significantly more lifetime and prior-year negotiation (aOR: 10.54, 3.97) and more prior-year verbal (aOR: 2.10), sexual (aOR: 4.31), and any (aOR: 2.02) IPV than CASI- screened women. Discussion: African American women in a WIC setting disclosed IPV more often in face-to-face than computer screening, and race-matching of client and interviewer did not affect disclosure. Findings highlight the potential value of face-to-face screening to identify women at risk of IPV. Programs should weigh the costs and benefits of training staff versus using computer-based technologies to screen for IPV in WIC settings.