329422
Intimate partner violence screening practices in California after passage of the Affordable Care Act
Tuesday, November 3, 2015
Brittnie Bloom, MS,
College of Sciences / SDSU's National Institute of Health funded Initiative for Maximizing Student Diversity (IMSD) for Minorities in Biomedical Research Support (MBRS) Program, San Diego State University, San Diego, CA
Paula Tavrow, PhD,
Department of Community Health Sciences, University of California at Los Angeles, Los Angeles, CA
Background: At least one in four U.S. women experience intimate partner violence (IPV) in their lifetime. Early screening and intervention could reduce suffering, disability and death. Most healthcare providers, especially in primary care, are in a good position to screen women privately for IPV, but it is not known how often screening occurs and what it entails. Under the Affordable Care Act (ACA), insurance includes screening for IPV, which might be expected to raise frequency. Objectives: To investigate current IPV screening practices among primary health care providers in California, to assess providers’ confidence in screening and referral, and to determine if there are any biases in screening frequency or procedures by demographics of providers or patients. Methods: A cross-sectional survey of 137 primary healthcare providers was conducted between October 2013 and March 2014 in southern California. Results: Overall, self-reported frequency of screening was low. Female providers and non-physicians were more likely to screen and use recommended direct questioning. Most providers lacked confidence in screening, referral and record-keeping. Serving a low-income population predicted more frequent screening and better record-keeping. Conclusions: IPV screening in primary care is inadequate in California and needs attention. Screening occurs infrequently and seems to target low-income patients. Less than half of providers use recommended screening questions. Providers may need more encouragement, information, and feedback to achieve higher rates of IPV screening.
Learning Areas:
Planning of health education strategies, interventions, and programs
Public health or related education
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research
Learning Objectives:
Identify the obstacles health care providers in California experience while screening women for intimate partner violence in primary care settings, despite policy and institutional push for universal screening (e.g. lacked confidence in screening, referral and record-keeping leading to minimal screening practices).
Describe factors that contribute to a health care provider screening patients more or less often (e.g. serving a low income population).
Describe biases that may contribute to a health care provider screening patients more or less often (e.g. serving a low income population)
Keyword(s): Low-Income, Women's Health
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I worked in collaboration with Drs. Tavrow and Withers on data for this project when I was a graduate student at UCLA's Fielding School of Public Health. After obtaining my M.S. in Public Health from UCLA, I have continued to work alongside Drs. Tavrow and Withers to publish work about IPV screening and procedures. Among my post-graduation endeavors is working alongside victims of IPV and sexual assault as an advocate in San Diego county.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
