Intervention Directed at Providers
Improves Identification of Domestic Violence

WESTPORT, CT (Reuters Health) Nov 6 - Specifically questioning patients about domestic violence increases the likelihood that it will be documented, according to research conducted at the Group Health Cooperative of Puget Sound in Seattle. Placing informational materials in patient care areas also increases the probability that victims will identify themselves to their physicians.

Dr. Robert S. Thompson and associates implemented an intervention in which providers were trained to ask about domestic violence and were given information on community resources. Two clinics were randomly selected for the intervention, while three clinics served as controls. The findings appear in the November issue of the American Journal of Preventive Medicine.

The investigators conducted chart reviews of 3795 patients at baseline and 3392 at 9 months following the intervention. Included were patients with high-risk indicators for domestic violence, including injuries, chronic pelvic pain, and depression, as well as patients presenting for physical examination.

At baseline, 3.5% of the patients were asked about domestic violence, which increased to 20.5% at the intervention clinics at follow-up. The most effect was seen when questions were more frequently asked during physical examination.

Healthcare providers' ratings of self-efficacy, fear of offending the patient, concerns about the safety of the patient and the provider, and their perception that they had asked about domestic violence, improved significantly between baseline and 9 months after the intervention.

Results of questionnaires also showed that providers believed that they better knew how to ask patients about domestic violence and had strategies for helping victims change their situation. At 21 months, "the change pattern was clearly sustained," the investigators report.

Another part of the intervention included hanging wall posters about domestic violence and placing brochures in clinic bathrooms. The investigators note that six victims self-identified after seeing the posters, and the brochures were taken regularly by patients. Am J Prevent Med 2000;19:000-000.

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