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Screening for Intimate Partner Violence

Women preferred self-administered screening methods over face-to-face assessments for IPV.

Studies estimate that at least 15% of women are subjected to intimate partner violence (IPV). The need for screening for IPV in healthcare settings has gained increased attention, but researchers and professionals have been divided on the best way to screen and identify victims of IPV. Some women have been more responsive to self-administered methods, including written or computerized questionnaires. Others seem more likely to disclose IPV when directly asked by a clinician.

To determine the best approach for IPV screening, 2461 women were assessed at emergency departments, family practices, and women’s health clinics in Canada. Participants were randomized to screening by one of three methods: a face-to-face interview, a written self-completed questionnaire, or a computer-based self-completed questionnaire. All three approaches included standardized questions for IPV screening, as well as measures of acceptability (ease of responding, likeability, and privacy).

The 12-month prevalence of IPV ranged from 4.1% to 17.7%, depending on the screening method and setting. As expected, IPV was reported more often at emergency departments, compared with family practices or women’s health clinics. Overall, women preferred written methods, followed closely by computerized screening, over face-to-face questioning about IPV. The use of written methods also minimized the risk that data would be lost.

Comment: These findings suggest that most women feel more comfortable disclosing IPV via written methods, possibly due to the greater degree of privacy involved. There are a number of IPV screening instruments that could easily be incorporated into clinicians’ first assessments at clinics or emergency departments. Questions about the level of tension in the relationship, the degree of difficulty in working out arguments with a partner, or the occurrence of hitting, kicking, or punching by someone in the past year, are highly sensitive in detecting IPV. A positive response to one or more of these items should be considered indicative of exposure to IPV and addressed accordingly.

— Claudio N. Soares, MD, PhD

Published in Journal Watch Women's Health September 14, 2006

Citation(s):

MacMillan HL et al. Approaches to screening for intimate partner violence in health care settings: A randomized trial. JAMA 2006 Aug 2; 296:530-6.

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