Just Read: Integrating Intimate Partner Violence Assessment and Intervention into Healthcare in the United States: A Systems Approach

I read the things that Brigid McCaw, MD (@BrigidMcCaw) writes. She’s a systems thinker, she’s passionate, and she’s humble about changing the world as she changes it. See my profile of her on our first walk here.

Important to know

The Affordable Care Act includes IPV screening and brief counseling as part of required free preventive services for women; thus, such screening and counseling must be implemented safely and effectively throughout the health care delivery system.

The Kaiser Permanente Systems Model approach, which makes use of the entire healthcare environment (see Fig. 3) for improving IPV services, has been associated with an eightfold increase in IPV identification between 2000 and 2013 in KP’s Northern California Region.

As the KP experience illustrates, the combination of clinician training, a robust EHR system, and an integrated system of care supports effective IPV screening, prevention, and intervention in the course of routine healthcare delivery.

Unanswered questions

There’s more work to do.

Many research questions remain unanswered regarding the range of optimal approaches to IPV screening. These questions include comparisons of methods of inquiry (verbal, written, online); the effectiveness of and clients’ satisfaction with standard questions compared to conversational inquiry; differences in approaches needed across clinical settings and with different populations, such as with male victims, adolescents, sexual minority individuals, or elders; and validity of screening strategies in various languages and cultures.

In a separate report, I found this:

In January, 2013 the Centers for Disease Control and Prevention (CDC) released a report titled: “The National Intimate Partner Violence and Sexual Violence Survey (NISVS): 2010 findings on Victimization by Sexual Orientation.” This groundbreaking report is the first nationally representative prevalence estimate of sexual violence, stalking, and intimate partner violence among those who identify as lesbian, gay, or bisexual in the United States. In many instances of stalking, intimate partner violence, and specifically sexual violence against LGBTQ and HIV-affected communities, anti-LGBTQ bias is utilized. In this study, participants were asked to identify their sexual orientation and/or gender identity. Transgender and gender non-conforming people were not represented in the NISVS findings because the sample size was too small and based on self-reporting.

I’ll report on this later. There’s a great opportunity to assist, this year, by supporting the 2015 U.S. Trans Survey.

Those are the headlines and opportunities. There are things that can be done. There’s a Family Violence Prevention resource @KPShare and Brigid also makes herself available via twitter (see above).

Ted Eytan, MD