Patient and provider barriers, facilitators, and implementation preferences of intimate partner violence perpetration screening.
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ABSTRACT:
SUBMITTER: Portnoy GA
PROVIDER: S-EPMC7424651 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The prevention of intimate partner violence is a desirable individual and public health goal for society. The purpose of this study is to provide a comprehensive assessment of adolescent risk factors for partner violence in order to inform the development of evidence-based prevention strategies. We utilize data from the Rochester Youth Development Study, a two decade long prospective study of a representative community sample of 1000 participants that has extensive measures of adolescent characteristics, contexts, and behaviors that are potential precursors of partner violence. Using a developmental psychopathology framework, we assess self-reported partner violence perpetration in emerging adulthood (ages 20-22) and in adulthood (ages 29-30) utilizing the Conflict Tactics Scale. Our results indicate that risk factors for intimate partner violence span several developmental domains and are substantially similar for both genders. Internalizing and externalizing problem behaviors as well as early intimate relationships are especially salient for both genders. Additionally, cumulative risk across a number of developmental domains places adolescents at particularly high risk of perpetrating partner violence. Implications for prevention include extending existing prevention programs that focus on high risk groups with multiple risks for developmental disruption, as well as focusing on preventing or mitigating identified risk factors across both genders.
| S-EPMC5957086 | biostudies-literature
Project description:BackgroundUganda clinical guidelines recommend routine screening of pregnant women for intimate partner violence (IPV) during antenatal care (ANC). Healthcare providers play a critical role in identifying IPV during pregnancy in ANC clinics. This study explored facilitators and barriers for IPV screening during pregnancy (perinatal IPV screening) by ANC-based healthcare workers in Uganda.MethodsWe conducted qualitative in-depth interviews among twenty-eight purposively selected healthcare providers in one rural and an urban-based ANC health center in Eastern and Central Uganda respectively. Barriers and facilitators to IPV screening during ANC were identified iteratively using inductive-deductive thematic analysis.ResultsParticipants had provided ANC services for a median (IQR) duration of 4.0 (0.1-19) years. Out of 28 healthcare providers, 11 routinely screened women attending ANC clinics for IPV and 10 had received IPV-related training. Barriers to routine IPV screening included limited staffing and space resources, lack of comprehensive gender-based violence (GBV) training and provider unawareness of the extent of IPV during pregnancy. Facilitators were availability of GBV protocols and providers who were aware of IPV (or GBV) tools tended to use them to routinely screen for IPV. Healthcare workers reported the need to establish patient trust and a safe ANC clinic environment for disclosure to occur. ANC clinicians suggested creation of opportunities for triage-level screening and modification of patients' ANC cards used to document women's medical history. Some providers expressed concerns of safety or retaliatory abuse if perpetrating partners were to see reported abuse.ConclusionsOur findings can inform efforts to strengthen GBV interventions focused on increasing routine perinatal IPV screening by ANC-based clinicians. Implementation of initiatives to increase routine perinatal IPV screening should focus on task sharing, increasing comprehensive IPV training opportunities, including raising awareness of IPV severity, trauma-informed care and building trusting patient-physician relationships.
| S-EPMC8889632 | biostudies-literature
Project description:At least half a million women are victims of intimate partner violence in the United States annually, resulting in substantial harm. However, the etiology of violence to intimate partners is not well understood. Witnessing such violence in childhood has been proposed as a principal cause of adulthood perpetration, yet it remains unknown whether the association between witnessing intimate partner violence and adulthood perpetration is causal.We conducted a propensity-score analysis of intimate partner violence perpetration to determine whether childhood witnessing is associated with perpetration in adulthood, independent of a wide range of potential confounding variables, and therefore might be a causal factor. We used data from 14,564 U.S. men ages 20 and older from the 2004-2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions.Nearly 4% of men reported violent behavior toward an intimate partner in the past year. In unadjusted models, we found a strong association between childhood witnessing of intimate partner violence and adulthood perpetration (for witnessing any intimate partner violence, risk ratio [RR] = 2.6 [95% confidence interval = 2.1-3.2]; for witnessing frequent or serious violence, 3.0 [2.3-3.9]). In propensity-score models, the association was substantially attenuated (for witnessing any intimate partner violence, adjusted RR = 1.6 [1.2-2.0]; for witnessing frequent or serious violence, 1.6 [1.2-2.3]).Men who witness intimate partner violence in childhood are more likely to commit such acts in adulthood, compared with men who are otherwise similar with respect to a large range of potential confounders. Etiological models of intimate partner violence perpetration should consider a constellation of childhood factors.
| S-EPMC3108188 | biostudies-literature
Project description:ContextIntimate partner violence (IPV) among sexual minority young adults has been understudied, and victimization and perpetration estimates are needed.MethodsData on 13,653 women and men aged 24-32 who participated in Wave 4 of the National Longitudinal Study of Adolescent to Adult Health were used to examine associations between sexual orientation and IPV perpetration and victimization in respondents' current or most recent relationship. Logistic regression analyses were used to identify associations between respondent characteristics and three IPV categories (physical violence, threatened violence and forced sex).ResultsSome 94% of males and 80% of females identified as 100% heterosexual; 4% of males and 16% of females as mostly heterosexual; 1% of males and 2% of females as bisexual; and 2% of males and females as either mostly homosexual or 100% homosexual. Compared with their heterosexual counterparts, mostly heterosexual women were more likely to report having perpetrated or been a victim of physical IPV (odds ratios, 1.9 and 1.6, respectively), having threatened violence (2.0) and having been a victim of threatened violence and forced sex (1.6 for each); mostly heterosexual males were more likely to have been a perpetrator or victim of physical IPV (3.1 and 1.8, respectively) and a perpetrator of forced sex and threatened violence (2.0 and 1.8, respectively). Bisexual males had elevated odds of physical violence victimization (3.3) and forced sex victimization (4.9) and perpetration (5.0).ConclusionsSome sexual minority groups are disproportionately affected by IPV, indicating a need for increased prevention efforts and for studies exploring the mechanisms underlying these differences.
| S-EPMC7669537 | biostudies-literature
Project description:Intimate partner violence (IPV) is a serious public health problem. Substance use, particularly alcohol, is a robust risk factor for IPV. There is a small but growing body of research demonstrating that marijuana use is positively associated with IPV perpetration. However, research on marijuana use and IPV has failed to control for other known predictors of IPV that may account for the positive association between marijuana use and IPV perpetration. Therefore, the current study examined whether marijuana use was associated with IPV perpetration after controlling for alcohol use and problems, antisocial personality symptoms, and relationship satisfaction, all known risk factors for IPV. Participants were men arrested for domestic violence and court-referred to batterer intervention programs (N = 269). Findings demonstrated that marijuana use was positively and significantly associated with psychological, physical, and sexual IPV perpetration, even after controlling for alcohol use and problems, antisocial personality symptoms, and relationship satisfaction. Moreover, marijuana use and alcohol use and problems interacted to predict sexual IPV, such that marijuana use was associated with sexual IPV at high, but not low, levels of alcohol use and problems. These findings lend additional support to the body of research demonstrating that marijuana use is positively associated with IPV perpetration in a variety of samples. Results suggest that additional, rigorous research is needed to further explore why and under what conditions marijuana is associated with IPV perpetration.
| S-EPMC5663469 | biostudies-literature
Project description:Objectives Emergency Department (ED) screening for intimate partner violence (IPV) is typically nursing-initiated, often with visitors present. Since the onset of the COVID-19 pandemic, we have seen both an increase in societal stress, a known exacerbator of IPV, and the implementation of visitor restriction policies. This combination presents the need for enhanced IPV screening and the opportunity to perform screening in a controlled, patient-only environment. Our goal was to evaluate the frequency of nurse-initiated screening for IPV prior to and during the early months of the COVID-19 pandemic as well as the frequency of positive screens for IPV. Methods We conducted a retrospective cross-sectional study evaluating all adults (age >18 years) presenting to a tertiary care center ED. Patients were identified as presenting prior to the COVID-19 pandemic (June 1, 2019 to August 31, 2019) and after the COVID-19 visitor restriction policies (June 1, 2020 to August 31, 2020). Descriptive statistics were performed using chi-square and t-tests compared the demographic variables. Chi-square was used for a bivariate analysis of our primary outcomes (IPV screening performed and screening positive for IPV). Further analysis was done using a binary logistic regression model adjusting for the demographic characteristics. Results Both the odds of nursing-initiated IPV screening and the odds of verbally screening positive for IPV significantly increased (OR 1.509, 95% CI 1.432–1.600) and (OR 1.375, 95% CI 1.126–1.681) respectively following the implementation of COVID-19 visitor restriction policies. Conclusions These findings suggest that nurse-initiated IPV screening should continue to be performed with the patient privately, even after COVID-19 related ED visitor restrictions are removed. These findings also support the hypothesis that the stress related to COVID-19 is contributing to a rise in IPV.
| S-EPMC10124835 | biostudies-literature
Project description:ObjectiveThis study had three goals: (a) to examine the association between racial discrimination and intimate partner violence (IPV) perpetration; (b) to determine whether this relationship is explained by mental health (MH) symptoms; and (c) to determine whether these associations vary by poverty status or gender.MethodsDuring the Wave 4 (2013-2017) visit of the Healthy Aging in Neighborhoods of Diversity Longitudinal Study (HANDLS), Black adults who were in a relationship (N = 433; mean age = 55.26, SD = 9.30; 51% men) provided self-report data on IPV perpetration; frequency of racial discrimination; and levels of anxiety, depression, and posttraumatic stress symptoms. Multigroup mediation models used these cross-sectional data to test whether racial discrimination was associated with MH symptoms, which in turn were associated with IPV perpetration, determining the significance of direct and indirect pathways and whether any pathways varied by poverty status or gender.ResultsRacial discrimination was associated with more MH symptoms, which in turn was associated with IPV perpetration. The negative effect of discrimination on MH was stronger for Black women than Black men and for Black adults with household incomes below 125% of the Federal poverty line than those with incomes above this cutoff.DiscussionEfforts to prevent and treat IPV in the Black community should address the negative effects of racial discrimination experiences on MH and partner aggression, especially among those with multiple marginalized identities. IPV prevention efforts may be enhanced through an overarching commitment to dismantle structural racism and intersectional forms of oppression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
| S-EPMC9470245 | biostudies-literature
Project description:The aims of the study were to examine barriers to cervical cancer screening among women who have experienced intimate partner violence (IPV) and accessed domestic violence shelters, to compare barriers among those up-to-date (UTD) and not UTD on screening, and to evaluate acceptability of human papillomavirus self-sampling.This is a cross-sectional survey in which domestic violence shelters in Ohio were identified and women completed an anonymous survey assessing UTD screening status, barriers related to screening, history of IPV, intention to follow up on abnormal screening, and acceptability of self-sampling. Characteristics of UTD and not UTD women were compared using Mann-Whitney U tests.A total of 142 women from 11 shelters completed the survey. Twenty-three percent of women were not UTD. Women who were not UTD reported more access-related barriers (mean = 2.2 vs 1.8; p = .006). There was no difference in reported IPV-related barriers between women who were not UTD and those who are UTD (mean = 2.51 in not UTD vs 2.24 in UTD; p = .13). Regarding future screening, of the women who expressed a preference, more women not UTD preferred self-sampling than UTD women (32% vs 14%; p = .05).In this study, access-related barriers were more commonly reported among women not UTD with screening. Addressing these barriers at domestic violence shelters may improve screening among not UTD women. Self-sampling may also be one feasible approach to support screening in this population.
| S-EPMC4693628 | biostudies-literature
Project description:Deficits in executive functioning have been associated with aggressive and violent behavior toward intimate partners. However, it is unclear what specific mechanisms are being affected by cognitive deficits that increase an individual's tendency to become aggressive. The current study examined empathy as a mediating factor between deficits in working memory and perpetration of intimate partner aggression and violence. Men in heterosexual relationships (N = 49) were administered a measure of visual-spatial working memory, and questionnaire measures of head injury and empathy. During a second session, men participated in a conflict discussion with their female partner that was coded for aggressive behavior. Female partners also reported on men's physical and psychological abuse. Working memory was positively related to cognitive and affective empathy, and negatively related to men's physical abuse perpetration and observed aggression during the conflict discussion. The effects of working memory on observed aggression during the conflict were fully mediated by cognitive and affective empathy. Additionally, the effects of working memory on reported physical IPV frequency were fully mediated by affective empathy. Deficits in working memory may decrease men's ability to use empathetic processes, resulting in increased aggression and violence toward their intimate partners. Clinically, incorporating empathy training in battering intervention programs may be helpful, especially among men with deficits in cognitive functioning.
| S-EPMC7139593 | biostudies-literature
Project description:BackgroundIntimate partner violence (IPV) is highly prevalent and associated with physical and mental health problems. Mentor mother support is a low threshold intervention in family practice consisting of support by non-professionals trained to support mothers experiencing IPV. A mentor mother support study showed reduced exposure to IPV and decreased symptoms of depression.ObjectivesIdentify factors determining implementation success of mentor mother support in family practice.MethodsIndividual interviews were conducted with 12 family physicians, 16 abused mothers and three mentor mothers. Four mentor mothers participated in a focus group. Qualitative content analysis was used to analyse the data.ResultsThe identification and discussion of abuse is hindered by family physicians' attitudes because they considered mothers experiencing IPV as a difficult target group with a responsibility of their own to break out of their violent situation. Some family physicians doubted the partner's violence because he was known as a patient as well. Acceptance of mentor mother support is related to the readiness for change of mothers experiencing IPV. Mentor mothers facilitate acceptance and completion of their support by connecting as a friend who is equal and less threatening than professionals.ConclusionTo improve successful implementation of mentor mother support in primary care, we should focus on family physicians' attitudes towards IPV. To change these attitudes, we recommend continuous training of family physicians. By being paraprofessional friends, mentor mothers offer low threshold support that is complementary to professional support and should be embedded more widely in primary care. [Box: see text].
| S-EPMC5774271 | biostudies-literature