Dataset Information

Screening and receiving information for intimate partner violence in healthcare settings: a cross-sectional study of Arab and Jewish women of childbearing age in Israel.

ABSTRACT: OBJECTIVES:We studied the proportion of women who have ever been screened (ES) for intimate partner violence (IPV) in a healthcare setting, received information (RI) about relevant services, or both, and explored disparities in screening and information provision by ethnicity and other characteristics. DESIGN:In 2014-2015, we undertook a cross-sectional study, conducting interviews using a structured questionnaire among a stratified sample of 1401 Arab and Jewish women in Israel. SETTING:A sample of 63 maternal and child health clinics (MCH) clinics in four geographical districts. PARTICIPANTS:Women aged 16-48 years, pregnant or up to 6 months after childbirth. PRIMARY AND SECONDARY OUTCOME MEASURES:We used multivariable generalised estimating equation analysis to determine characteristics of women who were ES (Has anyone at the healthcare services (HCS) ever asked you whether you have experienced IPV?); RI (Have you ever received information about what to do if you experience IPV?); and both (ES&RI). RESULTS:Less than half of participants (48.8%) reported ES; 50.5% RI; and 30% were both ES&RI. Having experienced any IPV was not associated with ES or ES&RI, but was associated with RI in an unexpected direction. Women at higher risk for IPV (Arab minority women, lower education, unmarried) were less likely to report being ES, RI or both. The OR and 95% CI for not ER&RI were: 1.58 (1.00 to 2.49) among Arab compared with Jewish women; 1.95 (1.42 to 2.66) among low education versus academic education women; 1.34 (1.03 to 1.73) among not working versus working. ES, RI and both differ across districts. CONCLUSIONS:While Israel mandates screening and providing information regarding IPV for women visiting the HCS, we found inequalities, suggesting inconsistencies in policy implementation and missed opportunities to detect IPV. To increase IPV screening and information provision, the ministry of health should circulate clarification and provide support to healthcare providers to conduct these activities.

SUBMITTER: Daoud N

PROVIDER: S-EPMC6398676 | biostudies-other | 2019 Feb

REPOSITORIES: biostudies-other

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Screening and receiving information for intimate partner violence in healthcare settings: a cross-sectional study of Arab and Jewish women of childbearing age in Israel.

Daoud Nihaya N Berger-Polsky Alexandra A Sergienko Ruslan R O'Campo Patricia P Leff Rebecca R Shoham-Vardi Ilana I

BMJ open 20190221 2

<h4>Objectives</h4>We studied the proportion of women who have ever been screened (ES) for intimate partner violence (IPV) in a healthcare setting, received information (RI) about relevant services, or both, and explored disparities in screening and information provision by ethnicity and other characteristics.<h4>Design</h4>In 2014-2015, we undertook a cross-sectional study, conducting interviews using a structured questionnaire among a stratified sample of 1401 Arab and Jewish women in Israel.< ...[more]

PMID: 30796117

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Project description:ObjectiveTo examine the effectiveness of screening for intimate partner violence conducted within healthcare settings to determine whether or not screening increases identification and referral to support agencies, improves women's wellbeing, decreases further violence, or causes harm.DesignSystematic review and meta-analysis of trials assessing effectiveness of screening. Study assessment, data abstraction, and quality assessment were conducted independently by two of the authors. Standardised estimations of the risk ratios and 95% confidence intervals were calculated.Data sourcesNine databases searched up to July 2012 (CENTRAL, Medline, Medline(R), Embase, DARE, CINAHL, PsycINFO, Sociological Abstracts, and ASSIA), and five trials registers searched up to 2010.Eligibility criteria for selecting studiesRandomised or quasi-randomised trials of screening programmes for intimate partner violence involving all women aged ≥ 16 attending a healthcare setting. We included only studies in which clinicians in the intervention arm personally conducted the screening, or were informed of the screening result at the time of the consultation, compared with usual care (or no screening). Studies of screening programmes that were followed by structured interventions such as advocacy or therapeutic intervention were excluded.Results11 eligible trials (n=13,027) were identified. In six pooled studies (n=3564), screening increased the identification of intimate partner violence (risk ratio 2.33, 95% confidence interval 1.39 to 3.89), particularly in antenatal settings (4.26, 1.76 to 10.31). Based on three studies (n=1400), we detected no evidence that screening increases referrals to domestic violence support services (2.67, 0.99 to 7.20). Only two studies measured women's experience of violence after screening (three to 18 months after screening) and found no reduction in intimate partner violence. One study reported that screening does not cause harm.ConclusionsThough screening is likely to increase identification of intimate partner violence in healthcare settings, rates of identification from screening interventions were low relative to best estimates of prevalence of such violence. It is uncertain whether screening increases effective referral to supportive agencies. Screening does not seem to cause harm in the short term, but harm was measured in only one study. As the primary studies did not detect improved outcomes for women screened for intimate partner violence, there is insufficient evidence for screening in healthcare settings. Studies comparing screening versus case finding, or screening in combination with therapeutic intervention for women's long term wellbeing, are needed to inform the implementation of identification policies in healthcare settings.

Project description:BACKGROUND:Violence against women has particular importance for women's health and wellbeing in the Arab world, where women face persistent barriers to social, political and economic equality. This review aims to summarize what is known about the prevalence of physical, sexual and emotional/psychological intimate partner violence (IPV) against women in the 22 countries of the Arab League, including geographic coverage, quality and comparability of the evidence. METHODS:A systematic review of IPV prevalence in Arab countries was carried out among peer-reviewed journal articles and national, population-based survey reports published by international research programmes and/or governments. Following PRISMA guidelines, Medline and the Social Sciences Citation Index were searched with Medical Subject Headings terms and key words related to IPV and the names of Arab countries. Eligible sources were published between January 2000 and January 2016, in any language. United Nations databases and similar sources were searched for national surveys. Study characteristics, operational definitions and prevalence data were extracted into a database using Open Data Kit Software. Risk of bias was assessed with a structured checklist. RESULTS:The search identified 74 records with population or facility-based IPV prevalence data from eleven Arab countries, based on 56 individual datasets. These included 46 separate survey datasets from peer-reviewed journals and 11 national surveys published by international research programmes and/or governments. Seven countries had national, population-based IPV estimates. Reported IPV prevalence (ever) ranged from 6% to more than half (59%) (physical); from 3 to 40% (sexual); and from 5 to 91% (emotional/ psychological). Methods and operational definitions of violence varied widely, especially for emotional/psychological IPV, limiting comparability. CONCLUSIONS:IPV against women in Arab countries represents a public health and human rights problem, with substantial levels of physical, sexual and emotional/psychological IPV documented in many settings. The evidence base is fragmented, however, suggesting a need for more comparable, high quality research on IPV in the region and greater adherence to international scientific and ethical guidelines. There is a particular need for national, population-based data to inform prevention and responses to violence against women, and to help Arab countries monitor progress towards the Sustainable Development Goals.

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.

Dataset Information

Screening and receiving information for intimate partner violence in healthcare settings: a cross-sectional study of Arab and Jewish women of childbearing age in Israel.

Publications

Screening and receiving information for intimate partner violence in healthcare settings: a cross-sectional study of Arab and Jewish women of childbearing age in Israel.

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