Integrating Intimate Partner Violence Screening Programs in Primary Care: Results from a Hybrid-II Implementation-Effectiveness RCT

Iverson, Katherine M.; Stolzmann, Kelly; Brady, Julianne E.; Adjognon, Omonyêlé L; Dichter, Melissa E.; Lew, Robert A.; Gerber, Megan R.; Portnoy, Galina A.; Iqbal, Samina; Haskell, Sally G.; Bruce, LeAnn E.; Miller, Christopher J.

doi:10.1016/j.amepre.2023.02.013

Cited by 6 publications

(2 citation statements)

References 64 publications

(90 reference statements)

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“…VHA screens all patients for MST 64 and increasingly strives to screen women for past-year IPV 65 though uptake of IPV screening is variable. 66 , 67 Pre- and post-military SV and lifetime IPV are not routinely assessed within VHA. Recent legislation 68 requires VHA to pilot services to address IPV and pre- and post-military SV (in addition to MST).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Sexual Violence and Intimate Partner Violence Among US Military Veterans: Findings from Surveys with Two National Samples

Iverson,

Livingston,

Vogt

et al. 2023

J GEN INTERN MED

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Background Sexual violence (SV) and intimate partner violence (IPV) experiences are major social determinants of adverse health. There is limited prevalence data on these experiences for veterans, particularly across sociodemographic groups. Objective To estimate the prevalence of SV before, during, and after military service and lifetime and past-year IPV for women and men, and explore differences across sociodemographic groups. Design Data are from two national cross-sectional surveys conducted in 2020. Weighted prevalence estimates of SV and IPV experiences were computed, and weighted logistic regression models were used for comparisons across gender, race, ethnicity, sexual orientation, and age. Participants Study 1 included veterans of all service eras (N = 1187; 50.0% women; 29% response rate). Study 2 included recently separated post-9/11 veterans (N = 1494; 55.2% women; 19.4% response rate). Main Measures SV was assessed with the Deployment Risk and Resilience Inventory-2 (DRRI-2). IPV was assessed with the extended Hurt-Insult-Threaten-Scream Tool. Key Results Women were more likely than men to experience pre-military SV (study 1: 39.9% vs. 8.7%, OR = 6.96, CIs: 4.71–10.28; study 2: 36.2% vs. 8.6%, OR = 6.04, CIs: 4.18–8.71), sexual harassment and/or assault during military service (study 1: 55.0% vs. 16.8%, OR = 6.30, CIs: 4.57–8.58; study 2: 52.9% vs. 26.9%, OR = 3.08, CIs: 2.38–3.98), and post-military SV (study 1: 12.4% vs. 0.9%, OR = 15.49, CIs: 6.42–36.97; study 2: 7.5% vs. 1.5%, OR = 5.20, CIs: 2.26–11.99). Women were more likely than men to experience lifetime IPV (study 1: 45.7% vs. 37.1%, OR = 1.38, CIs: 1.04–1.82; study 2: 45.4% and 34.8%, OR = 1.60, CIs: 1.25–2.04) but not past-year IPV (study 1: 27.9% vs. 28.3%, OR = 0.95, CIs: 0.70–1.28; study 2: 33.1% vs. 28.5%, OR = 1.24, CIs: 0.95–1.61). When controlling for gender, there were few differences across other sociodemographic groups, with the exception of sexual orientation. Conclusions Understanding veterans’ experiences of SV and IPV can inform identification and intervention efforts, especially for women and sexual minorities.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Sexual Violence and Intimate Partner Violence Among US Military Veterans: Findings from Surveys with Two National Samples

Iverson,

Livingston,

Vogt

et al. 2023

J GEN INTERN MED

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“…The fact that most patients in our sample were men is also noteworthy, as very few IPV screening Despite a relatively small proportion of eligible patients offered screening, the screening rate in this pilot reflects prior rates of IPV screening adoption at VHA. 8 In addition to building on literature identifying barriers to implementing screening for IPV experiences among women of reproductive age, 8,10,[25][26][27][28] further research, training, and implementation efforts are needed to enhance clinician adoption of IPV screening, including for patients of all genders and ages, as well as for IPV experiences and use concurrently. In terms of representativeness, the subsample of patients offered screening in this sample did not differ demographically or diagnostically from the 1520 patients not offered screening.…”

Section: Discussionmentioning

confidence: 99%

Screening for Intimate Partner Violence Experience and Use in the Veterans Health Administration

Portnoy,

Relyea,

Presseau

et al. 2023

JAMA Netw Open

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ImportanceThe practice of screening women for intimate partner violence (IPV) in health care settings has been a critical part of responding to this major public health problem. Yet, IPV prevention would be enhanced with detection efforts that extend beyond screening for IPV experiences to identifying those who use violence in relationships as well.ObjectiveTo determine rates of IPV experiences and use (ie, among perpetrators of IPV) and factors associated with disclosures among adult patients seeking mental health services at the Veterans Health Administration.Design, Setting, and ParticipantsThis cross-sectional study used electronic medical record data drawn from a quality improvement initiative at 5 Veterans Health Administration medical centers conducted between November 2021 and February 2022 to examine IPV disclosures following concurrent screening for IPV experience and use. Participants included patients engaged in mental health services. Data were analyzed in April and May 2023.ExposureMental health clinicians were trained to screen for IPV experience and use concurrently and instructed to screen all patients encountered through routine mental health care visits during a 3-month period.Main Outcomes and MeasuresOutcomes of interest were past-year prevalence of IPV use and experience, sociodemographic characteristics, and clinical diagnoses among screened patients.ResultsA total of 200 patients were offered IPV screening. Of 155 participants (mean [SD] age, 52.45 [15.65] years; 124 [80.0%] men) with completed screenings, 74 (47.7%) denied past-year IPV experience and use, 76 (49.0%) endorsed past-year IPV experience, and 72 (46.4%) endorsed past-year IPV use, including 67 participants (43.2%) who reported IPV experience and use concurrently; only 9 participants (5.8%) endorsed unidirectional IPV experiences and 5 participants (3.2%) endorsed unidirectional IPV use. Patients who reported past-year IPV experience and use were younger than those who denied IPV (experience: mean difference, −7.34 [95% CI, 2.51-12.17] years; use: mean difference, −7.20 [95% CI, 2.40-12.00] years). Patients with a posttraumatic stress disorder diagnosis were more likely to report IPV use (43 patients [59.7%]) than those without a posttraumatic stress disorder diagnosis (29 patients [40.3%]; odds ratio, 2.14; [95% CI, 1.12-4.06]). No other demographic characteristics or clinical diagnoses were associated with IPV use or experience.Conclusions and RelevanceIn this cross-sectional study of IPV rates and associated factors, screening for IPV found high rates of both IPV experience and use among patients receiving mental health care. These findings highlight the benefit of screening for IPV experience and use concurrently across gender and age. Additionally, the associations found between PTSD and IPV use underscore the importance of strengthening and developing additional targeted treatment for IPV.

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Twelve-Month Sustainment of IPV Screening and Response Programs in Primary Care: Contextual Factors Impacting Implementation Success

Iverson,

Brady,

Adjognon

et al. 2024

Women's Health Issues

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Integrating Intimate Partner Violence Screening Programs in Primary Care: Results from a Hybrid-II Implementation-Effectiveness RCT

Cited by 6 publications

References 64 publications

Prevalence of Sexual Violence and Intimate Partner Violence Among US Military Veterans: Findings from Surveys with Two National Samples

Prevalence of Sexual Violence and Intimate Partner Violence Among US Military Veterans: Findings from Surveys with Two National Samples

Screening for Intimate Partner Violence Experience and Use in the Veterans Health Administration

Twelve-Month Sustainment of IPV Screening and Response Programs in Primary Care: Contextual Factors Impacting Implementation Success

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