Intimate Partner Violence Victimization Among Women Veterans: Health, Health Care Service Use, and Opportunities for Intervention

Dichter, Melissa E.; Marcus, Steven C.

doi:10.1080/21635781.2013.830062

Cited by 29 publications

(27 citation statements)

References 20 publications

(20 reference statements)

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“…[42][43][44][45] Thus, women may have prematurely separated from military service due to violence and then also be at risk for future violence. This study replicated findings from smaller samples of women Veteran VHA patients 22,34 indicating that women who experienced MST were more than twice as likely to report past-year IPV relative to women who did not have a MST history. As such, MST prevention and response programs may be particularly fruitful points of intervention for more generalized violence prevention.…”

Section: Discussionsupporting

confidence: 79%

“…Race and ethnicity were not associated with past-year IPV, as other Veteran studies have found. 22,34 Studies of screening implementation should attend to race, however, as non-white race was associated with nonresponse to IPV items. Past-year IPV was associated with indicators of economic hardship, including lower levels of employment, receipt of public assistance, low income and past-year homelessness.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care

et al. 2016

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OBJECTIVES:The objectives of this study were to identify the prevalence of past-year intimate partner violence (IPV) among women Veterans utilizing Veterans Health Administration (VHA) primary care, and to document associated demographic, military, and primary care characteristics. DESIGN: This was a retrospective cohort design, where participants completed a telephone survey in 2012 (84% participation rate); responses were linked to VHA administrative data for utilization in the year prior to the survey. PARTICIPANTS: A national stratified random sample of 6,287 women Veteran VHA primary care users participated in the study. MAIN MEASURES: Past-year IPV was assessed using the HARK screening tool. Self-report items and scales assessed demographic and military characteristics. Primary care characteristics were assessed via selfreport and VHA administrative data. KEY RESULTS: The prevalence of past-year IPV among women Veterans was 18.5% (se = 0.5%), with higher rates (22.2% -25.5%) among women up to age 55. Other demographic correlates included indicators of economic hardship, lesbian or bisexual orientation, and being a parent/ guardian of a child less than 18 years old. Military correlates included service during Vietnam to post-Vietnam eras, less than 10 years of service, and experiences of Military Sexual Trauma (MST). Most (77.3%, se = 1.2%) women who experienced IPV identified a VHA provider as their usual provider. Compared with women who did not report past-year IPV, women who reported IPV had more primary care visits, yet experienced lower continuity of care across providers. CONCLUSIONS: The high prevalence of past-year IPV among women beyond childbearing years, the majority of whom primarily rely on VHA as a source of health care, reinforces the importance of screening all women for IPV in VHA primary care settings. Key considerations for service implementation include sensitivity with respect to sexual orientation, race/ethnicity, and other aspects of diversity, as well as care coordination and linkages with social services and MST-related care.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care

et al. 2016

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“…We identified documentation of IPV through a review of all provider progress notes, for all visit types, during the study period. Further details about the sample selection and identification of IPV are documented elsewhere (Dichter & Marcus, 2013).…”

Section: Methodsmentioning

confidence: 99%

Documentation of Intimate Partner Violence in Women Veterans’ Medical Records: An In-Depth Analysis

Dichter

True

Marcus

et al. 2013

Military Behavioral Health

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National guidelines for identifying and addressing intimate partner violence (IPV) in the health care setting recommend that health care practitioners screen for IPV experiences and document disclosure and response in patients' medical records. Women veterans are a growing population with particular risk of lifetime IPV victimization, yet we know little about how IPV presents and is addressed within the Veterans Health Administration (VHA). The purpose of this study was to examine documentation of women veterans' disclosed experiences of IPV victimization in electronic medical records to identify how IPV presents in the VHA and to compare IPV screening, assessment, and response at a VHA medical center to nationally recognized best practices. We reviewed medical records for a five-year period (2005 to 2009) of 533 women veteran patients receiving care at an urban Veterans Affairs (VA) medical center and analyzed documentation of IPV disclosure and clinician response for patients with any documentation of IPV (N = 126). Women veterans presented with both acute and chronic IPV victimization experiences, as well as long-term effects of past IPV. Documentation of screening and response revealed opportunities for improvement to meet best practices.

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“…In a study of women veterans receiving care at a VA Medical Center, those with documented IPV experience had higher rates of mood disorders, alcohol/drug dependence, sleep problems, and PTSD, as well as other health conditions compared to women without documented IPV exposure. They also had more frequent health care encounters and were more likely to use emergency department and mental or behavioral health care services (Dichter & Marcus, 2013). IPV victimization may compound health problems for women veterans and add existing burden to the VA health care system.…”

Section: Women Veterans and Ipvmentioning

confidence: 95%

Associations Between Psychological, Physical, and Sexual Intimate Partner Violence and Health Outcomes Among Women Veteran VA Patients

Dichter

Marcus

Wagner

et al. 2014

Social Work in Mental Health

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Women veterans experience high rates of lifetime intimate partner violence (IPV) and suffer a variety of trauma-related health conditions. The purpose of this study was to identify health status and health risk behaviors associated with experiences of psychological, physical, or sexual IPV among women veterans receiving care at a Veterans Affairs (VA) medical center. We conducted surveys with 249 women veteran patients and examined health factors associated with each form of violence. Sexual IPV victimization had the most pronounced associations with adverse health. In multivariate analysis, controlling for age, race, and income, women veterans who experienced sexual violence victimization were close to or 412 M. E. Dichter et al. more than three times as likely as those who experienced no IPV to report poor or fair overall health, a diagnosis of post-traumatic stress disorder or depression, bipolar disorder, or anxiety, difficulty sleeping, cigarette smoking, and problem drinking. Those who reported psychological violence only (without physical or sexual violence) also reported greater odds of self-rated poor or fair health. These findings are consistent with findings from studies with non-veteran populations and serve to further identify the unique contributions of sexual IPV to health outcomes. The integrated VA health care system offers opportunities for IPV identification and response including a coordinated team-based care model with social work integrated within primary care.

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Intimate Partner Violence Victimization Among Women Veterans: Health, Health Care Service Use, and Opportunities for Intervention

Cited by 29 publications

References 20 publications

Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care

Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care

Documentation of Intimate Partner Violence in Women Veterans’ Medical Records: An In-Depth Analysis

Associations Between Psychological, Physical, and Sexual Intimate Partner Violence and Health Outcomes Among Women Veteran VA Patients

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