Friday, 14 January 2005 - 12:00 PM

This presentation is part of: Poster Session I

Barriers to Intimate Partner Violence Screening in Health Care Settings: Implications for Social Work

Purpose: Each year medical treatment is required for more than 500,000 women injured as a result of IPV. Women experiencing intimate partner violence are more likely to utilize health services than non-abused women and current research suggests that 22-37% of patients seen in primary care settings experienced violence in their lifetime. Despite the documented frequency of intimate partner violence among women seeking health care, only 5-15% of female patients report being asked about abuse by health care professionals. This study sought to: 1) Explore what obstetrician/gynecologists, family physicians, and internists perceive as barriers to IPV screening through the development of an instrument that identifies specific barriers to IPV screening among their patients; 2) examine the association between the perceived barriers to screening and physician gender, specialty, length of time since specialty training, and practice setting; and 3) develop recommendations that will improve protocols and curriculum for IPV training delivered by social workers that can be tailored to those particular barriers.

Methods: We developed a mail survey that was sent to physicians regarding their agreement with statements that represented each identified IPV screening barrier. This was sent to 301 obstetrician/ gynecologists, family practice physicians, and internists in a medium-sized city in upstate New York and yielded a 47% response rate. Factor analysis was performed. Items within each of the resulting two factors – 1) General Knowledge and Attitudes Regarding IPV (IPV General Knowledge) and 2) Practice-Based Policy and Procedures (IPV Practice Policy) - were summed to derive separate factor scores. ANOVA and regression analyses were used to explore the differences between physician’s gender, physician’s medical specialty, years since specialty training, and practice setting for the two factors that emerged from the factor analysis.

Results: ANOVA’s of the summed factors suggested consistent differences for physicians of different specialty areas and by years since specialty training for items related to IPV Practice Policy. Multivariate analysis revealed that for IPV General Knowledge there are increased perceived barriers if the respondent is male but fewer perceived barriers if the respondent is an obstetrician/gynecologist and fewer perceived barriers if the respondent has 5-10 years in practice. For IPV Practice Policy, there are increased perceived barriers if the physician is in a private practice setting and fewer perceived barriers if the physician is an obstetrician/gynecologist.

Implications for Practice and Policy: There are significant differences by gender, years of training, area of medical specialty, and practice setting in perceived barriers to domestic violence screening. These barriers include knowledge and attitudes concerning IPV as well as a lack of supportive systems for screening in office practices. Social workers in health care settings and those who are connected to IPV Coalitions need to develop IPV screening training programs for physicians that address; 1) general knowledge and attitudes about IPV; and 2) methods to involve practice systems in the identification of IPV. We should carefully explore the issues of gender-specific training and continuing education in IPV screening.

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