Testing the Danger Assessment (DA)-5 for Immigrant Survivors of Intimate Partner Violence

Background: Compared to one-third U.S. women reporting any lifetime intimate partner violence (IPV) (Smith et al., 2018), a systematic review indicates that rates of IPV against immigrant women may be much higher, ranging up to 70.5% (Gonçalves & Matos, 2016). The context of immigration may exacerbate the risks of future lethal IPV and create additional barriers to help-seeking (Messing et al., 2020). The Danger Assessment for Immigrant Women (DA-I) is a validated IPV risk assessment instrument to predict the risk of severe and near-lethal IPV among immigrant women (Campbell et al., 2003; Messing et al., 2013). A brief version of the Danger Assessment (DA-5) has been created for use in brief screening protocols and has been found to effectively predict near-lethal violence (Messing et al., 2017), although these risk assessments have not been tested for predictive validity among immigrant women.

Methods: Using secondary data from a randomized controlled trial examining a culturally specific intervention for immigrant and refugee women (Sabri et al., 2019), we examined the predictive validity of the DA-5 among a diverse sample of immigrant women. A total of 123 immigrant women completed the DA-5 at baseline and responded to follow-up surveys at 3, 6, and 12 months regarding their experiences of violence and abuse. Women’s countries of origin were collapsed by region: South America & Caribbean (n=39), Asia (n=31), Central America (n=22), Northern Africa & Middle East (n=12), and South, West, and East Africa (n=11). Receiver Operating Characteristic (ROC) Area Under the Curve (AUC) analyses were used to examine the ability of the DA-5 to predict near-lethal violence at 3, 6, and 12-months post-baseline. The area under the curve (AUC) –the proportion of the graph that lies under the plotted ROC curve – provides overall predictive accuracy of the instrument (Douglas et al., 2005).

Results: Survivors in this sample were 33.28 years old on average. The majority were: married (67.2%), had U.S.-born partners (66.1%), attended vocational school or college (76.5%), had children (81.3%), and lived in the U.S. for more than 10 years (61%). High proportions of women in the sample report near fatal IPV at 3 (58.5%), 6 (64.2%), and 12 (65.0%) months follow-up. The AUC ranges from 0-1.0 with higher scores indicating more accurate prediction. The AUC for the original DA-5 ranged from .867 (3 months) to .871 (12 months). An adaptation of the DA-5 that includes strangulation increases predictive ability of the instrument slightly but not significantly, to AUC=.886 at 12 months follow-up.

Implications: This study is the first to validate the predictive validity of the DA-5 among a diverse sample of immigrant women. The findings suggests that practitioners in fast past assessment settings may use the DA-5 for immigrant women. Asking about strangulation slightly increases the predictive validity of the instrument and allows practitioners to work with survivors to engage in medical intervention and safety planning for strangulation, a dangerous form of IPV. Future research should examine additional culturally specific items that may increase the predictive validity of risk assessments among immigrant populations.