Adoption, penetration, and effectiveness of a secondary risk screener for intimate partner violence: Evidence to inform screening practices in integrated care settings

Gen Hosp Psychiatry. 2018 Mar-Apr:51:79-84. doi: 10.1016/j.genhosppsych.2018.01.002. Epub 2018 Jan 10.

Abstract

Objective: Veterans Health Administration (VHA) has implemented screening for past-year intimate partner violence (IPV) in some healthcare facilities along with secondary screening of risk for severe violence among those screening positive in order to facilitate follow-up care for high-risk patients. We evaluated the adoption, penetration, and effectiveness of secondary screening as a tool to facilitate timely follow-up services.

Methods: Retrospective review of medical records (screening and healthcare use) of 774 women screening positive for past-year IPV (IPV+) at 11 facilities nationwide from April 2014-April 2016. Chi-square and t-tests examined factors related to secondary screening.

Results: Three of eleven (27.3%) facilities that implemented primary IPV screening adopted secondary screening. At adopting sites, 56.4% eligible (i.e., IPV+) women received secondary screening. Among 185 IPV+ women who completed secondary screening, 33.0% screened positive for severe IPV. Screening positive during secondary screening was associated with higher rate of psychosocial care within 60 days (73.8% vs. 54.0% of IPV+ patients screening negative; p < .05), posttraumatic stress disorder diagnosis (31.1% vs. 15.3%; p < .05), and being physically threatened or harmed (>50% vs. <15%; p < .001).

Conclusions: Secondary risk assessment following IPV screening may expedite access to psychosocial follow-up care in integrated healthcare settings. However, program uptake needs to be enhanced.

Keywords: Behavioral health; Implementation; Screening; Service utilization; Timeliness; Women veterans.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Delivery of Health Care, Integrated / statistics & numerical data*
  • Electronic Health Records / statistics & numerical data
  • Female
  • Humans
  • Intimate Partner Violence / statistics & numerical data*
  • Mental Disorders / diagnosis
  • Mental Disorders / therapy*
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Retrospective Studies
  • Risk
  • Risk Assessment / statistics & numerical data*
  • Social Work / statistics & numerical data*
  • United States
  • United States Department of Veterans Affairs / statistics & numerical data*