Clinical Response to Positive Screens for Intimate Partner Violence in the Veterans Health Administration: Findings from Review of Medical Records

ABSTRACT

The Veterans Health Administration (VHA) is a leader in implementing healthcare-based intimate partner violence (IPV) screening and response. This study examined the early implementation of this program to assess clinical response to positive IPV screenings. We conducted an in-depth review of medical records for the six months following a positive IPV screen for all women patients who screened positive within the observation period in two medical centers (n = 208). Data included patient’s race, age, screening location, screening provider, screening response, and documentation of follow-up to positive screening, including interaction with an IPV Assistance Program Coordinator (IPVAP-C). The analysis, along with consultation with local staff for each site, revealed implementation challenges in consistency of response to IPV screens. Most (but not all) patients accepted offers of referral to the IPVAP-C. Case examples highlight the process of connecting with services and the content of support. Findings can be useful for VHA and other healthcare settings implementing IPV screening and response programs. Lessons learned include a need for processes for ensuring appropriate follow-up to a positive screen and that having an on-site IPVAP-C appears to be beneficial, although the uptake of such services is not universal.

KEYWORDS:

• Intimate partner violence
• social health screening
• veterans health administration

Acknowledgments

The authors acknowledge the contributions of Meagan Cusack, Terri Haywood, Ben Yu, and Kylee Clyatt to the data extraction and analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical standards and informed consent

This study was reviewed and approved by the Institutional Review Board of the Crescenz VA Medical Center. All procedures followed were in accordance with the ethical standards of the responsible committee on human subjects research, the institutional review board of the Crescenz VA Medical Center, Philadelphia, PA, and the Helsinki Declaration of 1975, as revised in 2000. As a retrospective chart review study, requirement for informed consent from individuals was waived.

Additional information

Funding

This work was supported by the U.S. Department of Veterans Affairs [IIR 15-142 (PI: Dichter)].

Notes on contributors

Melissa E. Dichter

Melissa E. Dichter, Center for Health Equity Research and Promotion, Crescenz VA Medical Center, Philadelphia, PA and School of Social Work, College of Public Health, Temple University, Philadelphia, PA; Katherine M. Iverson, Women’s Health Sciences Division, Naitonal Cetner for PTSD, VA Boston Healthcare System, Boston, MA and School of Medicine, Boston University, Boston, MA; Ann Elizabeth Montgomery, Birmingham VA Medical Center, Birmingham, AL and School of Public Health, University of Alabama at Birmingham, Birmingham, AL; Anneliese Sorrentino, Center for Health Equity Research and Promotion, Crescenz VA Medical Center. This study was funded by a grant from the U.S. Department of Veterans Affairs, Health Services Research and Development (IIR 15-142; PI: Dichter). Views expressed here do not necessarily reflect those of the Department of Veterans Affairs or the United States Government.Correspondence concerning this article should be addressed to Melissa E. Dichter, PhD, MSW, phone: [phone], e-mail: [email protected]; [email protected]

Katherine M. Iverson

Melissa E. Dichter, Ph.D., M.S.W., is a Core Investigator at the VA Center for Health Equity Research and Promotion at the Crescenz VA Medical Center and Associate Professor in the School of Social Work at Temple University in Philadelphia, PA.

Ann Elizabeth Montgomery

Katherine M. Iverson, Ph.D., is a Clinical Research Psychologist at the VA National Center for PTSD, Women’s Health Sciences Division, and Associate Professor of Psychiatry at the Boston University School of Medicine.

Anneliese Sorrentino

Ann Elizabeth Montgomery, Ph.D., is a Health Science Specialist at the Birmingham VA Health Care System and National Center on Homelessness among Veterans, and Associate Professor at the University of Alabama at Birmingham School of Public Health. Annelies Sorrentino, LMFT, MSS, is a Staff Therapist and Instructor at the Council for Relationships and Research Coordinator at the VA Center for Health Equity Research and Promotion at the Crescenz VA Medical Center.