Adolescent and young adult women’s recommendations for establishing comfort with family planning providers’ communication about and assessment for intimate partner violence

ABSTRACT

Background: Intimate partner violence (IPV) is a serious public health problem that disproportionately affects adolescent women seeking family planning services. Current clinical guidelines recommend routine IPV assessment yet provide limited guidance on how to establish patient comfort in addressing this sensitive issue. Few studies exist describing the perspectives of adolescent female patients who have experienced IPV and their suggestions on how providers should communicate about IPV.

Methods: This study is a subset of a larger IPV intervention trial in family planning clinics. For this study, we chose a qualitative approach using individual interviews to explore patient perspectives in an open, in-depth manner without limiting potential responses with predetermined answers or investigator-imposed assumptions. We audio recorded clinic encounters for participating providers and patients and interviewed patient participants, asking them to listen to and reflect on how their provider talked about IPV in their audio-recorded clinic encounters.

Results: The mean age for the 44 participants was 22.8 years old. Participants named ‘comfort’ as a main component for discussing and disclosing IPV in the clinical setting. The sub-themes associated with how to create patient comfort include: build the patient-provider relationship, provider should communicate like a friend/be on the patient's level, patient needs to feel cared for by provider, and appropriate timing and space.

Conclusion: Methods for establishing patient comfort via communication should be incorporated into and examined within sensitive healthcare areas such as IPV and can be extended to HIV, palliative, and oncological care to improve patient health outcomes.

KEYWORDS:

• Patient-provider communication
• young adult health
• adolescent health
• intimate partner violence
• shared decision-making

Acknowledgements

We wish to thank the staff at Adagio Health and Planned Parenthood of Western Pennsylvania for their support for and participation in this work. We also humbly thank all of the women who shared their stories with us in this and all of our studies. You are the reason we do this work and it is an honour to lift up your voices.

Disclosure statement

The authors declare that there is no conflict of interest in this study.

Ethical approval

This study was approved by the Institutional Review Board at University to Pittsburgh. IRB#: REN16110067 / PRO14020115.

Notes on contributors

Sarah M Zelazny, MPH is the Trauma Prevention Coordinator for Allegheny Health Network Trauma Centers. Her primary role is designing, implementing, and evaluating trauma, injury, and violence prevention programming at the community level in Western Pennsylvania.

Dr. Judy C Chang's, MD, MPH work has been primarily focused on violence against women, specifically on issues regarding health care screening and interventions for intimate partner violence. She has participated in multiple collaborative groups exploring various topics in women’s health services and outcomes, and is currently expanding her research to examine patient-provider communication in women’s health and obstetrics/gynecology.

The work of Jessica G Burke, PhD aims to improve the health and wellbeing of women and children by addressing complex community health issues including intimate partner violence, HIV/AIDS and racial disparities in birth outcomes.

Mary Hawk’s, DrPH, LSW research foci include evaluation and implementation of structural interventions to reduce the impact of HIV/AIDS and improve clinical outcomes for those living with the disease.

Elizabeth Miller’s, MD, PhD, current research focuses on reducing gender-based violence through clinic and community-based interventions to improve adolescent and young adult health.

ORCID

Elizabeth Miller http://orcid.org/0000-0002-7266-7766

Additional information

Funding

This work was supported by the National Institutes of Health under Grant R03HD079507