Secondary Prevention of Intimate Partner Violence

JUDITH M. McFARLANE · Janet Y. Groff · Kathy Watson

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Intimate Partner and Family Violence Elder Abuse and Neglect Stalking, Cyberstalking, and Harassment

Abstract

BACKGROUND: Despite the recognition of intimate partner violence (IPV) against women as a global health issue associated with significant morbidity and mortality, evidence-based treatment strategies for primary care settings are lacking. OBJECTIVE: To assess the comparative safety behaviors, use of community resources, and extent of violence following two levels of intervention. METHODS: A randomized, two-arm, clinical trial was completed in urban public primary care clinics with 360 abused women who assessed positive for physical or sexual abuse within the preceding 12 months. Two interventions were tested: a wallet-sized referral card and a 20-minute nurse case management protocol. Outcome measures were differences in the number of threats of abuse, assaults, danger risks for homicide, events of work harassment, safety behaviors adopted, and use of community resources between intervention groups over a 24-month period. RESULTS: Two years following treatment, both treatment groups of women reported significantly (p <.001) fewer threats of abuse (M = 14.5; 95% CI 12.6, 16.4), assaults (M = 15.5, 95% CI 13.5, 17.4), danger risks for homicide (M = 2.6; 95% CI 2.1, 3.0), and events of work harassment (M = 2.7; 95% CI 2.3, 3.1), but there were no significant differences between groups. Compared to baseline, both groups of women adopted significantly (p <.001) more safety behaviors by 24 months (M = 2.0; 95% CI 1.6, 2.3); however, community resource use declined significantly (p <.001) for both groups (M = -0.2; 95% CI -0.4,-0.2). There were no significant differences between groups. DISCUSSION: Disclosure of abuse, such as what happens with abuse assessment, was associated with the same reduction in violence and increase in safety behaviors as a nurse case management intervention. Simple assessment for abuse and offering of referrals has the potential to interrupt and prevent recurrence of IPV and associated trauma.

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References

2002Health consequences of intimate partner violence 1987Development of a Short Acculturation Scale for Hispanics 1992Development of the severity of violence against women scales 2003Interventions for Violence Against Women 2002Should health professionals screen women for domestic violence? Systematic review 1999Reducing violence using community-based advocacy for women with abusive partners.1986Nursing assessment for risk of homicide with battered women 1983How Women Experience Battering: The Process of Victimization

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2014Primary Care–Based Interventions for Intimate Partner Violence 2018A Systematic Review of Intimate Partner Violence Interventions: State of the Field and Implications for Practitioners 2014Intimate Partner Violence and Pregnancy: A Systematic Review of Interventions 2021Training healthcare providers to respond to intimate partner violence against women 2014Interventions for preventing or reducing domestic violence against pregnant women

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