Articlegreen2017

Implementation of a Family Planning Clinic–Based Partner Violence and Reproductive Coercion Intervention: Provider and Patient Perspectives

Elizabeth Penland Miller · Heather L. McCauley · Michele R. Decker · Rebecca R. Levenson · Sarah M. Zelazny · Kelley A. Jones +2 more

56 citations0/0 files storedPerspectives on Sexual and Reproductive Health

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Intimate Partner and Family Violence Reproductive Health and Contraception Sexual Assault and Victimization Studies

Abstract

CONTEXT: Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. METHODS: In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to offer a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. RESULTS: Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to offer the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. CONCLUSIONS: A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers.

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References

2006Women Exposed to Intimate Partner Violence 2006Vicarious traumatization and secondary traumatic stress: A research synthesis∗2012Intimate partner violence, abortion, and unintended pregnancy: Results from the WHO Multi‐country Study on Women's Health and Domestic Violence 2009Screening for Intimate Partner Violence in Health Care Settings A Randomized Trial 2010Male reproductive control of women who have experienced intimate partner violence in the United States 2012Screening Women for Intimate Partner Violence: A Systematic Review to Update the U.S. Preventive Services Task Force Recommendation 2012Committee Opinion No. 518 2010An Integrated Intervention to Reduce Intimate Partner Violence in Pregnancy

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2019Health Care Providers’ Readiness to Identify and Respond to Intimate Partner Violence 2023Intimate Partner Violence: Role of the Pediatrician 2021Women’s Reproductive Coercion and Pregnancy Avoidance: Associations With Homicide Risk, Sexual Violence, and Religious Abuse 2023Future directions for reproductive coercion and abuse research 2018

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