Screening for Domestic Violence in Health Care Settings. Prevalence of Screening


Research indicates that the prevalence of screening for intimate partner violence differs across health care specialties and is, overall, relatively low. One study synthesized the literature regarding screening rates from 1992 to 2005, finding that 3 to 41 percent of physicians reported routine screening for intimate partner abuse (Stayton and Duncan, 2005).3 Physicians caring for pregnant patients reported routine screening 11 to 39 percent of the time. Another study, conducted in 2002, examined screening practices among a large sample composed of family practitioners, gynecologists, and emergency medicine physicians. It found that 6 percent of clinicians always screened their patients for domestic violence, while 10 percent had never screened a patient (Elliott, et al., 2002).

Despite recommendations, screening prevalence is relatively low across health care specialties.

Despite the evidence that women experiencing violence often seek help in emergency departments, research indicates that women are commonly not asked about IPV when treated there. A 2006 study examining emergency department utilization by women who had been identified by police as victims of IPV found that only one-third of them were asked when treated if their injury was a result of violence (Kothari and Rhodes, 2006). Research also indicates that not every clinician is equally likely to screen. In general, clinicians are more likely to screen patients regularly if they have received training on the subject (Stayton and Duncan, 2005), are female (Jaffee et al., 2005), are younger (Stayton and Duncan, 2005), and/or are nurses rather than physicians (Stayton and Duncan, 2005).

The practice environment in which clinicians work also appears to play a role in predicting the likelihood of screening. For example, a study looking at the prevalence of screening across health care settings found that the highest rates occurred in settings where clinicians were prompted to screen (Stayton and Duncan, 2005). Kaiser Permanente, the largest nonprofit health plan in the United States, implemented an electronic medical record system to integrate IPV screening into everyday care, which resulted in a 600 percent increase in IPV identification from 2000 to 2011 in Kaiser Permanente’s Northern California region (Decker et al., 2012). The use of such system prompts may be increasingly relevant as more clinicians implement electronic health information technology that requires clinicians to respond to certain fields in client health records (Rhodes, 2012). Finally, research has also found increases in screening rates associated with “environmental enablers,” such as posters, pamphlets, on-site social workers, and reminder stickers on charts, as well as staff training (Stayton and Duncan, 2005).

3 Among the studies included in the Stayton and Duncan article, the date the study was conducted was not correlated with the reported prevalence of screening. In other words, according to the article, screening is not becoming more or less common.

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