More than a third of women and more than a quarter of men in the United States have been raped, physically assaulted, or stalked by an intimate partner at some point in their lives. Unfortunately, one strategy for reducing those numbers, screening for partner violence during visits to the doctor, simply isn't effective, according to two new studies.
Both studies were published today as part the Journal of the American Medical Association's special issue on violence and human rights.
In one, researchers led by Joanne Klevens, an epidemiologist at the Centers for Disease Control and Prevention, followed up on an earlier study on whether screenings at the doctor's office could reduce the impact of intimate partner violence on victims' quality of life. The researchers recruited 2,700 women at 10 Chicago-area hospitals to participate.
At one-year and three-year follow-ups, women reported being hospitalized, going to the emergency room, and visiting their doctors at the same rates.
Roughly a third of those women were screened using three questions: whether they'd been hit, punched, or kicked by someone in the last year (15 percent had); whether they felt safe in their current relationships; and whether a partner from a previous relationship was making them feel unsafe. Those who answered yes to at least one question were then shown a video on their hospital's resources for partner violence and a printout of partner violence resources, along with general health resources "for safety reasons." Another third were given the partner violence and general resources, and the remaining women received only the general resources.
Changing women's lives for the better turned out—perhaps unsurprisingly—to be harder than giving them a sheet of paper with some information and phone numbers. At one-year and three-year follow-ups, women reported being hospitalized, going to the emergency room, and visiting their doctors at the same rates, regardless of what resources they'd been given.
"Research should focus on more intensive interventions among women already identified as abused," Klevens and her colleagues write.
The second study focused on the connection between intimate partner violence and drinking. Researchers led by Karen Rhodes, a physician at the University of Pennsylvania's Perelman School of Medicine, went to the emergency departments (EDs) at two Philadelphia hospitals, where they recruited 600 women, all of whom drank heavily and had been involved in an incident involving intimate partner violence. (The women were not intoxicated at the time of the ED visit.) A group of 242 women went through a motivational intervention—essentially a 20- to 30-minute interview in which therapists encouraged patients to consider links between intimate partner violence and drinking while also helping them re-think ambivalence about changing their circumstances.
As with the Klevens study, both that intervention and a less intensive one, which involved regular follow-up calls with a therapist, had no effect on drinking habits or incidents of partner violence. "Integrated interventions that address multiple risk factors in the context of violence exposure may require a more in-depth approach than can be feasibly provided in an ED setting," Rhodes and her colleagues write.
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