Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
J Community Health. 2013 Oct;38(5):856-63. doi: 10.1007/s10900-013-9690-0.
Adolescent and young adult women are disproportionately burdened by violence at the hands of dating and intimate partners. Evidence supports routine screening in clinical settings for detection and intervention. Although screening for intimate partner violence in reproductive health care settings is widely endorsed, little is known about screening practices. We conducted qualitative in-depth interviews with healthcare providers (n = 14) in several urban reproductive health clinics in Baltimore City, Maryland to understand screening practices, including related barriers and motivations. Interviews were transcribed verbatim and analyzed using inductive content analysis. Findings demonstrated substantial variation in screening practices as well as related referral and follow-up, despite the existence of a screening tool. Factors that appeared to undermine consistent and successful screening implementation included lack of a common goal for screening, lack of clarity in staff roles, a gap in on-site support services, as well as lack of time and confidence. Findings affirm the value of applying a systems model to intimate partner violence (IPV) screening programs. This research advances the understanding of the implementation challenges for violence-related screening for high-risk populations such as adolescents and young adults in reproductive health care settings and is particularly relevant given the recent endorsement by the DHHS to cover IPV screening under the Affordable Care Act.
青少年和年轻女性不成比例地承受着约会和亲密伴侣暴力的负担。有证据表明，在临床环境中进行常规筛查以进行检测和干预是合理的。尽管在生殖保健环境中筛查亲密伴侣暴力得到广泛认可，但对筛查实践知之甚少。我们对马里兰州巴尔的摩市几家城市生殖健康诊所的医疗保健提供者（n=14）进行了定性深入访谈，以了解筛查实践，包括相关的障碍和动机。访谈逐字转录，并使用归纳内容分析进行分析。研究结果表明，尽管存在筛查工具，但筛查实践以及相关的转诊和随访存在很大差异。似乎破坏了一致和成功的筛查实施的因素包括缺乏筛查的共同目标、工作人员角色不明确、现场支持服务存在差距以及缺乏时间和信心。研究结果肯定了将系统模型应用于亲密伴侣暴力（IPV）筛查计划的价值。这项研究增进了对生殖保健环境中高危人群（如青少年和年轻女性）进行暴力相关筛查的实施挑战的理解，鉴于最近卫生与公众服务部（DHHS）决定根据《平价医疗法案》涵盖 IPV 筛查，这一点尤其重要。
