Assessing readiness to manage intimate partner violence 12 months after completion of an educational program in fracture clinics: a pretest-posttest study.

BACKGROUND

The aim of the EDUCATE study was to determine whether an intimate partner violence educational program for health care providers working in fracture clinics increased their knowledge about intimate partner violence and their preparedness to discuss this topic with their patients. Here, we present the long-term (12-mo) follow-up data from the EDUCATE study to determine whether improvements in knowledge were maintained.

METHODS

For this pretest-posttest study, we enrolled 140 health care providers from 7 academic fracture clinics in Canada and the United States. Training took place between October 2016 and June 2017. We administered the Physician Readiness to Manage Intimate Partner Violence Survey before participants completed the educational program (baseline), immediately after training, and at 3 months and 12 months after training. We used the actual knowledge subscale as the primary outcome for the planned 12-month analyses; we also report on the other subscales of the survey (perceived preparation to manage intimate partner violence, perceived knowledge about the issues, practice issues, preparation, legal requirements, workplace issues, self-efficacy, alcohol or drugs, and victim understanding). We used linear regression models to compare mean 12-month scores with mean baseline scores for each subscale of the survey.

RESULTS

Among the 109 participating health care providers for whom 12-month assessment data were available, we found statistically significant improvements in the actual knowledge about intimate partner violence subscale of the survey (mean difference [MD] 2.50, 95% confidence interval [CI] 1.69 to 3.32). Statistically significant improvements from baseline to 12 months were also observed for 8 of the 9 other subscales of the survey: perceived preparation (MD 2.06, 95% CI 1.88 to 2.24), perceived knowledge (MD 2.14, 95% CI 1.96 to 2.31), practice issues (MD 6.12, 95% CI 4.97 to 7.27), preparation (MD 1.10, 95% CI 0.94 to 1.26), legal requirements (MD 1.57, 95% CI 1.36 to 1.78), workplace issues (MD 1.19, 95% CI 1.04 to 1.35), self-efficacy (MD 0.56, 95% CI 0.46 to 0.67) and alcohol and drugs (MD 0.11, 95% CI 0.02 to 0.21). Improvements relative to baseline were not observed for the victim understanding subscale.

INTERPRETATION

The EDUCATE program led to significant improvements in health care providers' readiness to manage intimate partner violence, with positive changes being observed 12 months after training. These findings indicate that health care providers who receive this training may be better equipped to manage the care of patients who have experienced intimate partner violence.