University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
J Womens Health (Larchmt). 2021 Sep;30(9):1225-1232. doi: 10.1089/jwh.2020.8699. Epub 2021 Jan 18.
Intimate partner violence (IPV) and substance use are intersecting health problems that adversely impact sexual and reproductive health outcomes for women seeking care at family planning (FP) clinics. We aimed to characterize whether and how FP clinic providers (1) assessed for IPV and substance use and (2) combined IPV and substance use assessments. Providers and patients (female, 18-29 years old, English speaking) at four FP clinics participating in a larger randomized controlled trial on provider communication skills were eligible. Providers received training on universal education, a research-informed IPV assessment approach. Visits were audio recorded, transcribed verbatim, and coded by two independent coders. We used inductive and deductive coding to assess providers' communication approaches and examined codes for patterns and categories. We then converted these approaches into variables to calculate frequencies among recorded visits. Ninety-eight patient-provider encounters were analyzed. In almost all encounters (90/98), providers assessed for IPV. Many providers adopted best practice IPV assessment techniques, such as universal education (68/98) and normalizing/framing statements (45/98). Tobacco use screening was common (70/98), but alcohol (17/98) and other drug use screening (17/98) were rare. In only one encounter did a provider discuss IPV and substance use as intersecting health problems. This study provides insight on how FP clinicians, as key providers for millions of women in the United States, assess patients for IPV and substance use. Results show providers' willingness to adopt IPV universal education messaging and demonstrate room for improvement in substance use assessments and integrated discussions of IPV and substance use. Trial Registration Number: NCT01459458.
亲密伴侣暴力 (IPV) 和物质使用是相互交叉的健康问题，会对寻求计划生育 (FP) 诊所护理的妇女的性健康和生殖健康结果产生不利影响。我们旨在描述 FP 诊所提供者 (1) 是否以及如何评估 IPV 和物质使用，以及 (2) 如何综合评估 IPV 和物质使用。 符合条件的是参加一项关于提供者沟通技巧的更大的随机对照试验的四个 FP 诊所的提供者和患者（女性，18-29 岁，英语）。提供者接受了关于普遍教育和基于研究的 IPV 评估方法的培训。对访问进行了录音、逐字转录和两位独立编码员进行编码。我们使用归纳和演绎编码来评估提供者的沟通方法，并检查了模式和类别代码。然后，我们将这些方法转换为变量，以计算记录访问中的频率。 分析了 98 例患者 - 提供者的接触。在几乎所有接触中（90/98），提供者都评估了 IPV。许多提供者采用了最佳实践的 IPV 评估技术，例如普遍教育（68/98）和正常化/框架语句（45/98）。烟草使用筛查很常见（70/98），但酒精（17/98）和其他药物使用筛查（17/98）则很少见。在仅一次接触中，提供者讨论了 IPV 和物质使用作为相互交叉的健康问题。 本研究提供了有关 FP 临床医生如何为美国数百万妇女评估患者的 IPV 和物质使用情况的见解。结果表明，提供者愿意采用 IPV 普遍教育信息，并在物质使用评估和 IPV 和物质使用综合讨论方面有改进的空间。 试验注册号：NCT01459458。
