Department of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA, United States.
J Med Internet Res. 2021 Feb 19;23(2):e22790. doi: 10.2196/22790.
Intimate partner violence (IPV) is one of the leading causes of pregnancy-related death. Prenatal health care providers can offer critical screening and support to pregnant people who experience IPV. During the COVID-19 shelter-in-place order, mobile apps may offer such people the opportunity to continue receiving screening and support services.
We aimed to examine cases of IPV that were reported on a prenatal care app before and during the implementation of COVID-19 shelter-in-place mandates.
The number of patients who underwent voluntary IPV screening and the incidence rate of IPV were determined by using a prenatal care app that was disseminated to patients from a single, large health care system. We compared the IPV screening frequencies and IPV incidence rates of patients who started using the app before the COVID-19 shelter-in-place order, to those of patients who started using the app during the shelter-in-place order.
We found 552 patients who started using the app within 60 days prior to the enforcement of the shelter-in-place order, and 407 patients who used the app at the start of shelter-in-place enforcement until the order was lifted. The incidence rates of voluntary IPV screening for new app users during the two time periods were similar (before sheltering in place: 252/552, 46%; during sheltering in place: 163/407, 40%). The overall use of the IPV screening tool increased during the shelter-in-place order. A slight, nonsignificant increase in the incidence of physical, sexual, and psychological violence during the shelter-in-place order was found across all app users (P=.56). Notably, none of the patients who screened positively for IPV had mentions of IPV in their medical charts.
App-based screening for IPV is feasible during times when in-person access to health care providers is limited. Our results suggest that the incidence of IPV slightly increased during the shelter-in-place order. App-based screening may also address the needs of those who are unwilling or unable to share their IPV experiences with their health care provider.
亲密伴侣暴力（IPV）是导致与妊娠相关死亡的主要原因之一。产前保健提供者可以为经历 IPV 的孕妇提供关键的筛查和支持。在 COVID-19 就地避难令期间，移动应用程序可能为这些人提供继续接受筛查和支持服务的机会。
我们旨在检查在 COVID-19 就地避难令实施之前和期间在产前保健应用程序上报告的 IPV 病例。
使用一种在单个大型医疗保健系统中向患者传播的产前保健应用程序，确定接受自愿 IPV 筛查的患者人数和 IPV 的发生率。我们比较了在 COVID-19 就地避难令之前开始使用该应用程序的患者的 IPV 筛查频率和 IPV 发生率，以及在避难令开始时开始使用该应用程序的患者的 IPV 筛查频率和 IPV 发生率。
我们发现，在实施就地避难令之前的 60 天内，有 552 名患者开始使用该应用程序，而在避难令开始时，有 407 名患者开始使用该应用程序，直到命令解除。在两个时期，新应用程序用户的自愿 IPV 筛查发生率相似（在避难之前：252/552，46%；在避难期间：163/407，40%）。在避难令期间，IPV 筛查工具的总体使用量有所增加。在所有应用程序用户中，发现物理、性和心理暴力的发生率在避难期间略有上升，但无统计学意义（P=.56）。值得注意的是，在筛查呈阳性的患者中，没有提到他们的医疗记录中有 IPV。
在与医疗保健提供者的面对面接触有限的情况下，基于应用程序的 IPV 筛查是可行的。我们的结果表明，在避难期间，IPV 的发生率略有上升。基于应用程序的筛查还可以满足那些不愿意或无法与医疗保健提供者分享其 IPV 经历的人的需求。
