Miller Christopher J, Stolzmann Kelly, Dichter Melissa E, Adjognon Omonyele L, Brady Julianne E, Portnoy Galina A, Gerber Megan R, Iqbal Samina, Iverson Katherine M
Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts, USA.
VA Center for Health Equity Research and Promotion (CHERP), Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.
J Aggress Maltreat Trauma. 2022 Jan 24;a:1-19. doi: 10.1080/10926771.2021.2019160.
Thousands of women Veterans experience intimate partner violence (IPV) each year. The Veterans Health Administration (VHA) has encouraged IPV screening in Veterans Affairs medical centers (VAMCs) since 2014. Through retrospective analysis of VHA administrative data from fiscal year (FY) 2014 into FY2020, we examined IPV screening implementation outcomes of reach and adoption, as well as screen-positive rates using descriptive and multivariate linear regression analyses. We examined reach and screen-positive rates overall and as a function of childbearing age (18-44 vs. 45+ years). In FY2014 only one VAMC was screening women for IPV; by FY2020, over half of VAMCs had adopted IPV screening. This rollout of IPV screening was associated with a large increase in the number of women primary care patients screened (from fewer than 500 in FY2014, to nearly 35,000 in early FY2020). Overall, among women screened, 6.7% screened positive for IPV; this rate was higher among women of childbearing age (8.1% vs. 5.6%). Despite the spread of IPV screening practices during the early years of implementation in VHA, additional work is needed. This study is the first comprehensive analysis of implementation outcomes associated with VHA's IPV screening efforts, and lays the groundwork for ongoing evaluation and quality improvement.
每年都有成千上万的女性退伍军人遭受亲密伴侣暴力（IPV）。自2014年以来，退伍军人健康管理局（VHA）一直在鼓励在退伍军人事务医疗中心（VAMCs）进行IPV筛查。通过对2014财年至2020财年VHA行政数据的回顾性分析，我们使用描述性和多元线性回归分析，研究了IPV筛查在覆盖范围、采用情况以及筛查阳性率方面的实施成果。我们整体以及按育龄（18 - 44岁与45岁及以上）研究了覆盖范围和筛查阳性率。在2014财年，只有一家VAMC对女性进行IPV筛查；到2020财年，超过一半的VAMC采用了IPV筛查。IPV筛查的推广使接受筛查的女性初级保健患者数量大幅增加（从2014财年的不到500人，增加到2020财年年初的近35000人）。总体而言，在接受筛查的女性中，6.7%的人IPV筛查呈阳性；育龄女性的这一比例更高（8.1%对5.6%）。尽管在VHA实施的早期几年IPV筛查做法有所推广，但仍需开展更多工作。本研究是对与VHA的IPV筛查工作相关的实施成果的首次全面分析，并为持续评估和质量改进奠定了基础。
