Division of Health Policy and Management, University of Minnesota Rural Health Research Center, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
Division of Health Policy and Management, University of Minnesota, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
Health Serv Res. 2024 Apr;59(2):e14212. doi: 10.1111/1475-6773.14212. Epub 2023 Aug 8.
To describe rates and predictors of perinatal intimate partner violence (IPV) and rates and predictors of not being screened for abuse among rural and urban IPV victims who gave birth.
This analysis utilized 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 45 states and three jurisdictions.
This is a retrospective, cross-sectional study using multistate survey data.
DATA COLLECTION/EXTRACTION METHODS: This analysis included 201,413 survey respondents who gave birth in 2016-2020 (n = 42,193 rural and 159,220 urban respondents). We used survey-weighted multivariable logistic regression models, stratified by rural/urban residence, to estimate adjusted predicted probabilities and 95% confidence intervals (CIs) for two outcomes: (1) self-reported experiences of IPV (physical violence by a current or former intimate partner) and (2) not receiving abuse screening at health care visits before, during, or after pregnancy.
Rural residents had a higher prevalence of perinatal IPV (4.6%) than urban residents (3.2%). Rural respondents who were Medicaid beneficiaries, 18-35 years old, non-Hispanic white, Hispanic (English-speaking), or American Indian/Alaska Native had significantly higher predicted probabilities of experiencing perinatal IPV compared with their urban counterparts. Among respondents who experienced perinatal IPV, predicted probabilities of not receiving abuse screening were 21.3% for rural and 16.5% for urban residents. Predicted probabilities of not being screened for abuse were elevated for rural IPV victims who were Medicaid beneficiaries, 18-24 years old, or unmarried, compared to urban IPV victims with those same characteristics.
IPV is more common among rural birthing people, and rural IPV victims are at higher risk of not being screened for abuse compared with their urban peers. IPV prevention and support interventions are needed in rural communities and should focus on universal abuse screening during health care visits and targeted support for those at greatest risk of perinatal IPV.
描述城乡 IPV 产妇围产期亲密伴侣暴力（IPV）发生率和预测因素，以及未接受虐待筛查的发生率和预测因素。
本分析使用了来自 45 个州和 3 个司法管辖区的 2016-2020 年妊娠风险评估监测系统（PRAMS）数据。
这是一项回顾性、横断面研究，使用多州调查数据。
数据收集/提取方法：本分析包括 201413 名在 2016-2020 年分娩的调查受访者（n=42193 名农村受访者和 159220 名城市受访者）。我们使用调查加权多变量逻辑回归模型，按城乡居住情况进行分层，估计两个结果的调整后预测概率和 95%置信区间（CI）：（1）自我报告的 IPV 经历（当前或前任亲密伴侣的身体暴力）和（2）在怀孕前、期间或之后的医疗保健就诊中未接受虐待筛查。
农村居民围产期 IPV 发生率（4.6%）高于城市居民（3.2%）。与城市居民相比，农村居民中 Medicaid 受益人和 18-35 岁、非西班牙裔白人、西班牙语裔（英语）或美洲印第安人/阿拉斯加原住民的预测经历围产期 IPV 的概率显著更高。在经历围产期 IPV 的受访者中，农村居民未接受虐待筛查的预测概率为 21.3%，城市居民为 16.5%。与具有相同特征的城市 IPV 受害者相比，农村 IPV 受害者中 Medicaid 受益人和 18-24 岁或未婚的预测未接受虐待筛查的概率较高。
农村分娩人群中 IPV 更为常见，与城市同龄人相比，农村 IPV 受害者未接受虐待筛查的风险更高。需要在农村社区开展 IPV 预防和支持干预措施，应在医疗保健就诊期间进行普遍的虐待筛查，并针对围产期 IPV 风险最高的人群提供有针对性的支持。
