Rajaram Shireen S, Pereira Emiliane Lemos, Chiou Kathy, Reisher Peggy, Wichman Christopher, Miller Megan N, Estabrooks Paul A
University of Nebraska Medical Center.
University of Nebraska-Lincoln.
Res Sq. 2025 Jul 15:rs.3.rs-6925920. doi: 10.21203/rs.3.rs-6925920/v1.
Women who experience intimate partner violence (IPV) are at a high risk for injuries to the head, neck, and face that can result in a traumatic brain injury (BI). Despite increasing evidence of the high risk for BI in this vulnerable population, BI screenings remain critically under-implemented in community-based organizations (CBOs) serving IPV survivors. The aim of this community-engaged dissemination and implementation project was to co-identify implementation strategies to increase the adoption of brain injury (BI) screening and referral within intimate partner violence (IPV)-serving CBOs.
We used a modified Delphi method to prioritize 47 CBO relevant strategies from the Expert Recommendations for Implementation Change compendium to increase the adoption of BI screening and referral among IPV-serving CBOs. In Round-1, 14 Community-campus advisory board (CAB) members, including representatives from 10 CBOs prioritized relevant strategies in a virtual meeting. In Round-2, 62 CBOs staff members responded to a survey to refine a subset of prioritized strategies to 6-8 primary strategies that could be tested across the CBOs.
CAB participants identified 21 strategies as particularly relevant to CBOs including 4 educational, 2 technical assistance, 5 staff and leadership, 4 management and evaluation, and 6 organizational workflow strategies. Survey responses indicated rated 7 of the 21 strategies were most consistently rated as relevant and feasible. The final list of 7 strategies included training opportunities, ongoing consultation, developing implementation plans, establishing local screening and referral protocols, soliciting survivor feedback, promoting adaptability, and tailoring strategies to CBOs contexts.
This study highlights the importance of creating tailored implementation strategies within IPV-serving CBOs to enhance the adoption of brain injury screening and referral protocols. The identified strategies offer valuable insights into optimizing support for IPV survivors and advancing public health interventions.
遭受亲密伴侣暴力（IPV）的女性头部、颈部和面部受伤风险很高，可能导致创伤性脑损伤（TBI）。尽管有越来越多的证据表明这一弱势群体发生TBI的风险很高，但在为IPV幸存者提供服务的社区组织（CBO）中，TBI筛查的实施情况仍然严重不足。这个社区参与式传播与实施项目的目的是共同确定实施策略，以增加在为IPV提供服务的CBO中采用脑损伤（TBI）筛查和转诊的比例。
我们使用改良的德尔菲法，从《实施变革专家建议》汇编中对47项与CBO相关的策略进行优先排序，以增加在为IPV提供服务的CBO中采用TBI筛查和转诊的比例。在第一轮中，14名社区-校园咨询委员会（CAB）成员，包括来自10个CBO的代表，在一次虚拟会议上对相关策略进行了优先排序。在第二轮中，62名CBO工作人员对一项调查做出回应，将优先排序的策略子集细化为6-8项主要策略，这些策略可在各CBO中进行测试。
CAB参与者确定了21项与CBO特别相关的策略，包括4项教育策略、2项技术援助策略、5项员工与领导策略、4项管理与评估策略以及6项组织工作流程策略。调查回复表明，21项策略中有7项被一致评为最相关且可行。7项策略的最终清单包括培训机会、持续咨询、制定实施计划、建立本地筛查和转诊方案、征求幸存者反馈、促进适应性以及根据CBO的情况调整策略。
本研究强调了在为IPV提供服务的CBO中制定量身定制的实施策略以提高脑损伤筛查和转诊方案采用率的重要性。所确定的策略为优化对IPV幸存者的支持和推进公共卫生干预措施提供了宝贵的见解。
