The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60231

Anuradha Paranjape, MD, MPH, Division of General Medicine, Emory University, School of Medicine, Rm 219, Glenn Building, 69 Jesse Hill Jr Drive SE, Atlanta, GA 30303, 404-616-8496, aparanj@emory.edu, Jane M. Liebschutz, MD, MPH, Section of General Internal Medicine Research Unit, Boston University School of Medicine, 91 East Concord Street, Suite 200, Boston, MA 02118, and Kimberly Rask, MD, PhD, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 636, Atlanta, GA 30322.

BACKGROUND: One barrier to universal screening for intimate partner violence (IPV) is the lack of validated, easy to use, screening questions. Previously, we identified seven sensitive screening questions and created a three question screening tool to detect lifetime exposure to IPV. In this study, we validated those findings in a separate population. METHODS: We randomly selected English-speaking female patients between 18 and 65 attending an urgent care clinic of a public hospital. Subject interviews included demographics, depressive symptoms, post-traumatic stress symptoms, social support and previously identified screening questions, including a 3-question screening tool, STaT ("Have you been in a relationship where your partner… has pushed or slapped you?" …threatened you with violence?" …has thrown, broken and punched things?"). Using the Index of Spouse Abuse (ISA), a validated instrument to identify IPV, as a comparison standard, we estimated the sensitivity and specificity of individual screening questions, two-question combinations and STaT . RESULTS: Subject characteristics (n=240), included: mean age 38 years, 91% African- American, median monthly income $800. 152(64%) were in a relationship at the time of the interview; 79 (33%) had lifetime history of IPV., 60 (25%) and 61 (25.4%) had experienced physical and emotional IPV, respectively. The sensitivity (with 95% CIs) of STaT for a positive answer to any one, two and all three questions was 94.9% (90.1%, 99.8%), 84.8% (76.9%, 92.7%) and 62% (51.3%, 72.7%). The corresponding specificities were 36.6% (29.2%, 44.1%), 54%(46.3%,61.7%) and 65.8%(58.5%, 73.2%). Two questions alone (slapped, threatened) had a sensitivity of 94.9% (90.1%, 99.7%) and specificity of 41% (33.4%, 48.6%) for a single positive response. The same two question combination had a sensitivity of 77.2%(68%-86.5%) and specificity of 59% (51.4%, 66.6%) with an affirmative reply to both questions. Screening properties of STaT were similar for physical and emotional IPV as well.CONCLUSIONS: We have validated a three question screen for the detection of IPV. Two of the three questions in combination perform very well as a screening tool for exposure to lifetime IPV. The easy to use, brief sensitive screen, developed and validated in separate populations, promises to advance the state of practice in intimate partner violence.

Learning Objectives:

• At the end of this session, participants will be better able identify intimate partner violence using a brief screening tool.

Keywords: Domestic Violence, Screening

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.