160598 Computer-assisted risk screening for intimate partner violence in family practice: A randomized controlled trial (RCT)

Monday, November 5, 2007: 1:00 PM

Farah Ahmad, MBBS, MPH, PhD , Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
Sheilah Hogg-Johnson, PhD , Institute for Work and Health, Toronto, ON, Canada
Donna E. Stewart, MD, FRCPC , Women's Health Program, University Health Network, Toronto, ON, Canada
Harvey A. Skinner, PhD, CPsych , Faculty of Health, York University, Toronto, ON, Canada
Richard H. Glazier, MD, MPH , Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada
Wendy Levinson, MD, FRCPC , Department of Medicine, University of Toronto, Toronto, ON, Canada
Objectives: To test the effectiveness of computer-assisted screening in improving the rates of detection of women at risk for IPV in a family practice (FP), and assess its acceptance by the patients. Methods: A RCT was conducted with women in a current/recent intimate relationship visiting a hospital-affiliated FP in Toronto. Participants in the intervention arm completed a computer-based health risk assessment before seeing their physician. The computer survey included questions on IPV and other health risks. Computer-generated risk reports were attached to patients' medical charts for review by their physician. Participants in the control arm received standard medical care. Data were collected by audio taping of the medical visits and an exit survey of patients. Primary outcomes were: a) initiation of discussion about IPV (called discussion-opportunity), and b) detection of women at risk. Patient acceptance was measured by the Computerized Lifestyle Assessment Scale. Results: 314 women gave consent (response rate = 60.7%). The two arms were similar in socio-demographics and prevalence of IPV (13.7%). Compared to control visits, the odds ratios for IPV discussion-opportunity, and detection of IPV risk were OR 1.8, (95% CI 1.2-2.7; p = .008) and OR 2.5, (95% CI 1.1-5.1; p = .02), in the intervention group. Computer group participants agreed with the benefits of computer screening and were not concerned about its potential negative effects. Conclusion: Computer screening is an effective and patient-acceptable method to screen for IPV in busy FP clinics. This could shift the physician's role from screening to management of IPV risk.

Learning Objectives:
1. Recognize the barriers to disclose/detect experiences of partner violence in healthcare settings. 2. Articulate the procedures for evaluating an intervention using computer-assisted screening. 3. Discuss the implications for policy, education, and research programs.

Keywords: Access to Health Care, Domestic Violence

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.