A Realist Review: Screening & Identification Interventions for Victims of Intimate Partner Violence in Health Care Settings

Background: Intimate partner violence (IPV) is a major public health issue and has numerous adverse consequences including mortality, physical and mental health morbidity, excess physician and emergency room visits and hospitalizations. The thrust of recent health care initiatives focuses on the screening and identification of IPV to improve early detection and referrals to health and social services. At the same time, recent Cochrane-style systematic reviews have concluded that there is currently insufficient evidence supporting the benefits of IPV screening interventions. Missing from current reviews is evidence related to the process and practice of screening interventions by healthcare professionals in various healthcare contexts – an important but missing piece for policy makers, program planners, and providers within health sectors.

Purpose: To re-evaluate the evidence on program mechanisms of IPV screening and identification by health care providers, within a healthcare context, by addressing how IPV screening programs work, for whom they work, and in what circumstances.

Methods: Unlike conventional Cochrane style systematic reviews, we utilize Ray Pawson's Realist Review approach with its focus on program mechanisms and inclusion of various types of evidence such as scholarly literature (quantitative & qualitative), key documents and interviews with key informants. Outcomes from the systematic review will yield information about why and how programs work to inform the design of policies and programs.

Results: Our funded project is currently in the evidence appraisal phase. At the conference we will present our findings on best practices along with ineffective processes for IPV screening in health care settings.