Effect of an in-clinic IPV advocate intervention to increase reduce violence and improve health

Background: Intimate partner violence (IPV) is a common and significant health threat. Before health care clinics implement IPV screening, the effectiveness of clinic-based interventions must be established. The purpose of this quasi-experimental study was to investigate the efficacy of a clinic-based model of advocacy services for intimate partner violence (IPV). Methods: Eligible and consenting women attending one of six selected clinics in the rural South were assessed for IPV and followed for up to 24 months. Nurses used a structured assessment tool to determine physical, sexual, and psychological IPV in the past five years. Based on the intervention assignment of the clinic, women reporting IPV were offered either an in-clinic advocate intervention with follow-up or usual care. Generalized linear mixed model regression analysis was used to test the effects of the intervention. Results: Danger Assessment Scores (DAS) in the intervention trended toward greater decline over time relative to usual care (p=0.07). Among women experiencing IPV at baseline, the reduction in DAS scores for the intervention group relative to usual care reached statistical significance (p=0.001). Conclusions: Having a trained IPV advocate available to talk with women currently in an abusive relationship appears to reduce IPV scores over time relative to women receiving only a referral card.