Provider attitudes about intimate partner violence screening in a reproductive health care setting

Intimate partner violence (IPV) screening in health care settings is widely recommended, and a number of different screening tools and staff procedures are used across hospital and primary care settings. However, health care providers gather a variety of health information from patients in a single visit, and adding IPV assessment procedures may feel unnecessary or time consuming, resulting in low identification rates. Alternately, some providers see IPV screening as essential to good practice. This study describes attitudes and barriers of clinic staff about the use of an IPV screening tool and follow-up protocol at three urban, reproductive health care centers. The study employed a mixed-method design to collect qualitative and quantitative data on provider perceptions and barriers using focus groups and surveys. Participants were 100 health clinic staff, which included advanced practice clinicians, social workers, and health care assistants. Qualitative and quantitative data are triangulated, and differences between job roles in perceptions and barriers are delineated. Results indicate that perceptions of IPV screening importance and acceptability differ by job role, including discomfort with patient disclosure, lack of knowledge about how to respond, and need for training about the associations between IPV and reproductive health outcomes. Similarities included needs for collaboration with community agencies specializing in IPV and for written materials and referrals. Finally, staff reports of patient responses to screening are described.