249701 Facilitating disclosure of intimate partner violence during teen pregnancy

Tuesday, November 1, 2011: 1:10 PM

Fiona Somers, MD/MPH candidate , Schools of Medicine and Public Health, Mount Sinai Hospital, New York, NY
Andrea Rothenberg, MS, LCSW , Health Education Department, Mount Sinai Hospital, New York, NY
Elizabeth J. Garland, MD, MS , Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY
Background: One quarter of teen mothers experience intimate partner violence (IPV) before, during, or after pregnancy. Little research exists on health approaches targeting IPV in this vulnerable population. We attempt to identify barriers to disclosure and to explore effective approaches to help pregnant teens more comfortably disclose IPV. Methods: Participants were women who gave birth before age 24 and men who fathered children with women younger than 24, recruited via East Harlem parenting programs to participate in single-sex focus groups. Additionally, we interviewed counselors who regularly work with expectant teen parents. Focus groups were transcribed and analyzed for common themes. Results: Participants (n=14) were 7 women ages 18-26, 3 men ages 29-31, and 4 counselors. Multiple factors contributed to unwillingness to disclose IPV to providers including perceptions that providers are too hurried to listen properly and are “going down a checklist;” they use too much jargon; they cannot relate because they have not experienced IPV themselves; and they do not take teen relationships seriously. Participants had concerns that disclosure would lead to being viewed as unfit to parent, followed by drastic action such as police or ACS involvement. Suggestions for providers included developing ongoing relationships with patients, easing into discussions about IPV as casually as they approach other topics, providing written information about IPV, and offering concrete examples and advice about healthy relationships. Conclusions: A wide range of suggestions was elaborated. Ongoing patient-provider relationships based on trust and age-appropriate communication are key to facilitating pregnant teens' disclosure of IPV.

Learning Areas:
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
1. List 5 reasons why pregnant teens hesitate to disclose intimate partner violence (IPV) to healthcare providers. 2. Identify 4 barriers to IPV disclosure that are inherent to the system of care. 3. Describe 5 methods of facilitating IPV disclosure that have been suggested by teen parents and the social workers who counsel them.

Keywords: Adolescent Health, Violence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted this research as part of my MPH thesis work, and I volunteer with survivors of intimate partner violence and sexual assault as a New York State Department of Health Certified Rape Crisis Counselor.
Any relevant financial relationships? No

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.