Universal Screening Frameworks for Intimate Partner Violence DURING PREGNANCY: Qualtitatively Researched HEALTH Sector Interventions

Background: Intimate Partner Violence (IPV) is a global public health issue affecting the mortality and morbidity of women during reproductive years (Sagot, 2005). In 1998, the CDC reported that between 152,000 to 324,000 pregnant women in the U.S. experience violence yearly (Finger, 2000). While most pregnant women frequently seek health care, offering opportunity for health practitioner intervention (McFarlane et al., 2002), there is rarely a coordinated response to IPV between practitioners and the IPV policy community (Thurston et al., 2006). The purpose of this research was to develop a theoretical framework for U.S. obstetric clinic physicians to adopt a universal IPV screening and referral program with community linkages.

Methods: A literature review was conducted through PubMed on the social, epidemiological, behavioral, and environmental factors associated with the experience of IPV during pregnancy. The review also included applications of the following theoretical health behavior frameworks: PRECEDE-PROCEDE Model, Social Cognitive Theory (SCT), Transtheoretical Model (TTM), Transactional Model of Stress and Coping (TMSC), and Ecological Model (EM).

Results: The proposed theoretical framework for adoption of a universal screening program for pregnant women seen in obstetric clinics includes constructs from SCT, TTM, TMSC, and EM and social marketing techniques, bilingual materials, and 24-hour staffing.

Discussion and Conclusion: Implication of a multilevel theoretical framework can aid in the disclosure, detection, referral, and reduction of morbidity and mortality of pregnant IPV victims. It can also eliminate barriers often cited by providers in assessing and treating victims and assist in policy formation and adherence and culture change.