Online Program

Provider perspectives on a safety card intervention for partner violence and reproductive coercion

Tuesday, November 5, 2013 : 5:30 p.m. - 5:45 p.m.

Heather L. McCauley, ScD, ScM, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
Rebecca Levenson, MA, Futures Without Violence, San Francisco, CA
Heather Anderson, BS, Division of Adolescent Medicine, University of Pittsburgh, Pittsburgh, PA
Michele R. Decker, ScD, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Jay G. Silverman, PhD, Division of Global Public Health School of Medicine, University of California San Diego, La Jolla, CA
Daniel Tancredi, PhD, Department of Pediatrics, UC Davis School of Medicine, Sacramento, CA
Elizabeth Miller, MD, PhD, Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
Introduction: The prevalence of intimate partner violence (IPV) among family planning clients is significantly higher than population-based estimates. This care-seeking pattern is likely related to the association of IPV with increased risk for pregnancy and sexually transmitted infection. Thus, clinicians providing reproductive health services are particularly well-positioned to intervene with a large number of women affected by IPV. Methods: Qualitative interviews were conducted with 24 providers about their experiences implementing a brief safety card intervention to adolescent and young adult family planning clients. Results: Providers described feeling more confident discussing IPV and reproductive coercion with their clients after implementing the intervention. Specifically, the safety card helped to normalize the discussion about IPV. Introducing the safety card as something to share with friends and family facilitated a more open discussion about healthy relationships. The card also shifted provider behaviors from using a checklist to screen for IPV to a more fluid conversation integrated into the clinic visit. Intervention training helped providers make the link between reproductive coercion and IPV for the first time; most providers reported feeling more knowledgeable about and comfortable offering harm reduction strategies to their clients including longer acting reversible contraceptives. Implementation challenges included lack of time, the need for increased connections to local domestic violence programs, and in some sites, limited support from clinic administration when positive disclosures occurred. Conclusions: Family planning providers found a brief safety card was an acceptable way to guide their conversations with clients about partner violence and reproductive coercion.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the ways in which a brief safety card intervention can be used by family planning providers to facilitate discussions about intimate partner violence and reproductive coercion with their clients

Keyword(s): Family Planning, Domestic Violence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a postdoctoral research fellow who has spent the last 6 years working with Dr. Miller (PI) and her research team on several studies related to reproductive coercion and partner violence. I have published two dozen journal contributions in the field and given numerous talks on the health impacts of partner violence. I led the qualitative component of the study, which is the topic of the current presentation.
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.