Using videos in clinic exam rooms for domestic violence and human trafficking screening

INTRODUCTION: Low-income women experiencing domestic violence (DV) or human trafficking (HT) often have difficulty getting help. Healthcare providers might be able to provide basic counselling and referrals if these women were “coached” by videos to self-reveal.  METHODS: We developed PSA-type three-minute videos using the “trusted friend” approach, in multiple languages and ethnicities, to be shown privately in exam rooms of four safety net clinics in Los Angeles.  We also created a website with embedded videos, multilingual pocket cards with hotline information, DV/HT training for providers, and clinic binders of local DV/HT resources.  We were able to track website hits and locations using google analytics. RESULTS:  In the first five months (August-December 2013), female patients aged 15 and above in target clinics accessed the videos 1936 times. Average length of time spent on the website was 3.5 to 6 minutes. Website hits per day were 0 to 62 for the clinics combined. During the study period, 23 women in the study clinics revealed current domestic violence to a provider, compared to 0 women in four comparison clinics. Challenges included: maintaining clinic interest in showing videos, theft and breakage of tablet computers, provider reluctance to query patients on DV, provider turn-over, and failure to re-stock the cards.  DISCUSSION:  Preliminary data suggests that private video screening on DV and HT is acceptable to female patients and may facilitate disclosure, if providers support the activity. CONCLUSION:  Clinic-based video screening may increase the likelihood of DV and HT identification and referral in safety net clinics.