Healthcare Interventions for Family Violence

Amy Hunter, MPH, PhD, Department of Public Health Sciences, UCONN Health, 265 Farmington Avenue, Farmington, CT 06032

APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)


Connection and Celebration: Building Community to Reduce Child Abuse and Neglect

Elizabeth Tooher, MPH, RN1 and Julia DeChristoforo, BSN, RN2
(1)National Nurse-Led Care Consortium, Philadelphia, PA, (2)National Nurse-Led Care Consortium, Phila, PA

APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)

The Strengthening Families Protective Factors (SFPF) framework from the Center for the Study of Social Policy distills extensive research in child and family development into five protective factors that everyone can understand and recognize in their own lives. These protective factors engage families in the identifying their own strengths while upholding an environment where children thrive. When one builds and strengthens protective factors, risk factors for family violence are mitigated. Indeed, the research-informed approach of the SFPF framework increases family strengths, enhances child development, and reduces the likelihood of child abuse and neglect.

In hosting over 100 events, the nurse-led home visiting programs of the National Nurse-Led Care Consortium find value and expertise through embedding strategies for the five key factors of the SFPF approach into core functions of all events. Open to all families served, events offer opportunities to explore new communities through play groups, museums, cooking demonstrations, or simply a picnic in the park. Providing an escape from the challenges of living and parenting in deep poverty, these events bring celebration and connection with other families and community destinations. Furthermore, events provide a strengths-based approach to explore stress management, co-parenting, school readiness and many divergent topics that support the SFPF framework as relevant to those we serve. These events create a conduit to engaging families with community while building skills in caregivers to advocate for themselves, their children and their communities. Through this implementation and advocacy we see the SFPF outcomes take root and family violence prevented.

Administer health education strategies, interventions and programs Diversity and culture Implementation of health education strategies, interventions and programs Program planning Public health or related education


Addressing Intimate Partner Violence through Community-Medical Partnerships

Tali Ruskin, MSW, MPH, Lutheran Settlement House, Philadelphia, PA

APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)

Health care providers often face barriers in screening patients for intimate partner violence (IPV), citing discomfort with screening, uncertainty about how to handle a positive screen, and concerns related to safe documentation and resource connection. Optimal solutions include a universally applied process initiated by front-line clinicians, safe documentation for rapid, real-time referral, and on-site support and education.

The STOP IPV program, developed by Lutheran Settlement House (LSH)'s Bilingual Domestic Violence Program, has the overarching goal of increasing the capacity of medical providers to appropriately screen for and respond to patients experiencing IPV. LSH has partnered with the Children’s Hospital of Philadelphia (CHOP), Einstein Medical Center, and Jefferson Northeast, to create a fully integrated, clinician-initiated process that offers unique advantages in both adult care and pediatric settings. The LSH-employed IPV Specialist is based at the medical site and provides on-site counseling for patients and employees; training for providers; outreach and awareness activities; and institutional support for appropriate policies and practices throughout the site.

This presentation draws on the experience of an IPV service provider’s collaboration with hospital partners to develop a unique hospital-based IPV prevention and response program as a compass for individuals and agencies seeking to improve community response to survivors of violence. Through narrative of our process and efforts to increase detection and improve response to IPV in pediatric and adult health care settings, this presentation will explore strategies for transforming traditionally uninformed systems into safe spaces where survivors can be heard and safely connected to appropriate resources.

Implementation of health education strategies, interventions and programs Public health or related education


Implementation of intimate partner violence screening and referral in primary care

Melissa Dichter, PhD, MSW1, Shannon N. Ogden, MPH2, Marcella Nyachogo, LSW3, India Azzinaro, BSW3, Maggie Johnson, MD4 and Peter F. Cronholm, MD, MSCE2, (1)Temple University, Philadelphia, PA, (2)University of Pennsylvania, Philadelphia, PA, (3)Lutheran Settlement House, Philadelphia, PA, (4)University of Pennsylvania Perlman School of Medicine, Philadelphia, PA

APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)

Healthcare systems face challenges to implementation of national guidelines to conduct routine screening for patient experience of intimate partner violence (IPV) and offer or provide follow-up services in response to a positive screen. To inform improvements to such implementation, we assessed the practice of standardized IPV screening and referral to follow-up community agency services in a family medicine practice. Providers received training on IPV screening and response, as well as a process for direct referral to an advocate at a community-based IPV services agency for follow-up support. The clinic instituted a paper-based patient self-administered social health screen that included a screen for past-year IPV. To assess implementation processes and outcomes over the first fourteen weeks of implementation, we collected completed screens, conducted process observations, and surveyed participating providers. Of the completed screens, 19.1% included indication of any past-year IPV yet only 27.2% of those included notation of action taken by the provider in response. Ten of the 12 providers completed the feedback questionnaire. Providers noted that the screening process can improve patient care by facilitating discussion, increasing awareness, and connecting patients directly with services. Barriers included patients not receiving the paper screen and lack of time in the clinical visit. Clinic observations highlighted challenges with workflow as well as buy-in to the process from clinic staff. The IPV screening and referral to community-based services process was accepted and feasible; however, considerations of clinic workflow and staff support of integration of new processes is critical to ensuring effective implementation.

Assessment of individual and community needs for health education Clinical medicine applied in public health


Creating CARE: A health justice advocacy model assisting providers to address the health needs of survivors of domestic violence

Julianna Nemeth, MA, PhD1, Rachel Ramirez, MA, MSW, LISW-S2, Emily Kulow, BA2, Cathy Alexander, MSSA, LISW-S2, Alexandra Brown, MPH2, Amy Wermert, MPH1 and Cecilia Mengo, MSW, PhD1, (1)The Ohio State University, Columbus, OH, (2)Ohio Domestic Violence Network, Columbus, OH

APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)

background. Mental health vulnerability and brain injury caused by head trauma and strangulation are highly prevalent among domestic violence survivors. However, service providers advocating for survivor’s needs have lacked guidance regarding how to address these and other co-morbid health conditions when survivors seek their services.

methods. In partnership with researchers from Ohio State University (OSU), and grounded in the public health planning process, the Ohio Domestic Violence Network (ODVN), a 501(c)3 state coalition of 66 of Ohio’s domestic violence programs, secured a 3 year federally funded demonstration grant (2016-2019) to create and evaluate what became known as CARE (Connect, Acknowledge, Respond, Evaluate). Needs and process evaluation activities leading to the development and refinement of CARE were approved by OSU’s IRB.

CARE development & process evaluation. CARE is a new advocacy delivery model intended to help service providers normalize, address and respond to the mental and physical health needs of survivors. CARE focuses on creating connection, accommodating and adjusting services to effectively respond to the functional challenges survivors identify. Following a needs assessment conducted in 2017, ODVN created CARE training and tools, which were then implemented by five project community-of-practice partner agencies in 2018-2019. In this paper we outline the process used to create CARE in response to needs identified by service providers and survivors in pre-CARE assessment, along with the primary process evaluation results obtained through post-CARE implementation focus groups conducted with community-of-practice agency staff, and survivors utilizing their services. CARE tools for health justice advocacy are also presented.

Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs