Jacqueline Dienemann

Women's Opinions About Domestic Violence Screening and Mandatory Reporting

BACKGROUND The purpose of this paper is to describe womens opinions and policy preferences concerning domestic violence screening and mandatory reporting. METHODS This case-control study included 202 abused women and 240 randomly selected non-abused women recruited from a large metropolitan health maintenance organization who were interviewed by telephone. Of these women, 46.6% had a college degree, 53.4% were white, and 60% had a household income of

Annual and lifetime prevalence of partner abuse in a sample of female HMO enrollees

50,000 or more. RESULTS Forty-eight percent of the sample agreed that health care providers should routinely screen all women, with abused women 1.5 times more likely than non-abused women to support this policy. For mandatory reporting, 48% preferred that it be the womans decision to report abuse to the police. Women thought it would be easier for abused women to get help with routine screening (86%) and mandatory reporting (73%), although concerns were raised about increased risk of abuse with both screening (43%) and reporting (52%) policies. Two thirds of the sample thought women would be less likely to tell their health care providers about abuse under a mandatory reporting policy. Interventions offered in managed care settings that would be well received, according to the women in this study, include counseling services, shelters, and confidential hotlines. CONCLUSIONS Women expressed fears and concerns about negative consequences of routine screening and, even more so, for mandatory reporting. Domestic violence policies and protocols need to address the safety, autonomy, and confidentiality issues that concern women.

Collaboration as a Partnership

Abstract Self-reported data from a survey of roughly 1,100 female health maintenance organization enrollees in the Washington, DC, metropolitan area are used to investigate the lifetime and annual prevalence of emotional, physical, and sexual abuse by intimate partners. The sample consists of a racially balanced and, for the most part, well-educated group of working women. Three dimensions of abuse based on responses to questions from a modified version of the Abuse Assessment Screen are employed. In addition to simple descriptive analyses, logistic regression was performed. The estimated annual prevalence is lower than estimates reported in other studies. However, lifetime prevalence is very similar to estimates found in primary care clinical samples and somewhat higher than those derived from population-based surveys. More highly educated women report the lowest lifetime prevalence of intimate partner abuse. The finding that this sample of well-educated, middle-class working women has lifetime prevalence rates similar to those of women who are not as well off demonstrates that intimate partner abuse is not limited to disadvantaged women from vulnerable population subgroups.

African American HMO Enrollees: Their Experiences with Partner Abuse and its Effect on their Health and Use of Medical Services

This article traces and analyzes the development of a collaboration between a battered womens shelter and a university school of nursing to provide health services, nursing student education, action research, program evaluation and improvement, and data for policy change. The authors discuss the wide variety of shared activities that they undertook over time as well as competing and shared commitments to knowledge, programs, and audiences. The importance of a long-term commitment, development of trust, working through frustrations, and formulating mutual goals is stressed.

Informing the Research Agenda on Domestic Abuser Intervention Through Practitioner-Researcher Dialogues

Intimate partner violence has been demonstrated to be a significant public health problem among African American women. This study provided an opportunity to examine prevalence of intimate partner violence and health consequences among a group of primarily middle-class, employed African American women enrolled in a privately insured HMO (n = 109 abused and 97 never-abused women). Significantly more abused African American women were divorced or widowed and had incomes less than

Domestic violence in the workplace

50,000 a year. Abused women had more health problems (central nervous system, gynecological, STDs, gastrointestinal), more health problems per medical visits, and more emergency room visits (p < .05) compared to never-abused women. The health consequences of abuse and its association with health disparities are discussed.

CLINICAL RESEARCHA Critical Pathway for Intimate Partner Violence Across the Continuum of Care

Officials in the state of Maryland have adopted the goal of establishing empirically based practice standards for intervention programs that work with domestic abuse perpetrators. This article highlights a set of roundtable discussions between practitioners, policy makers, and researchers, the goal of which was to inform the research agenda on Abuser Intervention Programs (AIPs). Contextual material is provided on the gap between practice and research in mental health disciplines in general and on the need for structured communication between practitioners and researchers to help bridge this gap. Roundtable participants emphasized a number of important research directions that converge and diverge with recent trends in research on domestic abuse perpetrators and AIPs.

Long-term costs of intimate partner violence in a sample of female HMO enrollees

In Minneapolis on Valentines Day, a man walked into the second floor offices of his ex-girlfriend and loudly confronted her. He followed her as she fled into the womens restroom where they argued briefly and he shot her. He then fled the building and the state. She died (Star Tribune, February 15, 1996).

Developing a domestic violence program in an inner-city academic health center emergency department: the first 3 years.

Objective: The authors developed an interdisciplinary critical pathway for intimate partner violence (IPV) assessment and intervention for use across health care settings. Intimate partner violence may be emotional, physical, and/or sexual and involves coercion and control by one partner over the other. Design: A pathway developed with input from focus groups of battered women was subjected to a modified Delphi technique to improve the pathways scientific accuracy and feasibility. Setting: The study was conducted in one urban, one suburban, and one rural hospital with IPV advocacy programs in the mid-Atlantic region of the United States. Patients/Participants: Four researchers and 13 clinicians participated in the validation, with at least one physician, one nurse, and one social worker or IPV counselor from each hospital. Main Outcome Measures: Each element of the pathway was analyzed for the degree of consensus on scientific accuracy and feasibility. Results: Consensus on the scientific accuracy and feasibility of the pathway was achieved after three rounds of the Delphi process. Conclusions: This is the first known critical pathway for IPV. It addresses physical and mental health and safety and has content validity affirmed by an interdisciplinary panel of experts. Further process and outcome evaluation is warranted and invited.OBJECTIVE The authors developed an interdisciplinary critical pathway for intimate partner violence (IPV) assessment and intervention for use across health care settings. Intimate partner violence may be emotional, physical, and/or sexual and involves coercion and control by one partner over the other. DESIGN A pathway developed with input from focus groups of battered women was subjected to a modified Delphi technique to improve the pathways scientific accuracy and feasibility. SETTING The study was conducted in one urban, one suburban, and one rural hospital with IPV advocacy programs in the mid-Atlantic region of the United States. PATIENTS/PARTICIPANTS Four researchers and 13 clinicians participated in the validation, with at least one physician, one nurse, and one social worker or IPV counselor from each hospital. MAIN OUTCOME MEASURES Each element of the pathway was analyzed for the degree of consensus on scientific accuracy and feasibility. RESULTS Consensus on the scientific accuracy and feasibility of the pathway was achieved after three rounds of the Delphi process. CONCLUSIONS This is the first known critical pathway for IPV. It addresses physical and mental health and safety and has content validity affirmed by an interdisciplinary panel of experts. Further process and outcome evaluation is warranted and invited.