In 2015, NCCADV received funding from the US Office on Women’s Health (OWH) IPV Provider Network Project to improve the healthcare response to intimate partner violence (IPV) in North Carolina. NCCADV partnered with 7 health care sites and 7 local domestic violence programs across the state to: strengthen partnerships between DV advocates and healthcare workers; identify patients in primary care settings who have experienced IPV; respond to survivors in primary care settings with a range of interventions including safety planning and referrals.
Protocols
NCCADV designed, implemented and evaluated two interventions for primary healthcare settings. Both interventions (standard and enhanced) consist of the following basic components: strengthening relationships between primary health centers and domestic violence agencies; IPV training for all healthcare staff and providers; routine IPV education and screening of patients; offering resources to patients experiencing IPV. The resources offered in the ‘standard’ intervention included a facilitated referral to a local DV advocate and privacy for the patient to speak with that advocate. In the ‘enhanced’ intervention, resources offered included: a brief DV risk assessment; facilitated referral and time to speak with a DV advocate, and option of in-clinic DV safety planning.
Resources
Patient Education: Futures Without Violence has developed many IPV resources for healthcare settings. NCCADV has used and adapted some of these resources for the Healthcare IPV Response Project, including educational safety cards that describe how relationships affect health and help patients consider whether they might be in an unhealthy relationship.
Screening: There are several evidence-based IPV screening tools for health settings. NCCADV and participating health centers used the HARK screening tool during the Healthcare IPV Response Project. This 4-question tool assesses patients for experience of emotional, physical and sexual violence by a current or former partner during the past year.
DV Risk Assessment: The Danger Assessment (DA) is a 20-question evidence-based tool developed to measure risk of domestic violence lethality. NCCADV has used a brief 5 question version of this tool, the DA-5, in the Healthcare IPV Response Project.
Safety Plan: NCCADV developed this safety plan in English and Spanish for use in the Healthcare IPV Response Project.
Seeing Patients Alone Poster: recommended language for waiting room posters that will help facilitate seeing patients alone.