Screening for domestic violence doesn't always help
NEW YORK (Reuters Health) - Asking women about domestic violence through a computerized questionnaire and giving them a list of local abuse resources had no effect on their health or quality of life, a new study from Chicago-area health centers found.
Researchers agree that psychological and physical abuse in relationships is both common and a significant public health problem. But the question of how best to identify victims of violence and get them the help they need is unresolved.
"Although the findings are maybe disappointing to some, I don't think they should be used to conclude that screening for intimate partner violence in clinical settings shouldn't be done or doesn't work," said Andrea Gielen, head of the Johns Hopkins Center for Injury Research and Policy in Baltimore.
In June, the U.S. Preventive Services Task Force, a government-backed panel, released draft recommendations calling for doctors to screen women for intimate partner violence and refer those who screen positive for extra help (see Reuters Health story of June 12, 2012).
To test one option for screening and referral, Dr. Joanne Klevens of the Centers for Disease Control and Prevention and her colleagues randomly assigned more than 2,000 mostly poor, minority women in Cook County, Illinois to one of three groups.
Some of the women completed a computer questionnaire about domestic violence and, if they screened positive, watched a support and information video and received a list of local abuse resources. Another one-third of the women didn't undergo screening but did receive the list of resources. The final group had no screening and got no referral list.
In follow-up telephone interviews, researchers found that one in seven women had recently experienced intimate partner violence before the start of the study. And the majority of them continued to be abused a year later, regardless of whether or not they were screened by computer or received the resource list.
Learning about domestic violence resources also had no effect on women's physical or psychological health or on how often they went to the doctor or emergency room, the researchers reported Tuesday in the Journal of the American Medical Association.
"Just providing passive referral resources probably isn't enough," Klevens told Reuters Health.
But, "it's important to remember that this is just one study," she added.
"We think healthcare providers are well-situated to identify women who are experiencing partner violence. It makes a lot of sense for healthcare providers to ask women about partner violence and provide interventions."
According to a 2010 survey also done by the CDC, one-quarter of all U.S. women have been the victim of severe physical violence committed by a partner at some point.
Researchers said until more data on effective screening and interventions are available, doctors should still be asking women about abuse and identifying resources in the community where they can send them for help.
"We think the study does not rule out asking women questions about partner violence," Klevens said.
And women themselves shouldn't be afraid or ashamed to come forward if they are experiencing violence, Gielen told Reuters Health.
"They should feel comfortable asking their health provider for resources and help," she said.
SOURCE: bit.ly/JjFzqx Journal of the American Medical Association, online August 14, 2012.
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