Pregnant women identify benefits of combining computerized and in-person screening for domestic violence
When pregnant women were asked about intimate partner violence (IPV) at their initial obstetrics visit using both a computerized screening tool and in-person provider assessments, more women disclosed IPV in the response to the computer than to the provider. However, in semi-structured interviews, women IPV victims described benefits for both screening approaches and advised using both together.
The researchers found that the 52 providers in the study asked about IPV in 244 (97.6 percent) of 250 audiotaped patient visits. Overall, 36 percent of patients disclosed some form of IPV either via six questions on a tablet computer or in person. Of these women, 66 percent (60 women) disclosed via both methods, and 34 percent (31 women) disclosed IPV via only one of the methods, primarily via computer. Examining the disclosure discrepancies in more detail revealed that 22 of the women who only disclosed IPV via computer reported experiencing psychological IPV.
Twenty three of the women who had been IPV victims returned for a followup interview. While women described comfort with the anonymity and lack of immediate judgment when disclosing IPV to a computer, they also indicated that the dynamic interaction with a provider allowed them to sense their provider’s concern and empathy and allowed more flexibility in wording and communication styles. They also suggested providers use both type of methods to address IPV.
A 2010 national survey by the Centers for Disease Control and Prevention found that 35.6 percent of women in the United States have experienced rape, physical violence, or stalking by an intimate partner in their lifetime. Other studies estimate the prevalence of IPV during pregnancy to be between 4–8 percent, which is linked to delayed entry into prenatal care and postpartum depression. The findings from the current study involved audiotaping the women’s first obstetric visit and collecting data from tablet computers offered to the patients that presented six questions covering physical, psychological, and sexual IPV.
The study was funded by AHRQ (HS13913). More details are in "In person versus computer screening for intimate partner violence among pregnant patients," by Judy C. Chang, M.D., M.P.H., Diane Dado, M.S.W., Sara Schussler, and others in the September 2012 Patient Education and Counseling 88(3), pp. 443-448.