Advertisement

Journal of General Internal Medicine

, Volume 22, Issue 5, pp 579–584 | Cite as

Screening for Domestic Violence Among Adult Women in the United States

  • Ruth Klap
  • Lingqi Tang
  • Kenneth Wells
  • Sarah L. Starks
  • Michael Rodriguez
Original Article

Abstract

Background

Domestic violence is a problem frequently encountered in health care settings and a risk factor for physical and mental health problems.

Objective

To provide nationally representative estimates of rates of domestic violence screening among women, to identify predictors of screening, and to describe settings where women are screened.

Design and Participants

We examined 4,821 women over the age of 18 from the second wave of Healthcare for Communities, a nationally representative household telephone survey conducted in 2000–2001.

Measurements

Self-reports concerning whether the respondent was ever asked about domestic or family violence by any health care provider.

Results

Only 7% (95% CI, 6%–8%) of women reported they were ever asked about domestic violence or family violence by a health care professional. Of women who were asked about abuse, nearly half (46%) were asked in a primary care setting, and 24% were asked in a specialty mental health setting. Women with risk factors for domestic violence were more likely to report being asked about it by a health care professional, but rates were still low.

Conclusions

Self-reported rates of screening for domestic violence are low even among women at higher risk for abuse. These findings reinforce the importance of developing training and raising awareness of domestic violence and its health implications. This is especially true in primary care and mental health specialty settings.

KEY WORDS

domestic violence intimate partner violence screening 

Notes

Acknowledgments

This study was supported by the Robert Wood Johnson Foundation (grant 038273) and the National Institute of Mental Health (grant P30 MH068639). The Robert Wood Johnson Foundation approved the design and conduct of the study. We thank Lily Zhang, MS, for data analysis. Preliminary results were presented at the Academy Health Annual Research Meeting in Boston in June 2005. Any opinions expressed in this study are those of the authors and do not necessarily represent the views of any affiliated institutions.

Potential Financial Conflicts of Interest:

None disclosed.

References

  1. 1.
    McCloskey LA, Lichter E, Ganz ML, et al. Intimate partner violence and patient screening across medical specialties. Acad Emerg Med. 2005;12(8):712-22.PubMedCrossRefGoogle Scholar
  2. 2.
    Sassetti MR. Domestic violence. Prim Care. 1993;20(2):289-305.PubMedGoogle Scholar
  3. 3.
    Department of Health and Human Services. Costs of Intimate Partner Violence Against Women in the United States. Atlanta: Centers for Disease Control and Prevention; 2003Google Scholar
  4. 4.
    Campbell JC. Health consequences of intimate partner violence. Lancet. 2002;359(9314):1331–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Bergman B, Brismar B. A 5-year follow-up study of 117 battered women. Am J Public Health. 1991;81(11):1486–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Ulrich YC, Cain KC, Sugg NK, Rivara FP, Rubanowice DM, Thompson RS. Medical care utilization patterns in women with diagnosed domestic violence. Am J Prev Med. 2003;24(1):9–15.PubMedCrossRefGoogle Scholar
  7. 7.
    Alpert EJ. Violence in intimate relationships and the practicing internist: new “disease” or new agenda? Ann Intern Med. 1995;123(10):774–81.PubMedGoogle Scholar
  8. 8.
    Flitcraft A. Physicians and domestic violence: challenges for prevention. Health Aff (Millwood). 1993;12(4):154–61.CrossRefGoogle Scholar
  9. 9.
    Rhodes KV, Levinson W. Interventions for intimate partner violence against women: clinical applications. JAMA. 2003;289(5):601–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Warshaw C, Alpert E. Integrating routine inquiry about domestic violence into daily practice. Ann Intern Med. 1999;131(8):619–20.PubMedGoogle Scholar
  11. 11.
    Kemper P, Blumenthal D, Corrigan JM, et al. The design of the community tracking study: a longitudinal study of health system change and its effects on people. Inquiry. 1996;33(2):195–206.PubMedGoogle Scholar
  12. 12.
    Kramer A, Lorenzon D, Mueller G. Prevalence of intimate partner violence and health implications for women using emergency departments and primary care clinics. Womens Health Issues. 2004;14(1):19–29.PubMedCrossRefGoogle Scholar
  13. 13.
    Sugg NK, Inui T. Primary care physicians’ response to domestic violence. Opening Pandora’s box. Womens Health Issues. JAMA. 1992;267(23):3157–60.PubMedCrossRefGoogle Scholar
  14. 14.
    American Medical Association Diagnostic and Treatment Guidelines on Domestic Violence. Arch Fam Med. 1992;1(1):39–47.Google Scholar
  15. 15.
    American College of Obstetricians and Gynecologists. Screening Tools-Domestic Violence 2006 [http://www.acog.org/departments/dept_notice.cfm?recno=17&bulletin=585, cited 2006 August 3].
  16. 16.
    Novello AC, Rosenberg M, Saltzman L, Shosky J. From the Surgeon General, US Public Health Service. JAMA. 1992;267(23):3132.PubMedCrossRefGoogle Scholar
  17. 17.
    Screening for family and intimate partner violence: recommendation statement. Ann Fam Med. 2004;2(2):156–60.Google Scholar
  18. 18.
    Summaries for patients. Screening for family violence: recommendations from the U.S. Preventive Services Task Force. Ann Intern Med. 2004;140(5):I70.Google Scholar
  19. 19.
    Nelson HD, Nygren P, McInerney Y, Klein J. Screening women and elderly adults for family and intimate partner violence: a review of the evidence for the U. S. Preventive Services Task Force. Ann Intern Med. 2004;140(5):387–96.PubMedGoogle Scholar
  20. 20.
    Ramsay J, Richardson J, Carter YH, Davidson LL, Feder G. Should health professionals screen women for domestic violence? Systematic review. BMJ. 2002;325(7359):314.PubMedCrossRefGoogle Scholar
  21. 21.
    Bradley F, Smith M, Long J, O’Dowd T. Reported frequency of domestic violence: cross sectional survey of women attending general practice. BMJ. 2002;324(7332):271.PubMedCrossRefGoogle Scholar
  22. 22.
    Friedman LS, Samet JH, Roberts MS, Hudlin M, Hans P. Inquiry about victimization experiences. A survey of patient preferences and physician practices. Arch Intern Med. 1992;152(6):1186–90.PubMedCrossRefGoogle Scholar
  23. 23.
    Hamberger LK, Saunders DG, Hovey M. Prevalence of domestic violence in community practice and rate of physician inquiry. Fam Med. 1992;24(4):283–7.PubMedGoogle Scholar
  24. 24.
    Rodriguez MA, Bauer HM, McLoughlin E, Grumbach K. Screening and intervention for intimate partner abuse: practices and attitudes of primary care physicians. JAMA. 1999;282(5):468–74.PubMedCrossRefGoogle Scholar
  25. 25.
    Parsons LH, Zaccaro D, Wells B, Stovall TG. Methods of and attitudes toward screening obstetrics and gynecology patients for domestic violence. Am J Obstet Gynecol. 1995;173(2):381–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Ware J, Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33.PubMedCrossRefGoogle Scholar
  27. 27.
    Kessler RC, Andrews G, Mroczek D, Ustun B, H.U W. The World Health Organization composite international diagnostic interview short-form (CIDI-SF). Int J Methods Psychiatr Res. 1998;7(4):171–85.CrossRefGoogle Scholar
  28. 28.
    Bergner M, Bobbitt RA, Carter WB, Gilson BS. The Sickness Impact Profile: development and final revision of a health status measure. Med Care. 1981;19(8):787–805.PubMedCrossRefGoogle Scholar
  29. 29.
    The Alcohol Use Disorders Identification Test (AUDIT). Guidelines for Use In Primary Care. Geneva, Switzerland: World Health Organization; 1992.Google Scholar
  30. 30.
    Koch G, Freeman DH, Freeman JL. Strategies in multivariate analysis of data from complex surveys. Int Stat Rev. 1975;43:59–78.CrossRefGoogle Scholar
  31. 31.
    Research Triangle Institute. SUDAAN user’s manual, Release 9.0. Research Triangle Park NC: Research Triangle Institute; 2004.Google Scholar
  32. 32.
    Rubin D. Multiple Imputation for Non-response in Surveys. New York, NY: John Wiley & Sons; 1987.Google Scholar
  33. 33.
    McCauley J, Kern DE, Kolodner K, et al. The “battering syndrome”: prevalence and clinical characteristics of domestic violence in primary care internal medicine practices. Ann Intern Med. 1995;123(10):737–46.PubMedGoogle Scholar
  34. 34.
    Coker AL, Davis KE, Arias I, et al. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med. 2002;23(4):260–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Plichta SB, Falik M. Prevalence of violence and its implications for women’s health. Womens Health Issues. 2001;11(3):244–58.PubMedCrossRefGoogle Scholar
  36. 36.
    Dearwater SR, Coben JH, Campbell JC, et al. Prevalence of intimate partner abuse in women treated at community hospital emergency departments. JAMA. 1998;280(5):433–8.PubMedCrossRefGoogle Scholar
  37. 37.
    Newman JD, Sheehan KM, Powell EC. Screening for intimate-partner violence in the pediatric emergency department. Pediatr Emerg Care. 2005;21(2):79–83.PubMedCrossRefGoogle Scholar
  38. 38.
    Abbott J, Johnson R, Koziol-McLain J, Lowenstein SR. Domestic violence against women. Incidence and prevalence in an emergency department population. JAMA. 1995;273(22):1763–7.PubMedCrossRefGoogle Scholar
  39. 39.
    Alpert EJ. Domestic violence and clinical medicine: learning from our patients and from our fears. J Gen Intern Med. 2002;17(2):162–3.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Ruth Klap
    • 1
  • Lingqi Tang
    • 1
  • Kenneth Wells
    • 1
    • 2
    • 4
    • 5
  • Sarah L. Starks
    • 1
  • Michael Rodriguez
    • 3
  1. 1.Semel Institute for Neuroscience and Human BehaviorUniversity of California at Los AngelesLos AngelesUSA
  2. 2.RAND CorporationSanta MonicaUSA
  3. 3.Department of Family MedicineDavid Geffen School of Medicine, University of California at Los AngelesLos AngelesUSA
  4. 4.Department of Psychiatry and Biobehavioral SciencesDavid Geffen School of Medicine, University of California at Los AngelesLos AngelesUSA
  5. 5.Department of Health ServicesUCLA School of Public Health, University of California at Los AngelesLos AngelesUSA

Personalised recommendations