Journal of Family Violence

, Volume 19, Issue 1, pp 1–11 | Cite as

Evaluation of a Health Care Provider Training Program to Identify and Help Partner Violence Victims

  • L. Kevin Hamberger
  • Clare Guse
  • Jennifer Boerger
  • Debbie Minsky
  • Deb Pape
  • Christine Folsom


This study tested four hypotheses about the impact of a 3-h domestic violence training program with 752 health care providers on attitudes and values related to screening and helping partner violence victims. Hypotheses 1, 2, and 3 were that training would be related to: 1) increased self-efficacy to identify and help partner violence victims, 2) increased endorsement of the role of health care providers and settings for helping partner violence victims, and 3) increased comfort making appropriate community referrals to help partner violence victims. Hypothesis 4 was that training effects would be moderated by prior training and by prior experience with helping a victim. Following training, health care providers reported increased self-efficacy, increased comfort making appropriate community referrals, and increased valuation of health care providers and the health care system as having an important role in stopping domestic violence. Hypothesis 4 was also supported. Prior training and/or experience with an abuse victim predicted smaller changes in the dependent variables. These gains held at a 6-month follow-up. Implications for training curriculum design are discussed, in addition to institutional policy implications for determining the benefits versus costs of universal training, including staff who demonstrate prior training or experience with battered victims. Study limitations and future research directions, including the need to measure performance and policy compliance will also be outlined.

domestic violence health care training self-efficacy 


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  1. Ambuel, B., Hamberger, L. K., and Lahti, J. (1997). The Family Peace Project: A model for training health care professionals to identify, treat, and prevent partner violence. In Hamberger, L. K., Burge, S., Graham, A., and Costa, A. (eds.), Violence Issues for Health Care Educators and Providers, Haworth, Binghamton, NY, pp. 55-81.Google Scholar
  2. Baker, N., and Reif, C. J. (1997). Designing a program to teach and practice domestic violence intervention using a community oriented primary care framework. In Hamberger, L. K., Burge, S., Graham, A., and Costa, A. (eds.), Violence Issues for Health Care Educators and Providers, Haworth, Binghamton, NY, pp. 33-54.Google Scholar
  3. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychol. Rev. 84: 191-215.Google Scholar
  4. Bandura, A. (1982). Self-efficacy mechanism in human agency. Am. Psychol. 37: 122-147.Google Scholar
  5. Bergman, B., and Brismar, B. (1991). A 5-year follow-up of 117 battered women. Am. J. Public Health 81: 1486-1488.Google Scholar
  6. Box, G. E. P., and Cox, D. R. (1964). An analysis of transformation. J. R. Stat. Soc. 5: 22-25.Google Scholar
  7. Cantos, A. L., Neidig, P., and O'Leary, K. D. (1994). Injuries of women and men in a treatment program for domestic violence. J. Fam. Violence 9: 113-124.Google Scholar
  8. Cascardi, M., Langhinrichsen, J., and Vivian, D. (1992). Marital aggression: Impact, injury, and health correlates for husbands and wives. Arch. Intern. Med. 152: 1178-1184.Google Scholar
  9. Coben, J. H., Forjuoh, S. N., and Gondolf, E. W. (1999). Injuries and health care use in women with partners in batterer intervention programs. J. Fam. Violence 14: 83-94.Google Scholar
  10. Coonrod, D. V., Bay, R. C., Rowley, B. D., DelMar, N. B., Gabriele, L., Tessman, T. D., and Chambliss, L. R. (2000). A randomized controlled study of brief interventions to teach residents about domestic violence. Acad. Med. 25: 55-57.Google Scholar
  11. Cornwell, E. E., Jacobs, D., Walker, M., Jacobs, L., Porter, J., and Fleming, A. (1995). National Medical Association surgical section position paper on violence prevention. JAMA 273: 1788-1789.Google Scholar
  12. Covington, D. L., Maxwell, G., Clancy, T. V., Churchill, M. P., and Ahrens, W. L. (1995). Poor hospital documentation of violence against women. J. Trauma Inj. Infect. Crit. Care 38: 412-416.Google Scholar
  13. Dearwater, S. R., Coben, J. H., Campbell, J. C., Nah, G., Glass, N., McLoughlin, E., and Bekemeier, B. (1998). Prevalence of intimate partner abuse in women treated at community hospital emergency departments. JAMA 289: 433-438.Google Scholar
  14. Feldhaus, K., Koziol-McLain, J., Amsbury, H. L., Norton, I. M., Lowenstein, S. R., and Abbott, J. L. (1997). Accuracy of 3 brief screening questions for detecting partner violence in the emergency department. JAMA 277: 1357-1361.Google Scholar
  15. Gazmararian, J. A., Lazorick, S., Spitz, A. M., Ballard, T. J., Saltzman, L. E., and Marks, J. S. (1996). Prevalence of violence against pregnant women: A review article. JAMA 275: 1915-1920.Google Scholar
  16. Gin, N. E., Rucker, L., Frayne, S., Cygan, R., and Hubbell, A. (1991). Prevalence of domestic violence among patients in three ambulatory care internal medicine clinics. J. Gen. Intern. Med. 6: 317-322.Google Scholar
  17. Gleason, W. J. (1993). Mental disorders in battered women: An empirical study. Violence Vict. 8: 53-68.Google Scholar
  18. Golding, J. M. (1999). Intimate partner violence as a risk factor for mental disorders: A meta-analysis. J. Fam. Violence 14: 99-132.Google Scholar
  19. Hamberger, L. K., and Ambuel, B. (2000). Community collaboration to develop research programs in domestic violence. J. Aggression Maltreatment Trauma 4: 239-272.Google Scholar
  20. Hamberger, L. K., Saunders, D. G., and Hovey, M. (1992). Prevalence of domestic violence in community practice and rate of physician inquiry. Fam. Med. 24: 283-287.Google Scholar
  21. Helton, A. S., McFarlane, J., and Anderson, E. T. (1987). Battered and pregnant: A prevalence study. Am. J. Public Health 77: 1337-1339.Google Scholar
  22. Johnson, M., and Elliott, B. A. (1997). Domestic violence among family practice patients in midsized and rural communities. J. Fam. Pract 44: 391-399.Google Scholar
  23. Mandel, J. B., and Marcotte, D. B. (1983). Teaching family practice residents to identify and treat battered women. J. Fam. Pract. 17: 708-716.Google Scholar
  24. McFarlane, J., Parker, B., Soeken, K., and Bullock, L. (1992). Assessing for abuse during pregnancy: Severity and frequency of injuries and associated entry into prenatal care. JAMA 267: 3176-3178.Google Scholar
  25. McLeer, S. V., Anwar, R., Herman, S., and Maquiling, K. (1989). Education is not enough: A system failure in protecting battered women. Ann. Emerg. Med. 18: 651-653.Google Scholar
  26. New York State Office for Prevention of Domestic Violence. It's Not OK, Running time, 20 minutes, Albany, NY, Joseph Feury Productions.Google Scholar
  27. Olson, L., Anctil, C., Fullerton, L., Brillman, J., Arbuckle, J., and Sklar, D. (1996). Increasing emergency physician recognition of domestic violence. Ann. Emerg. Med. 27: 741-745.Google Scholar
  28. Riley, D. (1997). Educational methods in teaching about violence. In Hamberger, L. K., Burge, S., Graham, A., and Costa, A. (eds.), Violence Issues for Health Care Educators and Providers, Haworth, Binghamton, NY, pp. 131-152.Google Scholar
  29. Roberts, G. L., O'Toole, B. I., Raphael, B., Lawrence, J. M., and Ashby, R. (1996). Prevalence study of domestic violence victims in an emergency department. Ann. Emerg. Med. 27: 747-753.Google Scholar
  30. Sassetti, M. (1992). Battered women. In Hendricks-Matthews, M. (ed.), Violence Education: Toward a Solution, Society of Teachers of Family Medicine, Kansas City, MO, pp. 31-54.Google Scholar
  31. Saunders, D. G. (1994). Posttraumatic stress symptom profiles of battered women: A comparison of survivors in two settings. Violence Vict. 9: 125-138.Google Scholar
  32. Saunders, D. G., and Kindy, P. (1993). Predictors of physicians' responses to woman abuse: The role of gender, background, and brief training. J. Gen. Intern. Med. 8: 606-609.Google Scholar
  33. Short, L. M., Cotton, D., and Hodgson, C. S. (1997). Evaluation of the module on domestic violence at the UCLA School of Medicine. Acad. Med. 72: 75-92.Google Scholar
  34. Stark, E., Flitcraft, A., and Frazier, W. (1979). Medicine and patriarchal violence: The social construction of a private event. Int. J. Health Serv. 9: 461-493.Google Scholar
  35. StataCorp (1999). Stata Statistical Software: Release 6.0, Stata Corporation, College Station, TX.Google Scholar
  36. Sugg, N. K., and Inui, T. (1992). Primary care physicians' response to domestric violence: Opening Pandora's Box. JAMA 267: 3157-3160.Google Scholar
  37. Thompson, R. S., Meyer, B. A., Smith-DiJulio, K., Caplow, M. P., Maiuro, R. D., Thompson, D. C., Sugg, N. K., and Rivara, F. P. (1998). A training program to improve domestic violence identification and management in primary care: Preliminary results. Violence Vict. 13: 395-410.Google Scholar
  38. Ware, J. H., Mosteller, F., Delgado, F., Donnelly, C., and Ingelfinger, J. A. (1992). P-values. In Bailor, J. C., III, and Mosteller, F. (eds.), Medical Uses of Statistics, 2nd edn., NEJM Books, Boston, pp. 181-200.Google Scholar
  39. Warshaw, C. (1989). Limitations of the medical model in the care of battered women. Gender Soc. 3: 506-517.Google Scholar
  40. Wisner, C. L., Gilmer, T. P., Saltzman, L. E., and Zink, T. M. (1999). Intimate partner violence against women: Do victims cost health plans more? J. Fam. Pract. 48: 439-443.Google Scholar

Copyright information

© Plenum Publishing Corporation 2004

Authors and Affiliations

  • L. Kevin Hamberger
    • 1
  • Clare Guse
    • 1
  • Jennifer Boerger
    • 2
  • Debbie Minsky
    • 2
  • Deb Pape
    • 2
  • Christine Folsom
    • 3
  1. 1.Department of Family and Community MedicineMedical College of WisconsinMilwaukee
  2. 2.All Saints Health Care Systems, Inc.Racine
  3. 3.Women's Resource Center, Inc.Racine

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