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Implementing Screening for IPV in Medical Settings

By Jenny Jo Allen, ASPEN’s Education & Outreach Coordinator

IPV, short for “Intimate Partner Violence” encompasses physical violence, sexual and psychological aggression, and stalking by a romantic partner. In the U.S., approximately 1 in 4 women and 1 in 10 men annually report experiencing IPV, according to the Center for Disease Control (CDC).

A study published in the Feb. 28, 2019, New England Journal of Medicine (NEJM) found evidence that “women experiencing IPV may have more medical, gynecologic, and stress related symptoms than women who aren’t abused, including asthma, arthritis, stroke and cardiovascular disease. The acute and chronic stress caused by IPV may also increase the risk of autoimmune disorders and cancer and contribute to the use of cigarettes and other substances as coping strategies.” These findings support the need for medical providers to understand how IPV can influence an individual patient’s health and implement IPV screening tools and health care interventions that support survivors of IPV without stigma.

In the Oct. 2020, American College of Physicians (ACP) vol.40 No.9 issue, IPV expert, Brigid McCaw, MD, MS, MPH, FACP, gives an example of how she begins annual exams, “Because violence is so common, I’ve begun asking all of my patients about it routinely. In the past year, has your partner or anyone at home hit, hurt, threatened or frightened you?” Alternatively, “A lot of times when people struggle with controlling an illness or condition it’s because there’s something really stressful going on in their lives. Knowing what’s going on in your life will help me take better care of your health.” By providing all patients with the same screening questions, patients will be less likely to feel singled out, especially if the screening is adopted as protocol for all patients and not used per the discretion of individual providers who may not be educated on the topic of intimate partner violence.

The U.S. Preventive Services Task Force (USPSTF) recommends routine screening for IPV in medical settings, and yet implementation in primary care has been slow with rates ranging from 1.5 to 12%, according to ACP. One of the most common barriers to implementing IPV screenings in medical settings is a lack of physician comfort and/or training on intimate partner violence. In Park, Sweetgrass and Meagher counties of Montana, violence prevention staff at ASPEN (Abuse Support & Prevention Education Network) are available to help health care teams implement IPV screening tools in their everyday practice free of charge. ASPEN’s flexible scheduling can accommodate groups of 3 to 30 people, and routine refresher courses are also available. For more information, call or text ASPEN’s Education & Outreach Coordinator at 406-600-1241, or email to schedule an appointment.

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