The IPV Provider Network: Engaging the Health Care Provider Response to Interpersonal Violence Against Women
Condition: Violence, Domestic; Violence, Sexual
Study type: Interventional

Summary: 
      Violence against women is a major public health threat that carries significant consequences
      for women's health. Moreover, women experiencing intimate partner violence (IPV) and sexual
      assault (SA) are more likely than non-abused women to seek certain forms of health services,
      such as for sexually transmitted infections, chronic pain and illnesses, depression and/or
      pregnancy-related concerns. As a result, the health sector is an ideal setting to identify
      and support survivors. The U.S. Institute of Medicine has identified the health care system,
      including the public health infrastructure, as key for identification of and support for
      survivors of violence, as well as for violence prevention. While some evidence-based models
      exist, no current national consensus has been reached on scalable best practices in screening
      and brief counseling for IPV/SA.

      This multi-level intervention includes integrating into the clinic setting IPV/SA screening,
      universal education, trauma informed counseling, warm referrals (e.g. provider/staff contact
      advocacy program with survivor) to local IPV/SA advocacy agencies, and access to the
      evidence-based myPlan safety decision aid app. The evaluation, using a cluster randomized
      trial design, will measure longitudinal outcomes (over 6 months) of patient self-efficacy,
      health and safety outcomes, as well as participant and provider perceptions of the
      intervention and clinic level changes in primary and reproductive health clinics in four
      states (Arizona, Massachusetts, Pennsylvania and West Virginia) to achieve the following
      aims:

      Aim 1. Evaluate the effectiveness of an evidence-based screening, universal education and
      trauma-informed counseling with tailored safety action plan and referrals to partner IPV/SA
      programs compared to standard practice, on survivor health and safety outcomes over a
      cumulative period of six months.

      Aim 2. Examine longitudinal changes in clinic-level screening, universal education, trauma
      informed counseling, safety action plans and referrals to on-site and/or partner IPV/SA
      programs and improved standards for documentation through the electronic health record (EHR)
      and continuous quality measurement and reporting.
    


Intervention name(s): Universal Education
Intervention type(s): Behavioral
Intervention description(s): Clinic provider/staff training on implementing universal education into clinical practice to: 1.) provide all women information about IPV/SA, harm reduction, and available safety resources; 2) provide trauma-informed counseling to women who disclose IPV/SA; includes access to the myPlan safety decision aid to develop a tailored safety action plan; 3) provide warm referrals in partnership with local domestic violence and sexual assault (DV/SA) advocacy agencies; 4) integrate documentation and quality improvement templates and measures into clinical settings.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: cluster randomized trial
Masking: Single (Participant)
Primary purpose: Treatment