Does Routine Screening for Intimate Partner Violence Against Women in Health Care Settings do More Good Than Harm?

If, When and How to Ask the Question(s): Assessing Screening Approaches to Identifying Woman Abuse in Health Care Settings

The purpose of the research is to evaluate whether routine screening for woman abuse in health care settings, as compared to no screening, does more good than harm. Recent reviews have identified the need for high quality research to understand 1) the actual impact on all women of instituting mass screening procedures to identify woman abuse and 2) the extent to which early identification through screening is effective in preventing or ameliorating important outcomes. The main outcomes for the study are reduction in violence, improvement in life quality, and potential harms of screening. A number of secondary outcomes to help understand the process by which screening and usual care might lead to changes in the primary outcomes will also be assessed.

Study Overview

• Status: Completed
• Conditions: Intimate Partner Violence Against Women
• Intervention / Treatment: Other: Screening for intimate partner violence

• Study Type: Interventional
• Enrollment (Actual): 5681
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Brantford, Ontario, Canada, N3T 3C4
      • Brantford Aboriginal Health Centre
    • Burlington, Ontario, Canada, L7R 4C4
      • Joseph Brant Hospital
    • Grimsby, Ontario, Canada, L3M 1P3
      • West Lincoln Memorial Hospital
    • Grimsby, Ontario, Canada, L3M 1P2
      • Grimsby Medical Associates
    • Hamilton, Ontario, Canada, L8N 3Z5
      • McMaster University Medical Centre
    • Hamilton, Ontario, Canada, L8R 3L5
      • City of Hamilton Public Health and Community Services Department
    • Hamilton, Ontario, Canada, L8G 5E4
      • St. Joseph's Centre for Ambulatory Health Services
    • Hamilton, Ontario, Canada, L8K 1W2
      • Rosedale Medical Group
    • Hamilton, Ontario, Canada, L8L 4S1
      • North Hamilton Community Health Centre
    • Hamilton, Ontario, Canada, L8M 1K2
      • Aboriginal Health Centre
    • Hamilton, Ontario, Canada, L8R 1B6
      • Hamilton Urban Core Community Health Centre
    • Hamilton, Ontario, Canada, L8S 1A4
      • West End Clinic
    • Hamilton, Ontario, Canada, L8S 1B7
      • HART Clinic
    • London, Ontario, Canada, N6A 5A5
      • University Hospital
    • London, Ontario, Canada, N6A 4G5
      • Victoria Hospital
    • London, Ontario, Canada, N6A 4V2
      • St. Joseph's Health Care - Women's Ambulatory Health Centre
    • London, Ontario, Canada, N6A 4V2
      • St. Joseph's Urgent Care
    • London, Ontario, Canada, N6A 5R9
      • London Family Practice - Dr. Bhayana
    • London, Ontario, Canada, N6G 1J1
      • St. Joseph's Family Medical & Dental Centre
    • Paris, Ontario, Canada, N3L 2N7
      • Willett Hospital Urgent Care
    • St. Catharines, Ontario, Canada, L2R 5K2
      • Niagara Health Prompt Care
    • Sudbury, Ontario, Canada, P3B 1R6
      • Sudbury Family Physicians
    • Sudbury, Ontario, Canada, P3E 1H5
      • Sudbury Brady Clinic
    • Sudbury, Ontario, Canada, P3E 3A3
      • Sudbury District Health Unit
    • Sudbury, Ontario, Canada, P3E 3B5
      • Hopital Regional de Sudbury Regional Hospital, Emergency Services
    • Toronto, Ontario, Canada, M5G 1X5
      • Mt. Sinai Hospital
    • Toronto, Ontario, Canada, L8G 5E4
      • Mt. Sinai Hospital, Obstetrics & Gynecology Clinic
    • Toronto, Ontario, Canada, M5V 2R4
      • Central Toronto Community Health Centre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 64 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Women aged 18-64 years
• Patients at the health care site
• Able to participate in English
• Able to separate from accompanying person(s)

Exclusion Criteria:

• Too ill to participate
• Unable to separate from accompanying person(s)
• Unable to speak, read, or write English

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Screening
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1; Women are screened for intimate partner violence prior to seeing a health care provider.	Other: Screening for intimate partner violence; Women are screened for intimate partner violence prior to seeing a health care provider.
No Intervention: 2; Women see their health care provider without being asked about intimate partner violence.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Recurrence of intimate partner violence	18 months
Health-specific quality of life	18 months
Harms of screening and/or usual care	18 months

Secondary Outcome Measures

Outcome Measure	Time Frame
Mental health (depression, post-traumatic stress disorder [PTSD], anxiety, somatic complaints, substance use)	18 months
Global physical and emotional health and well-being	18 months
Health services utilization	18 months
Safety behaviours	18 months
Use of information and resources	18 months
Child quality of life	18 months
Stage in process of identifying and resolving abuse	18 months
Exposure to maltreatment as a child	18 months

Collaborators and Investigators

• Sponsor: McMaster University
• Collaborators: Echo: Improving Women's Health in Ontario (formerly Ontario Women's Health Council)
• Investigators: Principal Investigator: Harriet L MacMillan, MD, MSc, McMaster University

Publications and helpful links

General Publications

• MacMillan HL, Wathen CN, Jamieson E, Boyle MH, Shannon HS, Ford-Gilboe M, Worster A, Lent B, Coben JH, Campbell JC, McNutt LA; McMaster Violence Against Women Research Group. Screening for intimate partner violence in health care settings: a randomized trial. JAMA. 2009 Aug 5;302(5):493-501. doi: 10.1001/jama.2009.1089.

Study record dates

Study Major Dates

• Study Start: April 1, 2005
• Primary Completion (Actual): July 1, 2008
• Study Completion (Actual): July 1, 2008

Study Registration Dates

• First Submitted: September 13, 2005
• First Submitted That Met QC Criteria: September 13, 2005
• First Posted (Estimate): September 16, 2005

Study Record Updates

• Last Update Posted (Estimate): September 9, 2009
• Last Update Submitted That Met QC Criteria: September 8, 2009
• Last Verified: September 1, 2009

More Information

Terms related to this study

• Keywords: Domestic violence; Spouse Abuse
• Other Study ID Numbers: MacMillan_VAW_RCT