Confidential IPV Screening Tool

EHR-based Screening and Intervention for Intimate Partner Violence

Intimate partner violence (IPV) against women in the US is a serious public health problem and a human rights issue. Our research team has developed confidential screening tools using exam-room computer for intimate partner violence to be used in primary care.

Study Overview

• Status: Completed
• Conditions: Violence, Domestic
• Intervention / Treatment: Diagnostic test: Screening for intimate partner violence; Other: Assessment and referral

Detailed Description

The objective of this study was to develop and evaluate an integrated suite of electronic health record (EHR) tools that automates "best practices" from Northern California Kaiser Permanente for screening and intervention for IPV identified within clinical settings. The goal of the intervention goes beyond mere screening of patients for IPV and includes tools for assessment of IPV risk, for documentation of IPV care, and support for a warm hand-off during the primary care visit to a national IPV hotline resource. Importantly, the study includes work to keep notes documenting IPV and billing for IPV care confidential, segmenting this care in a secure segment of the electronic health record.

• Study Type: Interventional
• Enrollment (Actual): 19655
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • South Carolina
    • Charleston, South Carolina, United States, 29403
      • Biomedical Informatics Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Being an Medical University of South Carolina patient at primary care clinics (family medicine)
• Women 18-49 years of age inclusive
• Reported yes to wanting to be contacted for a follow-up research study
• English-speaking

Exclusion Criteria:

• No exclusion criteria

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Screening
• Allocation: Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Sequence 1; 5 clinics. In stepped wedge design study, this was the sequence with shortest control (run-in) period. All sequences have a run-in period and intervention period. In control period participants were screened using existing nurse-led oral screening, in intervention period both - nurse-led and our new confidential screen were used at the same time.	Diagnostic test: Screening for intimate partner violence; confidential screening using exam computer; Other: Assessment and referral; confidential assessment and referral of high-risk patients using decision-support templates
Other: Sequence 2; 5 clinics.	Diagnostic test: Screening for intimate partner violence; confidential screening using exam computer; Other: Assessment and referral; confidential assessment and referral of high-risk patients using decision-support templates
Other: Sequence 3; 5 clinics. This was the sequence with longest control (run-in) period.	Diagnostic test: Screening for intimate partner violence; confidential screening using exam computer; Other: Assessment and referral; confidential assessment and referral of high-risk patients using decision-support templates

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
IPV positive (Yes/No)	Depending on patient's answers to screening questions, they are flagged as either IPV positive or negative	29 months
Screening completed (Yes/No)	Whether the assigned screening was completed during patient visit	29 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Severity of risk	using Danger 5 risk assessment, ranging from 0 to 5	29 months
Physician compliance with IPV management tools	Measured as the rate of completion of follow-up decision templates, and the rate of referrals for post-visit counseling to a national hotline (a share from screened positive patients	29 months

Collaborators and Investigators

• Sponsor: Medical University of South Carolina
• Collaborators: Agency for Healthcare Research and Quality (AHRQ)

Study record dates

Study Major Dates

• Study Start (Actual): October 6, 2010
• Primary Completion (Actual): July 31, 2023
• Study Completion (Actual): July 31, 2023

Study Registration Dates

• First Submitted: February 9, 2024
• First Submitted That Met QC Criteria: February 21, 2024
• First Posted (Actual): February 28, 2024

Study Record Updates

• Last Update Posted (Actual): February 28, 2024
• Last Update Submitted That Met QC Criteria: February 21, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Intimate Partner Violence
• Other Study ID Numbers: Pro00093964; 5R18HS025654-03 (U.S. AHRQ Grant/Contract)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No