Intimate Partner Violence Screening Programs in VHA: Informing Scale-Up and Spread of Best Practices

Va Boston Health Care System, Boston MA

Investigators

Abstract

Background Intimate partner violence (IPV) is a major health concern, particularly for women Veterans. Women who experience IPV present frequently in health settings, providing opportunity for detection and intervention. The Veterans Health Administration (VHA) is implementing IPV screening programs in primary care. This is a critical first step to ensuring women Veterans receive quality care that leads to improved health. However, the initial uptake of IPV screening is low and there is variation in the clinical practices and implementation characteristics of IPV screening programs across VHA. As the implementation of IPV screening programs is still in its infancy, there is a time-sensitive opportunity to learn from VA Medical Centers that have implemented IPV screening programs to inform the scale-up and spread of best practices. Objectives This proposal will identify the `what,' `how' and `why' of successful implementation of IPV screening programs in VHA. The Specific Aims are to: 1) characterize best practices of IPV screening programs in VHA through key stakeholder interviews with clinicians and administrators (n>30) at five high and five low adopting facilities; 2) understand multi-level barriers to and facilitators of IPV screening program implementation through the interviews with key stakeholders in the high and low adopting facilities; and, 3) tailor context-sensitive implementation strategies through input from a Stakeholder Advisory Board to inform a future research proposal to enhance implementation effectiveness of IPV screening programs in VHA. Methods For Aims 1 and 2, we will collect qualitative data through key stakeholder interviews with clinicians and administrators (n>30) at VA Medical Centers that have implemented IPV screening within women's health clinics. High and low adopting sites have been identified by Care Management and Social Work Services. We will purposively select five high and five low adopting sites for participation. At each site, we will interview between 2-4 key administrators and clinicians (e.g., Women's Health Medical Director). Interviews will assess the IPV screening and response practices used in the clinics and identify implementation characteristics. Qualitative findings will inform the tailoring of implementation strategies through input from a Stakeholder Advisory Board (Aim 3). Anticipated Impact on Veteran's Healthcare VHA's Blueprint for Excellence identifies ?advancing innovations in women Veterans' health care? as a key transformational strategy. This program of research will address this goal for IPV care. The research will advance national efforts by establishing best clinical practices for IPV screening programs and strategies useful for enhancing implementation of IPV screening programs, thereby ultimately improving services for and health of women Veterans.