Citation

Ahmad F, Hogg-Johnson S, Stewart DE, Skinner HA, Glazier RH, Levinson W. Ann. Intern Med. 2009; 151(2): 93-102.

Affiliation

Dalla Lana School of Public Health and Department of Medicine, University of Toronto; Institute for Work & Health; Women's Health Program, University Health Network; Faculty of Health, York University; and Centre for Research on Inner City Health, St.

Copyright

(Copyright © 2009, American College of Physicians)

DOI

unavailable

PMID

19487706

Abstract

BACKGROUND: Intimate partner violence and control (IPVC) is prevalent and can be a serious health risk to women. OBJECTIVE: To assess whether computer-assisted screening can improve detection of women at risk for IPVC in a family practice setting. DESIGN: Randomized trial. Randomization was computer-generated. Allocation was concealed by using opaque envelopes that recruiters opened after patient consent. Patients and providers, but not outcome assessors, were blinded to the study intervention. SETTING: An urban, academic, hospital-affiliated family practice clinic in Toronto, Ontario, Canada. PARTICIPANTS: Adult women in a current or recent relationship. INTERVENTION: Computer-based multirisk assessment report attached to the medical chart. The report was generated from information provided by participants before the physician visit (n = 144). Control participants received standard medical care (n = 149). MEASUREMENTS: Initiation of discussion about risk for IPVC (discussion opportunity) and detection of women at risk based on review of audiotaped medical visits. RESULTS: The overall prevalence of any type of violence or control was 22% (95% CI, 17 to 27). In adjusted analyses based on complete cases (n = 280), the intervention increased opportunities to discuss IPVC (adjusted relative risk, 1.4 [CI, 1.1 to 1.9]) and increased detection of IPVC (adjusted relative risk, 2.0 [CI, 0.9 to 4.1]). Participants recognized the benefits of computer screening but had some concerns about privacy and interference with physician interactions. Limitation: The study was done at 1 clinic, control was more prevalent than violence in relationships, and no measures of women's use of services or health outcomes was used. CONCLUSION: Computer screening effectively detected IPVC in a busy family medicine practice, and it was acceptable to patients.

Language: en