Attitudes and barriers to intimate partner violence screening and follow-up during prenatal care as reported by survivors in the El Paso, Texas region
About 37.1% of Hispanic women in the United States have experienced intimate partner violence (IPV) (Breiding, 2014). In Texas, family violence cases among women comprised 73% of the total complaints (Texas Department of Public Safety 2012), and fatalities of women by an intimate partner totaled 102 women in 2011 (Office of Court Administration, 2013). In El Paso, Texas, the Center Against Sexual and Family Violence (CASFV) received 823 people in its emergency shelter from 2012 to 2013 and 70% of those residents were women (Center Against Family Violence, 2015). The Healthy People 2020 has assigned developmental objective IVP-39, under the Injury and Violence Prevention topic, to reduce violence by current or former intimate partners (U.S. Department of Health and Human Services, 2013). IPV occurring prior to pregnancy may continue through it in 59% of women and IPV with related homicide is a leading cause of death by injury among pregnant women (Dunn & Oths, 2014). Health care providers have a unique opportunity to identify IPV. Two out of every five femicide victims requested medical attention one year prior to the fatality (Sharps, Koziol-McLain, Campbell, McFarlane, Sachs, & Xu, 2001). The American Congress of Obstetricians and Gynecologists recommends providers to screen for IPV throughout pregnancy (ACOG, 2014). It is estimated that only about 22-39% of pregnant women are screened for IPV during prenatal care (Anderson, B., Marshak, H., & Hebbeler, D., 2002). Nevertheless, the communication about IPV between health care providers and survivors can be limited by factors including linguistic barriers (Schouten & Meeuwesen, 2006), and fear of retaliation (Rodriguez, M. A., Bauer, H. M., McLoughlin, E., & Grumbach, K., 1999). Moreover, it has been documented that Hispanics are less likely to report abuse (Anderson et al., 2002) and to receive timely prenatal care (Bengiamin, Capitman, & Ruwe, 2010), compared to other ethnicities. This mixed methods exploratory study documents the frequency of IPV screenings and follow-ups during pregnancy among IPV survivors and examines the attitudes and the barriers related to the communication about IPV between the survivor and the prenatal care provider. A standardized semi-structured individual interview guide was used to collect quantitative and qualitative data from 13 participants. The participants were adult women who had utilized services from the CASFV in El Paso, Texas during the last three years, had delivered at least once during the last three years, and had one prenatal care visit during the last pregnancy. Quantitative data were entered, cleaned, and analyzed for descriptive statistics related to study aims using Microsoft Excel. Qualitative data were transcribed, translated and coded to identify emergent themes and categories. There were only two cases of IPV screening reported by participants, although disclosure of IPV and referral did not occur. Emergent themes from data analysis include a positive perception of IPV screening, referral, and communication of the same with the provider, barriers for communication about IPV with the prenatal care provider, and provider-related characteristics such as being male and not speaking Spanish. The results of this study have implications for reducing the risk of IPV among women of Mexican origin, especially along the U.S.-Mexico border by increasing the effectiveness of IPV communication with care providers during the prenatal period.
Medicine|Health sciences|Public health
Luna, Luz Maria, "Attitudes and barriers to intimate partner violence screening and follow-up during prenatal care as reported by survivors in the El Paso, Texas region" (2016). ETD Collection for University of Texas, El Paso. AAI10118796.