Health Care Resources

 
 
 

Overview

Welcome to the Health Care Resources at the Ohio Domestic Violence Network. The Health Care Resources section is designed for Ohio’s health care providers in all 88 counties.

Recommendations by the Institute of Medicine (IOM) and the U.S. Department of Health and Human Services (HHS) led to the inclusion in The Patient Protection and Affordable Care Act (ACA) the requirement of health care providers to implement interpersonal and domestic violence screening and counseling for women in their care.

The recommendations by the Institute of Medicine (IOM) and the U.S. Department of Health and Human Services (HHS)recommendations align with ODVN’s mission to bring leadership, expertise, and best practices to community programs.

As part of our Mission, ODVN Health Care Resources provides one, up-to-date site for use by all of Ohio’s health care providers to access laws, professional position statements, clinical recommendations, screening instruments, and local domestic violence programs.

The Affordable Care Act (ACA)

Rules on Expanding Access to Preventive Services for Women

  • Rules on Expanding Access to Preventive Services for Women

    The law also requires insurers to cover additional preventive health benefits for women. In 2011, HHS adopted new guidelines recommended by the IOM for women’s preventive services to fill the gaps in current preventive services guidelines for women’s health. The Guidelines help ensure a comprehensive set of preventive services for women.  IOM conducted a scientific review and provided recommendations on specific preventive measures that meet women’s unique health needs and help keep them healthy. HHS based its Guidelines for Women’s Preventive Services on the IOM report issued July 19, 2011.

8 Additional Preventive Health Benefits for Women (ACA)

  1. Well Women visits
  2. Gestational Diabetes screening
  3. HPV DNA testing
  4. STI counseling
  5. HIV screening and counseling
  6. Contraception and contraceptive counseling
  7. Breastfeeding support, supplies and counseling
  8. Interpersonal and Domestic Violence screening and counseling
    • Screening and counseling for interpersonal and domestic violence will be covered for all adolescent and adult women.
    • An estimated 25 percent of women in the United States report being targets of intimate partner violence during their lifetimes.
    • Screening is effective in the early detection and effectiveness of interventions to increase the safety of abused women.

Professional Organization Committee Opinions


Organizational Capacity

Role of the Organization

Partnerships between health care organizations and local advocacy groups can likely increase the identification and referral of domestic violence survivors (Chapin, Coleman, & Varner, 2011).

Recommendation for hospitals and public health organizations to standardize care and referral procedures for domestic violence survivors; standardization potentially reduces confusion among patients and providers (Butler, Agubuzu, Hansen, & Crandall, 2014)

Barriers to Routine IPV Screening, Counsel, and Referral
  • Health care provider personal barriers & fears
  • Resource barriers
  • Attitudes and perceptions

(Sprague, Madden, Simunovic, Godin, Pham, & Bhandari, 2012)


Health Care Provider Personal Barriers and Fears

  • Personal discomfort
  • Concern for personal safety
  • Concern of misdiagnosis
  • Lack of personal confidence to refer victims
  • Forgetting to ask
  • Fear of invading patient’s privacy
  • Fear of offending patients
  • Fear of the partner’s reaction
  • Fear of making life more difficult for the victim
  • Fear patient would stop seeking health care

(Sprague et al., 2012)

Resource Barriers

  • Time constraints
  • Lack of provider knowledge, education, or training regarding domestic violence screening
  • Inadequate environment for screening
  • Lack of organizational protocol and procedure for addressing domestic violence
  • Inadequate follow-up referrals and support staff

(Sprague et al., 2012)

Overcoming Barriers Resources

  • Recommendations for organizations
  • Training
  • On-going education

Barriers of Attitude and Perception

  • It is not the HCP role to screen for domestic violence
  • HCP has more urgent, important issues to address
  • Patient’s language is a barrier to screening
  • Abused women are to blame for their abuse
  • Abuse is rare
  • Patients do not want referrals
  • Abuse is normal event for the patient

(Sprague et al., 2012)


Health Care Screenings

Screening Environment
  • Privacy, without the likelihood conversation could be overheard.
  • One-on-one: provider to patient
    • Exception:
    • Include an interpreter if the patient’s first language is not English
    • A child under age 2 may remain
  • Post well-placed signs advising all patients they will be assessed alone, for at least part of their visit.
  • Post signs in waiting area, examination rooms, and women’s bathrooms with local DV information
Screening Environment

Environmental 'Enablers':

  • Posters
  • Pamphlets
  • On-site social workers
  • Reminder stickers/flags on charts
  • Staff training

Stayton, C. & Duncan, M. (2005). Mutable influences on intimate partner abuse in health care settings: A synthesis of the literature. Trauma, Violence, & Abuse, 6(4).

Screening Instruments
Basile, K., Hertz, M., & Back, S. (2007). Intimate partner violence and sexual violence victimization assessment instruments for use in healthcare settings: Version 1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.
Provider Demeanor During Screening

“Are you physically safe with your partner?”(Chapin et al., 2011)

Safety Plan: example

  • Money
  • Emergency bag
  • Plan for pets
  • Practice how to get out of the home
  • Plan legal help
  • Get other help
  • Plan where to go
  • Plan how to get there
  • Know who to call
  • Numbers
    • Police/Emergency 911
    • Local shelter
    • Clinic/HCP
    • Legal aid
    • Animal shelter
    • Trusted friend
    • (Share with women, JMWH, 2008)

Pregnancy

Estimated prevalence rate of IPV associated with pregnancy: 3-30%

  • Adverse pregnancy outcomes associated with IPV:
    • Low birth weight
    • Preterm delivery
    • Infection
    • Miscarriage/abortion
    • Placental abruption
    • Fetal injury
    • Perinatal death
    • Other associated risks: depression, anxiety, suicide, late entry to prenatal care, poor nutrition, use of tobacco, alcohol and drugs
    (Van Parys, Verhamme, Temmerman, & Verstraelen, 2014)
Screening in Pregnancy: Timing & Intervals
    Health care providers should screen women and adolescent girls for IPV and reproductive and sexual coercion at least:
  • At first prenatal visit
  • At least once per trimester
  • At postpartum visit

ACOG Committee Opinion number 554, Reproductive and Sexual Coercion (2013)

Screening in Pregnancy: NIH
Screening for Intimate Partner Violence During Pregnancy
Screening in pregnancy: Framing questions

“Has your partner ever forced you to do something sexually that you did not want to do?”

“Has your partner ever refused your request to wear a condom?”

“Are you worried your partner will hurt you if you do not do what he wants with the pregnancy?”

“Does your partner support your decision about when or if you want to become pregnant?”

ACOG Committee Opinion number 554, Reproductive and Sexual Coercion (p. 412, 2013)

The Ohio Domestic Violence Protocol for Health Care Providers: Standards of Care

Revised by the Project Connect Protocol Committee (2012)


Ohio Domestic Violence Laws

Ohio Revised Code (ORC): Failure to Report a Crime Ohio Revised Code: Domestic violence

National Resources


Scholastic Resources

Intimate-Partner Violence — What Physicians Can Do

Electronic Journal Service



Links to found at this site are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs.

 

SAFETY ALERT: Computer use can be monitored and it is impossible to completely clear all website footprints. If you are in danger, please use a safer computer that your abuser can not access directly or remotely, or call ODVN 800-934-9840 or the National Domestic Violence Hotline at 800-799-SAFE.