Successful integration and maintenance of screening for domestic violence in health settings: Moving beyond individual responsibility

Domestic violence (DV) screening and prevention interventions have been imple-mented in the health sector; however, few health care settings have successfully implemented protocols that have been fully integrated and sustained within the larger organization. Researchers have tended to focus on individual-level charac-teristics of health care providers to explain this. The authors argue that organiza-tional, structural, social, and cultural factors, especially related to gender, also play roles in adoption and integration of these interventions. It is important for policy analysts and program evaluators to use this larger framework to ensure sus-tainable integration of DV screening programs within health care systems. Key words: domestic violence, screening, prevention, health sector THE IMPACT OF DOMESTIC VIOLENCE (DV) on the health of women and their families is rarely disputed, and rates of DV are recognized to be a significant public health problem among DV researchers and health policy analysts. In the health sector, screening has primarily been viewed as secondary prevention, that is, early identification of DV that will enable inter-vention and prevention of further incidents and negative outcomes, sometimes following disclosures outside of the screening encounter. Screening protocols may more than double rates of identification of spousal abus