Hispanic Mothers’ Comfort about Domestic Violence Screening Compared with Other Routine Screening Questions

Introduction One fourth of all women experience domestic violence at some point during their lives. Preliminary studies show that Latina women in the United States are less likely to report abuse, have a greater tolerance of severe abuse and are more likely to stay in an abusive relationship than their Anglo counterparts. Many organizations, including the American Medical Association and the American Academy of Pediatrics recommend that physicians screen routinely without children or partner present. Because mothers accompany their children 85 percent of the time to pediatric visits, screening the mother alone is logistically difficult in a busy practice. Furthermore, many doctors report that they don\u27t want to offend the patient by asking about domestic violence (DV). Research has shown that it may be acceptable to screen mothers for DV using general questions in front of their children. Rational/Hypothesis The purpose of our study is to evaluate the acceptability of general DV screening questions for women in Spanish compared with other routine sensitive screening questions when their children (3-12 yrs.) are with them in the primary care setting. Methods 46 Spanish-speaking mothers with children ages 3-12 were interviewed at community centers, churches and in their homes without children present. The survey composed of validated questions for drug/alcohol use, sexual activity, depression and general DV questions. The mother was asked to indicate her comfort level in answering each question alone and if her child were present using a 5-point Likert scale. The participants were then asked to rank the five general DV questions from most comfortable to answer in front of their children to the least comfortable in front of their children. Results Latina mothers were most comfortable answering sensitive issue screening questions alone. They indicated greater comfort with the DV screening questions: Do you feel safe in your current relationship and how is your partner treating you and the kids, than with questions about sex, depression and with the DV questions that talked about tension in the relationship and arguments, significance(\u3c 0.005) When subjects were examined by income, higher income (\u3e20,000 per year, N=11) reported no significant differences in any of the DV questions whereas those in the lower income cohort (\u3c20,000, N=35) reported significant differences with the two DV questions (tension and arguments). When asked to rank questions based on most comfort in front of the children, the questions with safe and treat were preferred. Conclusions and Significance Helping doctors understand that Latina mothers are more comfortable about general screening questions for DV than they are about screening for sexual activity and depression in front of their children may make physicians more willing to do routine DV screening. However, Latina mothers are uncomfortable with DV screening questions that include tension and argument. More research is needed to appreciate differences concerning DV screening among Latina women living in the United States