Integrating health services into intimate partner violence and sexual violence programs

Public Health Significance: Approximately one in four woman will experience intimate partner violence (IPV) in her lifetime. Reproductive Coercion (RC), a form of IPV, has a 9% lifetime prevalence, the likelihood of which significantly increases when a woman is already experiencing IPV. RC is linked to outcomes such as unintended pregnancy, emergency contraception use, sexually transmitted infections (STIs), and late or multiple abortions due to a partner’s controlling behavior. Given the complexities and often recent nature of abuse that women seeking help have experienced, time sensitive health services must be accessible and immediately available in order to prevent STIs, HIV, unwanted pregnancy, and permanent injury; however studies to date have not identified how to appropriately implement these urgent health services. This project evaluated a training aimed at integrating health services into IPV programming and identified barriers faced in implementing the integrating of health services into IPV/Sexual Violence (SV) programs. This training was completed as one aim of Project Connect, a national violence-prevention initiative developed to provide a more effective health care response to IPV/SV through bridging Public Health and IPV/SV agency partnerships Methods: IPV/SV advocates received a training on integrating health services into their agencies and completed a pre- and six month post-test to assess confidence, attitude, and behavior change. Semi-structured phone interviews from advocate and public health Project Connect site leads were examined for barriers to integration. Results: Survey results showed IPV/SV advocates were more likely to make a connection between IPV/RC and health, and more likely to provide woman seeking services with health services or health resources after receiving this training. Themes from coding interviews indicated clinical providers and advocates value warm referrals, partnerships and knowledge gained about RC. Interviews also revealed barriers including logistics to implementing health services, cultural differences in institutions, and difficulty creating partnerships. Conclusions: Trainings aimed at advocates integrating basic health services into their work may be one effective way to enable women experiencing violence to get these time sensitive health needs addressed. However, training alone cannot create needed partnerships with public health or family planning clinics, which is imperative to providing woman services