multifaceted quality improvement approaches to enhancing the secondary prevention of domestic violence (DV) in health maintenance organization (HMO) primary care settings. Study Design: A “2 new interventions ” pre/post design that compared a basic implementation strategy using current staff levels with an augmented basic strategy that added a paid part-time role for medical office social workers as DV social change agents. Methods: Comparison of pre-/postimplementation changes in clinicians ’ DV-related knowledge, attitudes, and self-reported practices (KAP) and rates of inquiry about DV with female patients. Study outcomes were measured in surveys of primary care clinicians and women aged 18 to 45 years who had recent appointments with them. Results: Both strategies resulted in significant improvements in rates of clinician inquiry about DV and in most clinician KAP

The Impact of Violence in Pennsylvania 2 for grants to communities to develop strategies to address juvenile problems and $17 million for new or expanded correctional facilities. The budget also allocated increased federal funds to provide services to victims of domestic violence and to educate school-aged children about rape prevention. The objective of this report is to systematically identify the relative frequency of violence in Pennsylvania, and to estimate the health care costs related to it. This information serves two purposes; (a) it identifies the impact of violence on the health care system in Pennsylvania, and (b) it provides information of relevance to the evaluation of violence prevention programs. Background Violence often appears to be an intractable problem in the United States. Crime, and specifically homicide, has been an important concern for Americans for many years. Concerns about violence have led to interest in finding better ways to prevent and control viol...

Health Organization identified domestic violence as a serious public health problem with victims experiencing more operative procedures, visits to doctors and hospital stays than non-victims. Domestic violence causes not only acute injuries, but also has been linked to serious health consequences such as chronic pain, abdominal complaints, sexually transmitted infections, unwanted pregnancies, depression, post-traumatic stress disorder, miscarriages and premature labor. Unfortunately, many victims suffer in silence and are not receiving assistance for their abusive situation. Analysis of family violence-related homicides in New York City reveals that 71 % of the cases in 2003 had no prior police contact and 87 % had no current order of protection. Healthcare professionals play a crucial role in identifying victims because they have a regular opportunity to ask patients about domestic violence, regardless of the reason for the medical visit. By routinely screening patients for domestic violence, healthcare professionals can assist victims who may not seek assistance elsewhere. By directly asking patients about domestic violence, regardless of symptoms, injuries or reason for the visit, there is an increased likelihood that victims will disclose abuse. Given medical practitioners ’ specific roles and time constraints, responding to domestic violence can be challenging. This manual explores methods of overcoming these challenges and intends to assist practitioners to efficiently identify domestic violence victims, intervene effectively, and provide meaningful referrals. It is key that

PDF corresponds to the article as it appeared upon acceptance. Fully formatted PDF and full text (HTML) versions will be made available soon. Primary care Identification and Referral to Improve Safety of women experiencing domestic violence (IRIS): protocol for a pragmatic cluster randomised controlled trial