TY - JOUR
T1 - Implementation of a Family Planning Clinic–Based Partner Violence and Reproductive Coercion Intervention
T2 - Provider and Patient Perspectives
AU - Miller, Elizabeth
AU - McCauley, Heather L.
AU - Decker, Michele R.
AU - Levenson, Rebecca
AU - Zelazny, Sarah
AU - Jones, Kelley A.
AU - Anderson, Heather
AU - Silverman, Jay G.
N1 - Funding Information:
The authors acknowledge the staff of Planned Parenthood of Western Pennsylvania and Adagio Health for their support with this study. Samantha Ciaravino, Hillary Darville, Jill Etienne, Tarrah Herman, Angela Hicks and Claire Raible provided research assistance. Daniel J. Tancredi and Lisa James participated in the study and provided critical review of early versions of this article. This work was supported by grant R01HD064407 from the National Institute of Child Health and Human Development. The opinions, findings, conclusions and recommendations expressed in this article are those of the authors and do not necessarily reflect those of the National Institutes of Health, Adagio Health or the Planned Parenthood Federation of America.
Publisher Copyright:
Copyright © 2017 by the Guttmacher Institute
PY - 2017/6
Y1 - 2017/6
N2 - CONTEXT: Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. METHODS: In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to offer a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. RESULTS: Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to offer the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. CONCLUSIONS: A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers.
AB - CONTEXT: Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. METHODS: In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to offer a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. RESULTS: Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to offer the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. CONCLUSIONS: A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers.
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U2 - 10.1363/psrh.12021
DO - 10.1363/psrh.12021
M3 - Article
C2 - 28272840
AN - SCOPUS:85014671067
SN - 1538-6341
VL - 49
SP - 85
EP - 93
JO - Perspectives on sexual and reproductive health
JF - Perspectives on sexual and reproductive health
IS - 2
ER -