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A RCT of Computer Screening for Domestic Violence
(Archived Project)
Investigator (PI): Howes, David
Past Investigator: Levinson, Wendy
Performing Organization (PO): (Current): University of Chicago, Pritzker School of Medicine, Department of Medicine
Supporting Agency (SA): Agency for Healthcare Research and Quality (AHRQ)
Initial Year: 2000
Final Year: 2003
Record Source/Award ID: CRISP/R01HS11096
Funding: Total Award Amount: $941,195
Award Type: Grant
Award Information: Reports resulting from this project
Abstract: Victims of domestic violence frequently seek medical care in emergency departments (EDs) and health care providers have the opportunity to detect DV and intervene. Unfortunately ED personnel often do not screen for DV due to time pressures and the sensitive nature of the problem. Novel methods are needed to improve detection and intervention in the ED. We developed and piloted a self-administered computer health risk assessment (ED Prevent) that is completed by patients before their ED visit. High-risk behaviors are provided to the ED physician. Our pilot demonstrated significant improvement in the chart documentation of DV by physicians in patients receiving ED Prevent (19 chart notes of DV) compared to controls (1 chart note). This study is a randomized control trial to test the effect of ED Prevent on the communication between physicians/nurses and patients about DV. 800 women patients presenting to two different EDs (an urban ED with largely African American patients and a suburban community ED with mainly Caucasian patients) will be randomized to either ED Prevent or Usual Care. All visits will be audio-taped. Primary outcomes for the study will be patient disclosure and physician/nurse discussion of DV based on the audio-tapes. Secondary outcomes will include patient knowledge of, or contact with, DV services, patient satisfaction with communication with ED staff, and chart documentation of DV. The effect of ED Prevent on rates of disclosure and discussion will be evaluated using logistic regression controlling for hospital site and patient demographics. In addition a qualitative analysis will explore the effect of ED Prevent on DV communication variables, such as the timing and initiation of discussions about DV and ED provider/patient affective responses. The study has the potential to provide a novel way to screen women in the ED relying on a computer instead of a busy physician and potentially shifting the role of the physician to discussion and referral, ultimately improving the likelihood that women will change the abusive situation. The study results may be generalizable to many other EDs with a variety of populations. Further, the data will be available for future investigations of communication in the ED.
MeSH Terms:
  • Domestic Violence /*classification
  • /psychology /statistics & numerical data
  • * Emergency Service, Hospital
  • Female
  • Humans
  • Knowledge
  • * Mass Screening
  • * Medical Records Systems, Computerized
  • Nurse-Patient Relations
  • Patient Satisfaction
  • Physician-Patient Relations
  • Program Development
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • * Software
  • Triage
  • Truth Disclosure
  • United States
Keywords:
  • African American
  • Caucasian American
  • audiotape
  • behavioral /social science research tag
  • clinical research
  • clinical trial
  • computer assisted diagnosis
  • emergency service
  • health care service
  • health care service evaluation
  • health services research tag
  • health survey
  • human subject
  • interview
  • nursing intervention
  • outcomes research
  • patient care management
  • questionnaire
  • research support, U.S. Gov't, P.H.S.
  • spouse abuse
  • statistics /biometry
  • violence
  • women's health
Country: United States
State: Illinois
Zip Code: 60637
UI: 20011183
Project Status: Archived
Record History: ('2001: PI changed. ',)