Clinicians' decisions to screen for intimate partner violence use and experience and observed impacts: Qualitative study

BACKGROUND: Recent research has found that concurrent intimate partner violence (IPV) experience (ie, victimization) and use (ie, perpetration) may be more common than experiencing or using IPV in isolation. Therefore, screening for IPV experience and use concurrently is needed to provide resources and connect patients to care. 

OBJECTIVE: In this work, we explore how clinicians made decisions to use a screening protocol for IPV use and experience and their perceptions of how concurrent screening impacted patients, clinicians, and the health care system. 

METHODS: We conducted qualitative interviews with 19 clinicians (18 women and 1 man) who participated in a 90-day pilot screening implementation initiative, in which they were asked to integrate screening for IPV use and experience concurrently into their daily practice. Most clinicians (17/19, 89.5%) had prior IPV-related training. Interviews focused on clinicians' experiences implementing the screening tool and were analyzed using thematic analysis. 

RESULTS: We identified four themes: (1) new screening implementation is challenging, (2) screening for IPV use and experience concurrently can be uncomfortable, (3) pivoting strategies can make screening easier, and (4) screening for IPV use and experience concurrently is impactful. Findings highlighted complexities of implementing new screening protocols, as clinicians spoke about the importance of screening for IPV use and experience concurrently, while pointing out barriers to integrating the screening protocol into their daily clinical routines. Clinicians made adaptations to the screening protocol and the screener itself to assist with adherence to screening efforts. 

CONCLUSIONS: Findings demonstrate the need for and importance of screening concurrently for IPV use and experience, while bringing awareness to difficulties with implementing any new screener. Findings underscore the importance of addressing barriers to increasing screening efforts for IPV use and experience concurrently through increased allotment for screening efforts. The results also highlight opportunities for pivoting strategies and ongoing training and education around managing concurrent IPV use and experience. Future research should explore how decreasing barriers to screening efforts and adaptations to screening practices impact decisions to screen, while also exploring clients' perspectives on being screened for IPV use and experiences concurrently.