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Getting routine intimate partner violence screening right: Implementation strategies used in Veterans Health Administration (VHA) primary care

O.L. Adjognon, J.E. Brady, M.R. Gerber, M.E. Dichter, A.R. Grillo, A.B. Hamilton, S.W. Stirman, & K.M. Iverson
J Am Board Fam Med

Background: Evidence supports the clinical effectiveness of intimate partner violence (IPV) screening programs, but less is known about implementing and sustaining them. This qualitative study identified implementation strategies used to integrate IPV screening programs within Veterans Health Administration (VHA) women's health primary care. Methods: Thirty-two administrators and clinician key informants from 11 VHA facilities participated in semistructured interviews. Implementation strategies were identified using established definitions from implementation science literature, through multistep content analysis, involving site comparisons by implementation status.
Results: We identified 8 implementation strategies. Three were present across all sites: (1) conduct ongoing IPV trainings, (2) conduct educational meetings and outreach visits, and (3) develop and distribute educational materials. Five strategies were unique to early adopting sites: (4) identify and prepare champions, (5) change record systems to remind clinicians, (6) create a learning collaborative through advisory boards or workgroups, (7) audit and provide feedback with relay of clinical data to providers, and (8) access new funding. Discussion: Strategies align with and extend literature addressing barriers to screening. Evidence shows that effective IPV screening implementation in primary care requires a bundle of well-defined, carefully selected strategies. Conclusions: Implementation strategies used collectively can enable integration of IPV screening programs in primary care.

Adjognon OL, Brady JE, Gerber MR, et al. Getting routine intimate partner violence screening right: Implementation strategies used in Veterans Health Administration (VHA) primary care. J Am Board Fam Med. 2021 Mar-Apr;34(2):346-356. doi: 10.3122/jabfm.2021.02.200311. PMID: 33833003.

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Publication year
Resource type
Peer Reviewed Research
Outcomes
Process
Population
Veterans
Screening research
Yes
Social Determinant of Health
Violence/Safety
Study design
Other Study Design