OUTCOMES FOR IPV: PATIENT AND PROVIDER PERSPECTIVES

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Intimate partner violence (IPV) is a major public health problem. In addition to the immediate trauma caused by intimate partner physical assault, such violence negatively impacts health status in the domains of medical morbidity, psychiatric morbidity, substance abuse, access to health care, birth outcomes, and family functioning. The broad long-term objectives of this work are to develop methodologies for effectiveness research that have the capacity to sensitively measure the heterogeneity of health problems associated with IPV among the diverse patient populations affected. Such methods are critical to understanding the short- and long-term health care outcomes for IPV interventions within the health care settings. The proposed study applies standard methods for preference (or utility) assessment common to cost-effectiveness studies in order to quantify health care outcomes for women exposed to intimate partner violence (IPV). We use patient-centered methods for this work, and develop outcome measures that incorporate the values of the individuals affected by IPV-focused health care interventions and policies. We also quantify provider preferences for health outcomes in an effort to determine differences in the priorities between patients and providers, and to better understand provider IPV screening behaviors. The study focuses on women at high risk for IPV and who have few resources with which to cope with this major health issue: low income and ethnic minority women who are receiving prenatal care form the public sector. Among our diverse patient sample, we focus on Latina women, who face significant cultural barriers to addressing IPV within the health care context. The specific aims of the proposed project are to (a) quantify the importance that women patients in public women; (b) quantify the importance that providers of public sector prenatal care place on potential health care outcomes for IPV interventions with their patients; and (c) describe the long-term alterations in Health Related Quality of Life of IPV-exposed women, comparing estimates calculated with outcomes valued according to patient and provider preferences. The adaptation of our proposed method of effectiveness measurement will provide a comprehensive indicator of an intervention's impact on health status in a patient-centered manner that helps to insure that low SES and minority women are not marginalized in the process of evaluating and refining IPV interventions for health care settings.