ORAL HEALTH CARE PROFESSIONAL RESPONSE TO DOMESTIC VIOLENCE

家庭暴力造成的身体伤害通常发生在面部、头部和颈部。因此，口腔保健专业人员在解决这一重大公共卫生问题方面发挥着重要作用。最近的研究表明，许多口腔保健专业人员没有意识到头颈部损伤和家庭暴力之间的这种重要关系，并且不确定他们在与患者解决这个问题时的作用。此外，其他研究表明，许多口腔保健专业人员感到不舒服提供援助的家庭暴力受害者。在一项随机对照试验中，我们建议开发和测试教育和行为改变干预的有效性，旨在帮助口腔卫生保健专业人员有效地克服不愿意识别和治疗家庭暴力受害者，并在他们的知识，态度和行为方面产生积极的变化照顾这一患者群体。这项工作的最终目标是帮助防止寻求牙科护理的家庭暴力受害者遭受进一步的暴力和口腔创伤。研究受试者将从北方加州的所有执业、办公室牙医和牙科医师中招募，并随机分配到实验组或对照组。所有受试者将被要求在三个测量点-预测试、后测试（干预结束后立即）和六个月随访-完成口腔健康专业书面调查。本调查询问了牙医和牙科医生关于识别、评估和干预家庭暴力受害者的知识、态度和做法。实验组的参与者将接受有针对性的教育和行为改变干预，这些干预措施是基于本研究小组和其他人成功的干预措施，但也包含独特的元素。的组件 干预措施包括：1）预测试分数的个性化反馈（与“理想”反应或所有科目的平均反应相比）; 2）以技能为本的课程，包括研讨会模块和基于互联网的自学模块; 3）牙科记录提醒卡（将插入实验组受试者的所有新患者的牙科记录中），提供家庭暴力评估问题的简便清单，有关社区援助计划的转介信息和为受害者提供验证和支持的提示;以及，4）以实践为导向的通讯，探讨口腔保健专业人员对在牙科保健环境中识别和援助家庭暴力受害者的一些障碍的看法，并提出消除或减少这些障碍的方法。主要的结果措施将是牙医和牙科医生的知识，态度和行为，关于治疗和帮助病人谁是家庭暴力的受害者，口腔卫生保健专业书面调查测量。

Physical injuries from domestic violence commonly appear in the areas of the face, head, and neck. For this reason, oral health care professionals have an important role to play in addressing this major public health problem. Recent studies have revealed that many oral health care professionals are unaware of this significant relationship between head and neck injuries and domestic violence, and are uncertain of their role in addressing this issue with their patients. Furthermore, other studies suggest that many oral health care professional feel uncomfortable offering assistance to domestic violence victims. In a randomized, controlled trial, we propose to develop and test the effectiveness of an educational and behavioral change intervention designed to help oral health care professionals effectively overcome reluctance to identify and treat victims of domestic violence, and to effect positive changes in their knowledge, attitudes, and behaviors with respect to caring for this patient population. The ultimate goal of this undertaking is to help prevent victims of domestic violence who seek dental care from being subjective to further violence and oral trauma. Research subjects will be recruited from among all practicing, office- based dentists and dental hygienists in Northern California and randomly assigned to either an Experimental or a Control Group. All subjects will be asked to complete the Oral Health are Professional Written Survey at each of three measurement points--pre-test, post-test (immediately following conclusion of an intervention), and six-month follow-up. This survey asks about dentists' and dental hygienists knowledge, attitudes, and practices regarding identifying, assessing, and intervening with patients who are victims are domestic violence. Experimental Group participants will receive a targeted educational and behavioral change intervention based upon interventions shown to be successful by this research team and by others, but incorporating unique elements as well. The components of the intervention will include 1) individualized feedback of pretest scores (compared against either an "ideal" response or the average response of all subjects); 2) Skills-based Course consisting of a seminar module and an internet-based, self-study module; 3) Dental Record Reminder Cards (to be inserted into the dental record of all new patients of subjects in the Experimental Group) that provide a handy checklist of domestic violence assessment questions, referral information regarding community-based assistance programs and tips for providing validation and support to victims; and, 4) Practice-oriented newsletters exploring oral health care professionals' perceptions of some of the barriers to identifying and aiding victims of domestic violence in a dental care setting, and suggesting ways to remove or reduce these barriers. The main outcome measures will be dentists' and dental hygienists' knowledge, attitudes, and behaviors regarding treating and assisting patients who are victims of domestic violence as measured by the Oral Health Care Professional Written Survey.