Enhancing Care Provider Skills in IPV and Reproductive Coercion Assessment

提高护理人员在 IPV 和生殖强制评估方面的技能

• 批准号: 8677020
• 负责人: JUDY C CHANG
• 金额: $ 7.69万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-15 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8677020
• 关键词: Address; Affect; Age; Attitude; Behavior; Caring; Client; Clinic; Clinic Visits; Clinical; Coercion; Communication; Contraceptive Agents; Contraceptive methods; Counseling; Decision Making; Disclosure; Educational Intervention; Family Planning; Feeling; Female; Frequencies; General Population; Goals; Harm Reduction; Intervention; Interview; Knowledge; Modeling; Outcome; Parents; Participant; Prevalence; Provider; Randomized; Randomized Controlled Trials; Recording of previous events; Reporting; Reproduction; Reproductive Health; Research; Resources; Risk; Safety; Self Efficacy; Testing; Time; Training; Trauma; Uncertainty; Validation; Victimization; Violence; Visit; Woman; arm; base; birth control; condoms; design; expectation; experience; improved; innovation; intimate partner violence; male; patient oriented; pregnant; pressure; public health relevance; randomized trial; reproductive; response; skills; skills training; unintended pregnancy; young woman

DESCRIPTION (provided by applicant): Young women ages 16-29 years utilizing family planning (FP) clinics report significantly higher rates of intimate partner violence (IPV) compared to general population prevalence estimates, experiences which are associated with poor reproductive health outcomes, particularly unintended pregnancy. In the parent study from which this study emerges (Miller, R01HD064407), 46% of females seeking FP services report ever experiencing IPV. One mechanism connecting IPV with poor reproductive health is male partners' control of women's reproduction through their refusal to use condoms, abusive responses to women's use of contraception, pressuring women to get pregnant, and birth control sabotage; cumulatively, these partner behaviors constitute a phenomenon described as reproductive coercion (RC). Five percent of clients in the parent study report experiencing RC in the past 3 months which is closely associated with increased rates of unintended pregnancy in the past year. Thus, addressing IPV/RC in the FP clinic setting has the potential to reach significant numbers of women at risk for violence victimization and unintended pregnancy. The proposed exploratory study uses a two-armed cluster-randomized design to test a communication skills-building approach to improve IPV/RC assessment in the FP setting. The parent study is a randomized trial testing a brief, universal IPV/RC assessment and harm reduction intervention. Two thirds of participants report discussing IPV with their clinician (69%) and even fewer (23%) discussed RC with their provider. Focusing on provider communication-skills has been shown to increase provider self-efficacy when discussing other sensitive topics. Thus, adding communication skills training to providers' training on IPV/RC may improve the frequency and quality of IPV/RC assessment and counseling in the FP clinic setting. While prior IPV/RC trainings (including those provided in the parent study) have focused on increasing provider knowledge, this proposed training also incorporates communication skills-building and uses audio recorded client-provider discussions to examine the frequency and quality of IPV/RC assessment and counseling. This R03 expands the impact of the original parent study by incorporating and evaluating the influence of communication skills- training on FP providers' assessment and counseling regarding IPV/RC with the goal of increasing women's safety and improving reproductive decision making. Audio-recorded client-provider discussions will be used to assess whether a communication skills-based training improves the frequency and quality of FP providers' assessment and counseling regarding IPV/RC (Aim 1, 4 clinics; N = 100 clients). Interviews with clients (n = 40) and providers to review the audio-recorded visits will explore attitudes, concerns, and experiences discussing IPV/RC and impact on reproductive decision making. This exploratory study to identify strategies to enhance provider skills in IPV/RC assessment and counseling will inform quality improvement in intervention delivery as well as guide implementation and dissemination planning of this intervention model.

描述（由申请人提供）：使用计划生育（FP）诊所的16-29岁年轻女性报告的亲密伴侣暴力（IPV）发生率明显高于