Assessment of Survivor and Provider Perception of Trauma and Violence Informed Care Among Black Women (ASAP-TVIC in Black Women)

亲密伴侣暴力（IPV）凶杀案的发生率在黑人妇女和IPV相关的 死亡剥夺了黑人妇女相对于白色妇女至少十年的寿命。终身IPV患病率也是 黑人妇女（50%）高于白色妇女（35%）。IPV的这种持续和不成比例的影响， 黑人妇女强烈建议需要一个跨部门框架，为IPV干预提供信息， 由卫生保健提供者为黑人妇女提供预防服务。美国妇产科学院 妇科（ACOG）建议进行常规IPV筛查，并支持实施“创伤知情 密切注意避免污名化和优先重视守法“。作为田纳西州的HBCU， 梅哈里医学院是理想的位置，以听取ACOG的呼吁采取行动。我们建议使用一个 为适应、实施和评估基于诊所的创伤和 暴力知情护理干预。梅哈里是一个以证据为基础的创伤知情护理的家 艾滋病毒护理干预;这一干预将为我们的IPV重点干预的发展提供信息。支持 妇女健康公平和实现ACOG的建议，我们提出了适应，实施， 和严格的评估创新TVIC干预。通过在联合国系统中使用一个跨部门框架， 为了调整我们的TVIC干预措施，我们力求确保其对黑人妇女的相关性。我们的首要目标是 * 调整、执行和评价为黑人妇女设计的TVIC干预措施， 田纳西中部。在这个为期五年的RCMI项目中，我们提出了三个目标。目标1）让利益相关者委员会参与进来 患者，提供者和专家（科普），以适应创伤和暴力知情护理（TVIC）干预， 黑人妇女和他们的医疗保健提供者在梅哈里。[1-2年级]。目标2）实施和前瞻性 在医疗保健提供者层面评估适应性TVIC干预，测量Meharry的变化 医疗服务提供者实施TVIC自我效能与TIC知识、态度和 实践[第2-3年]目标3）在患者层面实施经调整的TVIC干预，以提供创伤- 知情的IPV筛查、简短干预和转诊治疗（SBIRT），并严格评估这一点 TVIC干预对患者感知的干预有用性的主要结局的影响， 与IPV服务的联系，以及与气候和 文化，通过非随机务实的试验设计。[Year 4-5]。Meharry的“促进健康”使命 通过创新研究实现公平“和”富有同情心的卫生服务“使HBCU成为 这一创新和有影响力的研究。这项研究有可能改变黑人妇女的护理， IPV的目标是解决IPV对黑人妇女的不成比例的影响。早期 通过普遍筛查结合IPV相关的创伤知情护理检测IPV可以减少 与IPV相关的精神和身体健康后果以及医疗费用，估计为2.1万亿美元。

Rates of intimate partner violence (IPV) homicides are three-fold higher among Black women and IPV-related deaths rob Black women of at least a decade of life relative to White women. Lifetime IPV prevalence is also higher among Black (50%) than White (35%) women. This persistent and disproportionate impact of IPV for Black women strongly suggests the need for an intersectionality framework to inform IPV intervention and prevention services for Black women delivered by health care providers. The American College of Obstetrics & Gynecology (ACOG) recommends routine IPV screening and supports implementation of `trauma-informed care with close attention to avoiding stigmatization and prioritizing resilience'. As a Tennessee-based HBCU, Meharry Medical College is ideally positioned to heed ACOG's call to action. We propose the use of an intersectionality framework to inform the adaptation, implementation and evaluation of clinic-based trauma and violence informed care (TVIC) intervention. Meharry is home to an evidence-based trauma-informed care intervention for HIV care; this intervention will inform our IPV focused intervention's development. To support women's health equity and actualize ACOG recommendations, we propose the adaptation, implementation, and rigorous evaluation of an innovative TVIC intervention. By using an intersectionality framework in the adaptation of our TVIC intervention, we seek to ensure its relevance for Black women. Our primary goal is the adaptation, implementation and evaluation of a TVIC intervention designed for Black women in Central Tennessee. In this 5-year RCMI project, we propose 3 aims. Aim 1) Engage a stakeholder committee of patients, providers, and experts (COPE) to adapt a trauma & violence informed care (TVIC) intervention for Black women and their healthcare providers at Meharry. [Years 1-2]. Aim 2) Implement and prospectively evaluate the adapted TVIC intervention at the healthcare provider-level, measuring changes in Meharry healthcare provider's self-efficacy for TVIC implementation and alignment with TIC knowledge, attitudes, and practices. [Years 2-3] Aim 3) Implement the adapted TVIC intervention at the patient-level to provide trauma- informed IPV screening, brief interventions, and referrals to treatment (SBIRT), and rigorously evaluate this TVIC intervention's impact on the primary outcome of patient-perceived usefulness of intervention and reported linkage to IPV services, and the secondary outcome of changes at the clinic-level relative to climate and culture, through a non-randomized pragmatic trial design. [Year 4-5]. Meharry's mission of `advancing health equity through innovative research' and `compassionate health services' make this HBCU an ideal setting for this innovative and impactful research. This research has the potential to transform the care Black women who experience IPV receive with the goal of addressing the disproportionate impact IPV has for Black women. Early detection of IPV via universal screening coupled with IPV-related trauma-informed care can reduce the range of IPV-associated mental and physical health consequences and medical costs, estimated at $2.1 trillion USD.