OUTCOMES FOR IPV: PATIENT AND PROVIDER PERSPECTIVES

亲密伴侣暴力(IPV)是一个主要的公共卫生问题。除了亲密伴侣身体攻击造成的直接创伤外，这种暴力还在医疗发病率、精神发病率、药物滥用、获得医疗保健的机会、生育结果和家庭功能等领域对健康状况产生负面影响。这项工作的广泛的长期目标是开发有效性研究的方法，这些方法有能力敏感地测量受影响的不同患者群体中与IPV相关的健康问题的异质性。这些方法对于理解卫生保健环境中IPV干预的短期和长期卫生保健结果至关重要。拟议的研究采用成本效益研究中常见的偏好(或效用)评估的标准方法，以量化暴露于亲密伴侣暴力(IPV)的妇女的保健结果。我们使用以患者为中心的方法进行这项工作，并制定结果衡量标准，纳入受以IPV为重点的卫生保健干预措施和政策影响的个人的价值观。我们还量化提供者对健康结果的偏好，以努力确定患者和提供者之间优先事项的差异，并更好地了解提供者IPV筛查行为。这项研究的重点是感染IPV的高风险妇女，她们几乎没有资源来应对这一重大的健康问题：低收入和从公共部门接受产前护理的少数民族妇女。在我们多样化的患者样本中，我们将重点放在拉丁裔妇女身上，她们在医疗保健背景下解决IPV问题时面临着重大的文化障碍。拟议项目的具体目的是：(A)量化女性患者在公共部门中的重要性；(B)量化公共部门产前护理提供者对与其患者进行传染性肺炎干预的潜在保健结果的重要性；(C)说明接触传染性支气管炎的妇女在与健康相关的生活质量方面的长期变化，并将计算结果与根据患者和提供者偏好确定的结果进行比较。我们建议的有效性测量方法的改编将以患者为中心，提供干预对健康状况影响的综合指标，有助于确保在评估和完善卫生保健环境中的IPV干预措施的过程中，低SES和少数族裔妇女不会被边缘化。

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.