OUTCOMES FOR IPV: PATIENT AND PROVIDER PERSPECTIVES

亲密伴侣暴力（IPV）是一个重大的公共卫生问题。除了亲密伴侣的身体攻击造成的直接创伤外，这种暴力行为还在医疗发病率、精神病发病率、药物滥用、获得保健、生育结果和家庭功能等方面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，这些方法能够敏感地测量受影响的不同患者人群中与IPV相关的健康问题的异质性。这些方法对于了解卫生保健环境中IPV干预措施的短期和长期卫生保健结果至关重要。拟议的研究采用标准方法的偏好（或效用）评估常见的成本效益研究，以量化的医疗保健结果的妇女暴露于亲密伴侣暴力（IPV）。我们使用以患者为中心的方法进行这项工作，并制定结果的措施，纳入受IPV为重点的医疗保健干预措施和政策的个人的价值观。我们还量化了提供者对健康结果的偏好，以确定患者和提供者之间的优先级差异，并更好地了解提供者IPV筛查行为。这项研究的重点是IPV高风险妇女和几乎没有资源来科普这一重大健康问题的妇女：低收入妇女和正在接受公共部门产前护理的少数民族妇女。在我们多样化的患者样本中，我们专注于拉丁裔妇女，她们在医疗保健背景下面临着解决IPV的重大文化障碍。拟议项目的具体目标是：（a）量化妇女患者在公共卫生领域的重要性;（B）量化公共部门产前护理提供者对其患者进行IPV干预的潜在保健结果的重要性;和（c）描述暴露于IPV的妇女的健康相关生活质量的长期改变，将计算的估计值与根据患者和提供者偏好评估的结果进行比较。我们提出的有效性测量方法的适应将提供一个全面的指标，干预措施对健康状况的影响，以病人为中心的方式，有助于确保低SES和少数民族妇女不被边缘化的过程中，评估和完善IPV干预的卫生保健设置。

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.