OUTCOMES FOR IPV: PATIENT AND PROVIDER PERSPECTIVES

亲密伴侣暴力是一个重大的公共卫生问题。除了亲密伴侣身体攻击造成的直接创伤外，这种暴力行为还在医疗发病率、精神发病率、药物滥用、获得保健、分娩结果和家庭功能等方面对健康状况产生负面影响。这项工作的广泛长期目标是制定有效性研究的方法，以便能够敏感地衡量受影响的不同患者群体中与IPV有关的健康问题的异质性。这些方法对于了解卫生保健机构内IPV干预措施的短期和长期卫生保健结果至关重要。拟议的研究采用与成本效益研究相同的偏好（或效用）评估标准方法，以量化遭受亲密伴侣暴力的妇女的保健结果。我们在这项工作中采用以患者为中心的方法，并制定了纳入受以ipvv为重点的卫生保健干预措施和政策影响的个人价值的结果衡量标准。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优先考虑的差异，并更好地了解提供者IPV筛查行为。这项研究的重点是易患IPV的妇女，她们没有足够的资源来应对这一重大健康问题：低收入和少数民族妇女，她们正在接受公共部门的产前护理。在我们不同的患者样本中，我们重点关注拉丁裔妇女，她们在卫生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)量化妇女病人在公共妇女中的重要性；(b)量化公共部门产前保健提供者对其患者进行IPV干预的潜在保健结果的重视程度；(c)描述暴露于ipvv的妇女健康相关生活质量的长期变化，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。调整我们提出的有效性测量方法将以患者为中心的方式提供干预措施对健康状况影响的综合指标，有助于确保低社会经济地位和少数民族妇女在评估和完善卫生保健机构的IPV干预措施的过程中不会被边缘化。

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.