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

黑人女性和与亲密伴侣暴力(IPV)相关的杀人率高出三倍 与白人女性相比，死亡剥夺了黑人女性至少十年的生命。终身IPV流行率也是 黑人女性(50%)高于白人女性(35%)。IPV的持续和不成比例的影响 黑人妇女强烈建议有必要建立一个交叉框架，以便为艾滋病毒/艾滋病干预和培训提供信息 卫生保健提供者为黑人妇女提供的预防服务。美国妇产科学院 妇科(ACOG)建议进行常规的IPV筛查，并支持实施 密切注意避免污名化和优先考虑复原力“。作为总部位于田纳西州的HBCU， 梅哈里医学院是响应奥组委行动号召的理想人选。我们建议使用一种 为适应、实施和评估以临床为基础的创伤和治疗提供信息的交叉框架 暴力知情关怀(TVIC)干预。Meharry是基于证据的创伤知情护理的发源地 艾滋病毒护理干预；这一干预将为我们以IPV为重点的干预措施的发展提供信息。支持 妇女健康公平和落实ACOG建议，我们建议适应、实施、 并对创新的TVIC干预进行严格评估。通过使用交叉性框架 为了适应我们的TVIC干预措施，我们寻求确保其与黑人妇女的相关性。我们的首要目标是 为黑人妇女设计的TVIC干预措施的适应、实施和评估 田纳西州中部。在这个为期5年的RCMI项目中，我们提出了3个目标。目标1)参与利益相关者委员会 患者、提供者和专家(COPE)调整创伤和暴力知情护理(TVIC)干预 梅哈里的黑人妇女和她们的医疗保健提供者。[1-2岁]。目标2)实施并具有前瞻性 在医疗保健提供者层面评估适应的TVIC干预，衡量Meharry的变化 医护人员对TVIC实施的自我效能及其与TIC知识、态度和 练习。[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 TVIC干预对患者主要结局的影响--感知干预的有效性和报告 与IPV服务的联系，以及临床一级相对于气候和气候变化的次要结果 文化，通过非随机化的实用试验设计。[4-5年级]。Meharry的使命是‘促进健康 “通过创新研究实现公平”和“富有同情心的健康服务”使这所HBCU成为 这项创新和有影响力的研究。这项研究有可能改变那些关心黑人女性的 体验IPV的目的是解决IPV对黑人妇女的不成比例的影响。早些时候 通过普遍筛查和IPV相关创伤知情护理来检测IPV可以缩小范围 与IPV相关的心理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.