Cueing Prenatal Providers: Effects on Discussions of Intimate Partner Violence
Background
Intimate partner violence (IPV) during pregnancy poses a significant health risk to the mother and developing fetus. Practice guidelines recommend that prenatal providers screen for and counsel their patients about IPV, yet many physicians express reluctance or discomfort regarding such discussions. The Health in Pregnancy (HIP) computer program was designed to improve prenatal providers’ counseling about behavioral risks.
Methods
English-speaking women 18 years or older, less than 26-weeks pregnant, and receiving prenatal care at one of the five participating clinics in the San Francisco area, were randomized in parallel groups in a controlled trial (June 2006–present; data analyzed June 2007). Participants reporting one or more risks were randomized to intervention or control in stratified blocks. Providers received summary “cueing sheets” alerting them to their patient’s risk(s) and suggesting counseling statements.
Results
Thirteen percent (37/286) of the sample reported current IPV. Provider cueing resulted in 85% of the IPV-intervention group reporting discussions with their provider, compared to 23.5% of the control group (p<0.001).
Conclusions
IPV discussions were influenced strongly by cueing providers. Provider cueing is an effective and appropriate adjunct to routine risk counseling in prenatal care.
aDivision of Behavioral Sciences, Professionalism, and Ethics, University of California San Francisco, San Francisco, California
bDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
cDepartment of Obstetrics, Gynecology, and Reproductive Sciences, San Francisco General Hospital, University of California San Francisco, San Francisco, California
Address correspondence and reprint requests to: Barbara Gerbert, PhD, Professor, Division of Behavioral Sciences, Professionalism, and Ethics, University of California San Francisco, 350 Parnassus Avenue, Suite 905, San Francisco CA 94117.
ABSTRACT