An ecological model for family violence prevention across the life cycle

Family violence (FV) impacts individuals and their families, their communities, their physical health, and the economic health of society. The origins of FV are complex, and relationships among historical, cultural, interpersonal, and intrapersonal components are poorly understood. The morbidity, mortality, and cost of FV are enormous. This paper introduces an ecological model for FV prevention through the life cycle-from child abuse through interpersonal violence and to elder abuse. The model incorporates medical as well as social, justice, and educational literature about violence prevention efforts and programs. Health care professionals, particularly in family medicine, are on the front line of preventing family violence. The responsibilities and competencies related to preventing/addressing family violence include (1) identifying risk factors, (2) noting early signs and symptoms, (3) assessing for violence within families, (4) managing sequelae to minimize morbidity and mortality, (5) knowing/using referral and community resources, and (6) advocating for changes that promote a violence-free society. The model presented in this article provides a holistic approach to FV. This model can be applied to the Patient-centered Medical Home to promote educational initiatives, inter-professional collaborations, and community and population-based efforts to prevent and to decrease violence.