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Expert Perspectives on Intimate Partner Violence Power and Control in Pediatric Healthcare Settings
Maya I Ragavan1, Lindsey A Query2, Megan Bair-Merritt1
1Division of General Academic Pediatrics (MI Ragavan and M Bair-Merritt), Boston University School of Medicine/Boston Medical Center, Boston, Mass.
Insights
Intimate partner violence (IPV) experts reveal abusive partners subtly control survivors in pediatric settings, impacting care. Recognizing these behaviors is crucial for improving healthcare access and quality for children and families.
Area of Science:
- Public Health
- Child Health
- Domestic Violence Research
Background:
- Childhood exposure to intimate partner violence (IPV) is a significant public health issue with severe consequences for child well-being.
- While IPV's impact in various settings is documented, its manifestation within pediatric healthcare remains under-researched.
Purpose of the Study:
- To explore pediatric intimate partner violence (IPV) experts' perspectives on controlling behaviors in healthcare settings.
- To understand how these behaviors affect healthcare access and quality for IPV survivors and their children.
- To gather recommendations for pediatric healthcare teams to address IPV-related control.
Main Methods:
- Conducted individual semi-structured interviews with 28 pediatric IPV experts.
- Utilized snowball sampling for participant recruitment.
- Analyzed interview data through thematic analysis after individual coding by two researchers.
Main Results:
- Experts identified controlling behaviors such as limiting healthcare access, dominating discussions, and manipulating perceptions.
- Participants highlighted challenges in recognizing subtle controlling behaviors.
- Recommendations included leveraging multidisciplinary team expertise to address IPV dynamics.
Conclusions:
- Abusive partners employ subtle tactics to control or discredit IPV survivors within pediatric healthcare settings.
- Findings underscore the need for further research, including survivor perspectives and frequency analysis.
- Development of multidisciplinary IPV training for pediatric healthcare teams is recommended to improve identification and response.
Objective:
Childhood exposure to intimate partner violence (IPV) is a pervasive public health epidemic with profound impact on child health. While past work has demonstrated how abusive partners exert control over IPV survivors in a variety of settings (eg workplace, courts, home), scant research has examined how IPV power and control behaviors manifest themselves in pediatric healthcare settings. In this study, we explore the perspectives of pediatric IPV experts about: (1) behaviors used by abusive partners to control IPV survivors in pediatric healthcare settings; (2) how controlling behaviors impact healthcare access and quality; and (3) recommendations for the pediatric healthcare team.
Methods:
Individual semi-structured interviews were conducted with pediatric IPV experts recruited through snowball sampling. Interviews were individually coded by two research team members and analyzed using thematic analysis.
Results:
Twenty-eight pediatric IPV experts participated. Participants described several types of controlling behaviors including limiting healthcare access, dominating conversations during medical visits, controlling medical decision making, and manipulating perceptions of the healthcare team. Participants acknowledged the challenges of recognizing controlling behaviors and provided several recommendations to addressing behaviors such as leveraging the expertise of multidisciplinary teams.
Conclusions:
Participants described how abusive partners may attempt to control or discredit their partners in pediatric healthcare settings, using subtle behaviors that may be easily missed by the healthcare team. These results set the stage for further research and clinical practice innovation including triangulating the findings with IPV survivors, examining how frequently these behaviors occur, and developing multidisciplinary IPV training for the pediatric healthcare team.
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