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Acceptability and feasibility of trauma- and violence-informed care for intimate partner violence
Gunjan Tiyyagura1, John M Leventhal2, Paula Schaeffer2
1Yale University School of Medicine, United States of America; Department of Emergency Medicine, Yale University School of Medicine, United States of America.
Insights
A trauma- and violence-informed care (TVIC) model effectively evaluated children exposed to intimate partner violence (IPV) and connected caregivers to support. This approach is feasible and acceptable, improving engagement with child abuse evaluations and IPV services.
Area of Science:
- Pediatric healthcare
- Public health
- Social work
Background:
- Intimate partner violence (IPV) and child physical abuse often co-occur, but children exposed to IPV are not routinely assessed for abuse.
- Pediatric visits present a crucial opportunity to address IPV, as caregivers often seek medical care for their children but not themselves.
Purpose of the Study:
- To assess the feasibility and acceptability of a trauma- and violence-informed care (TVIC)-based model.
- The model aimed to evaluate children exposed to IPV and link survivor-caregivers with an IPV advocate.
Main Methods:
- The study included children under 3 reported to Child Protective Services (CPS) for IPV exposure and their survivor-caregivers.
- Feasibility was measured by the percentage of eligible children evaluated and caregivers meeting/following up with an IPV advocate.
- Acceptability was assessed through qualitative interviews with caregivers regarding their perceptions of the model.
Main Results:
- Of 216 eligible children, 49 (22.7%) were evaluated. Of 41 caregivers, 68.6% met with an IPV advocate, and 91.7% had follow-up visits.
- Caregivers attended due to child behavioral concerns and CPS compliance.
- Key themes included motivations for visits, engagement facilitated by rapport and non-judgmental support, and benefits like recognizing IPV's impact and immediate advocacy linkage.
Conclusions:
- A TVIC-based model is feasible and acceptable for evaluating children exposed to IPV.
- The model shows potential to enhance caregiver engagement in child abuse evaluations and IPV services.
- This approach may improve safety and promote the well-being of children and families affected by IPV.
Background/Objectives:
Intimate partner violence (IPV) and child physical abuse frequently co-occur, yet IPV-exposed children are not routinely evaluated for abuse. Furthermore, IPV survivors often seek care for their children but not for themselves, making pediatric visits an opportunity to address IPV. We developed a trauma- and violence-informed care (TVIC)-based model that 1) evaluated IPV-exposed children and 2) linked survivor-caregivers to an IPV advocate. We aimed to assess the feasibility and acceptability of the model.
Participants:
Children < 3 who were reported to Child Protective Services (CPS) for exposure to IPV and their survivor-caregiver.
Methods:
To examine feasibility, we calculated the percentage of 1) eligible children evaluated and 2) caregivers who met with an IPV advocate during the child's visit and followed up with the advocate. To assess acceptability, we conducted qualitative interviews with 30/41 caregivers about their perceptions of the model.
Results:
From 7/1/20-6/30/22, 49 (22.7 %) of 216 eligible children were evaluated. Of 41 caregivers, six already were receiving IPV services; Of the remaining 35, 24 (68.6 %) met with an IPV advocate, and 22 (91.7 %) had ≥1 follow-up visit with an advocate. We identified three themes: 1) Motivations for the visit, 2) Engagement with the model, and 3) Benefits. Caregivers attended the visit due to behavioral concerns about the child and a desire to comply with CPS. Engagement occurred as medical providers established rapport and provided support without judgment. Benefits included recognizing the impact of IPV on the child and immediate linkage to advocacy services.
Conclusion:
A TVIC-based model is feasible and acceptable and could improve caregivers' engagement with the evaluation of IPV-exposed children for abuse and with IPV services, which have the potential to improve safety and promote well-being.
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