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Area of Science:

  • Public Health
  • Health Services Research
  • Gender Studies

Background:

  • Intimate partner violence (IPV) is a significant public health concern requiring effective screening within healthcare systems.
  • The Veterans Health Administration (VHA) implements routine IPV screening and secondary lethality risk assessment.
  • Limited research exists on the implementation of IPV-related lethality screening, particularly concerning male veterans.

Purpose of the Study:

  • To investigate sex-based differences in the administration of IPV-related lethality screening.
  • To examine disparities in clinical outcomes following IPV screening between male and female veterans.
  • To identify potential improvements in IPV screening and response for all genders.

Main Methods:

  • Retrospective cross-sectional study utilizing electronic health record data from 135 VHA medical centers.
  • Data collected from October 1, 2022, to September 30, 2023, focusing on veterans with IPV-positive screens.
  • Mixed-effects logistic regression analysis to assess associations between sex and screening outcomes.

Main Results:

  • Of 67,379 patients with IPV-positive screens, 82.3% received secondary lethality screening, with higher error rates in administration among men (aOR, 1.42).
  • Nearly 1 in 5 men were misclassified, not receiving the lethality screen per protocol.
  • Women were significantly more likely than men to report past-year IPV-related lethality risk (29.9% vs. 13.3%, aOR, 2.29).

Conclusions:

  • Sex-based disparities exist in IPV-related lethality screening administration and outcomes within the VHA.
  • Gaps in screening for male veterans require further investigation and targeted interventions.
  • Enhanced strategies are needed to improve IPV screening, response, and connection to services for all at-risk individuals.