Effects of an emergency department-based advocacy program for battered women on community resource utilization

The emergency department is often accessed by battered women. Although it is recommended that information about community resources be given to women, there is little information regarding how often women use these resources. The objective of this study was to determine whether an ED-based advocacy program resulted in increased community resource utilization by battered women.

The study used a before-after trial design at an urban county hospital ED. Before the program, a consecutive sample of 117 women was identified in the ED as having sustained injuries by domestic violence. After the program, a consecutive sample of 105 (57% of the 183 asked) who agreed to meet with an advocate in the ED was identified. Participants in both groups lived in Kansas City, Missouri, and were 18 years of age or older. The outcome measures were the proportion of women with shelter use, shelter-based counseling, police calls, full orders of protection, and repeat ED visits for domestic violence after the index ED visit.

After the initiation of the program, shelter use increased from 11% to 28% (P =.003) and shelter-based counseling increased from 1% to 15% (P <.001). There was no change in repeat police calls (25% versus 35%, P =.14), full orders of protection (9% versus 6%, P =. 58), or repeat ED visits for domestic violence (11% versus 8%, P =. 63).

ED-based advocacy for domestic violence resulted in increased use of shelters and shelter-based counseling.