Effects of a Systems Change Model to Respond to Patients Experiencing Partner Violence in Primary Care Medical Settings

Using an 18-month longitudinal follow-up of women receiving healthcare at intervention clinics compared to control clinics, the present study tested four hypotheses related to the effectiveness of a systems change intervention on intimate partner violence (IPV) inquiry, violence reduction and the health and wellbeing of women patients in family medicine clinics. The study also examined participants’ views of the benefits and harms of IPV inquiry. Results showed that the intervention increased IPV inquiry, discussion, and disclosure compared to usual care. Women in intervention clinics made fewer doctor visits, but also received more prescriptions over time. The groups did not differ in change in physical violence, use of safety plans and strategies, connection to the community, patient satisfaction, or quality of health. Over the course of the study, both the intervention and usual care groups adopted more safety behaviors and experienced less violence, suggesting that participating in research interviews may have constituted an unintentional intervention. Small sample size (N = 34), low participation rate (32 %) and attrition (35 %) call for caution in interpreting these results.