Violence Threatens Health of Pregnant Women & Newborns, Study Finds

A new study demonstrates conclusively that physical abuse by husbands and boyfriends compromises a woman’s health during pregnancy, her likelihood of carrying a child to term and the health of her newborn. A Harvard School of Public Health (HSPH) study, published in the July 2006 issue of the American Journal of Obstetrics and Gynecology, finds that violence from male partners both in the year prior to and during a woman’s pregnancy harms the health of women during pregnancy and the health of newborn children, and increases the risk of serious health complications during pregnancy. Abuse also increases a woman’s risk of delivering prematurely and having a child who is born clinically underweight and in need of intensive care. Led by Jay Silverman, PhD, Assistant Professor of Society, Human Development and Health at the HSPH, and Anita Raj, PhD, Associate Professor of Social and Behavioral Sciences at Boston University School of Public Health, researchers examined data on more than 118,000 women in 26 states who gave birth to live infants from 2000 to 2003. Information was gleaned from the Pregnancy Risk Assessment Monitoring System, which gathers information from women around the time of pregnancy. They found that women experiencing abuse in the year prior to and/or during a recent pregnancy were 40 percent to 60 percent more likely than non-abused women to report high-blood pressure, vaginal bleeding, severe nausea, kidney or urinary tract infections and hospitalization during pregnancy. Abused women also were 37 percent more likely to deliver preterm, and children of abused women were 17 percent more likely to be born underweight. Both of these conditions pose grave health risks to newborns. Children born to abused mothers were more than 30 percent more likely than other children to require intensive care upon birth. The study did not examine the impact of emotional abuse. The HSPH study was supported by a grant from the Division of Reproductive Health of the Centers for Disease Control and Prevention. Michele R. Decker, MPH, and Elizabeth Reed, MPH, both of the HSPH, co-authored the Journal article on the findings.

Pregnancy: A Teachable Moment for Violence Prevention

Opportunities to reduce or stop smoking, alcohol use, illicit drug use, and the risk of domestic violence with prenatal patients were explored through a series of six focus groups with OB/GYN physicians, nurse practitioners, and certified nurse midwives. Three major themes were identified: 1) specific risk-prevention tactics or strategies exist that are useful during pregnancy; 2) some providers address patients’ isolation or depression; and 3) providers can adopt a policy of “just chipping away” at risks.
Pregnancy was identified as a “teachable moment” and described a number of tactics to address risk behaviors with prenatal patients. The importance of normalizing risk prevention by letting patients know that risk assessment and intervention is a routine part of prenatal care was an important starting point to help patients feel comfortable. Providers described strategies to make questions less threatening such as asking about behaviors prior to pregnancy, using extreme amounts in assessment questions to reduce the stigma of disclosing a risk behavior (“Would you say six drinks a day?”), and opening with more general questions. A wide range of counseling practices were employed by prenatal health care providers to take advantage of follow-up visits to monitor progress on an issue and to use the maternal instinct to protect the baby as a motivator to change risk behaviors. Isolation and depression were noted as key factors that exacerbated substance abuse and domestic violence. Creating a group setting for discussion and support with pregnant women was an effective and efficient strategy used for domestic violence and smoking cessation. Pregnancy provides a ongoing window of opportunity to assess for risk behaviors, give supportive, risk-reduction messages, involve patients in problem-solving interventions such as motivational interviewing and the “5 As” (Ask, Advise, Assess, Assist, Arrange), and to employ a strategy of “chipping away” at risk prevention during prenatal care.
For more information please see: Patient Education and Counseling. 2006. Volume 61:228-235 or go online to http://www.sciencedirect.com/science/journal/07383991.

Recommendations to Improve Preconception Health and Health Care

Ten recommendations to improve preconception health and health care in the United States have been published in a special report by the Centers for Disease Control and Prevention. The recommendations, a product of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care, are aimed at addressing four goals: 1) improve knowledge, attitudes, and behaviors of men and women related to preconception health; 2) assure that all women of child-bearing age receive preconception care services to enable them to enter pregnancy in optimal health; 3) reduce risks indicated by previous adverse pregnancy outcomes through interventions during the interconception period; and 4) reduce disparities in adverse pregnancy outcomes. Recent studies indicate that 84% of women between the ages of 18-44 years visited a healthcare provider during the previous year, and slightly more than half (55%) accessed preventive health care services in any given year. While these visits provide ongoing opportunities to provide preconception care, data suggests that health care providers infrequently address this issue with their patients. The recommendations outline action steps to improve preconception health through changes in consumer knowledge, clinical practice, public health programs, health-care financing, and data and research activities. To download Recommendations to Improve Preconception Health and Health Care-United States go to http://www.cdc.gov/MMWR/preview/mmwrhtml/rr5506a1.htm

Effects of Domestic Violence on Perinatal and Early-Childhood Mortality: Evidence From North India

According to a new study by Dr. Ahmed and colleagues published in the August, 2006 issue of the American Journal of Public Health, infants born to mothers who experienced physical domestic violence during their most recent pregnancy were more than twice as likely to die in the first months of life compared to infants of nonbattered mothers. Nearly 1 in 5 women experienced physical abuse by their husband during their most recent pregnancy based on husbands’ self-disclosures of whether they had physically hit, slapped, or kicked their wives. The study authors felt that preventing domestic violence could signifcantly decrease early childhood mortality. It is estimated that 1 in 5 stillbirths and neonatal deaths could be prevented if domestic violence during pregnancy was eliminated. These results come from a population-based survey of 2199 women in Uttar Pradesh, India. Available online at http://www.ajph.org/current.shtml

New Study on Randomized Trial of Approaches to Screening for Intimate Partner Violence and Opportunity to Talk with the Author

A randomized trial of screening strategies for intimate partner violence by Dr. MacMillan and colleagues has been published in the latest issue of JAMA. This multi-site study involved more than 2500 Canadian women, 18 to 64 years of age, at two emergency rooms, two family practices, and two women’s health clinics. Three screening approaches were compared: face-to-face interviews with a physician or nurse, written self-administered questionnaire, and computer-based, self-administered questionnaire. Two screening instruments, the Partner Violence Screen (PVS) and the Woman Abuse Screening Tool (WAST) were used and compared with the Composite Abuse Scale (CAS) as the criterion standard. There were no statistically significant main effects on the rate of domestic violence disclosure by screening method or screening instrument. Study results indicated that women preferred self-completed approaches compared to face-to-face questioning, that computer-based screening did not increase the rate of disclosure, and that written screens had the fewest missing data. Dr. MacMillan is the featured “Author in the Room” to discuss screening patients for intimate partner violence on September 20, 2006, from 2 to 3 PM EST. Information to sign-up for the teleconference and obtain this study are available online at http://pubs.ama-assn.org/

Public Health Reports Focuses on Intimate Partner Violence

The July/August, 2006 issue of PUBLIC HEALTH Reports features a series of articles on intimate partner violence by leading researchers. Some key research findings presented in this issue include:
• Men and women who are exposed to intimate partner violence are at increased risk for a wide range of negative health outcomes including poor physical health, physical disability, mental illness, and substance abuse (Carbone-Lopez et al., 2006)
• Women who talked to their health care providers about their victimization were nearly four times more likely to use an intervention and those who received interventions were more than twice as likely to leave an abusive relationship (McCloskey et al, 2006)
• Although recent reviews suggest that batterer intervention programs (BIPs) have had very limited effects on preventing future abuse, many states have implemented standards that support the adoption of BIP intervention models that are supported by minimal evidence. The authors discuss factors that may impede progress in designing more effective interventions and identify effective strategies from the field of psychotherapy research that may help to advance multidisciplinary research on intimate partner violence (Eckhardt et al, 2006)
This issue is available online at http://www.publichealthreports.org

Study Sheds Light on Children’s Exposure to Domestic Violence in San Francisco

In a new study released by Education, Training, & Research Associates, it is estimated that between 11,000 and 16,500 children living in San Francisco are exposed to domestic violence each year and that only a small fraction receive any intervention through law enforcement or the judicial system. Children’s spontaneous statements recorded by police are highlighted throughout the report to provide a contextual understanding of the impact of violence on families. According to San Francisco police dispatch, officers respond to a domestic violence incident every 90 minutes. Police dispatchers characterized more than one-half (53%) of domestic violence calls as “life-threatening.” Victims typically sustained two visible injuries and 20% of the cases involved attempted strangulation. Approximately one-half of victims received medical care immediately following the incident. Domestic violence persists as a disparities issue with the highest rates of police responses to domestic violence occurring in San Francisco’s disenfranchised and vulnerable populations. African-American and Latino families are disproportionately represented in police responses to domestic violence incidents. The study results and recommendations for police practices and reaching more children exposed to domestic violence have been published in a report called “I Tried to Stop Them”: Children’s Exposure to Violence in San Francisco. To request a copy of this report e-mail the author, Dr. John Shields, at johns@etr.org

NEW RESOURCES

National Training Standards For Sexual Assault Medical Examiners

The Office of Violence Against Women has developed and published standards for sexual assault forensic examiners. The document is divided into three parts: introduction (background and overall recommendations); didactic content (includes operational issues and the examination process); and clinical practice recommendations. A companion document, A National Protocol for Sexual Assault Medical Forensic Examinations: Adults/Adolescents, is also available. The National Training Standards for Sexual Assault Medical Forensic Examiners can be downloaded at http://www.nicic.org/Library/021645

International Report on Female Genital Mutilation

The World Health Organization (WHO) has released their findings on female genital mutilation and obstetric outcomes from a prospective study conducted in six African countries. A total of 28,393 women at 28 obstetric centers in Burkina Faso, Ghana, Kenya, Nigeria, Senegal, and Sudan participated in the study. Women were classified into three levels of genital mutilation using the WHO system. Women with female genital mutilation had significantly higher risks of adverse obstetric outcomes including postpartum hemorrhage, stillbirth or neonatal death, and extended maternal stay. The highest rates of adverse outcomes were associated with more extensive female genital mutilation. A summary of this report is available at http://www.who.int/reproductive-health/fgm/

National Research Plan on Addressing Health Disparities

A new report, Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business, provides an assessment of the National Institutes of Health Strategic Research Plan and Budget to Reduce and Ultimately Eliminate Health Disparities. Observations and recommendations are provided for defining and measuring health disparities, the development and availability of the strategic plan including budget and finances, the National Center on Minority Health and Health Disparities, and the Health Disparities Research Program. The executive summary is available at http://www.nap.edu

Where Women Have no Doctor- Available Online

The 2006 edition of Where Women Have No Doctor provides comprehensive self-help health information that can be accessed online. Developed by health care experts and community-based groups from over 30 countries, this resource promotes an understanding of how poverty, discrimination, and culture contribute to health disparities among women and has been translated into more than 20 languages. Topics included in the 2006 edition are HIV/AIDS, older women and refugees, sex workers, sexual assault and intimate partner violence. Available online at http://www.hesperian/org/publications_download.php#wwhnd

INTERNSHIPS, REQUEST FOR PROPOSALS and FUNDING OPPORTUNITIES

Physician Advocacy Fellowship

The Physician Advocacy Fellowship supports doctors to develop or enhance their advocacy skills by implementing a project in partnership with an advocacy organization. The Physician Advocacy Fellowship provides support to doctors who want to develop their policy and advocacy skills by partnering with an advocacy organization on a project that they design jointly. Fellows will Design and implement an advocacy project to improve health and service delivery, Address social issues such as racism, violence, healthcare access, and environmental hazards which adversely affect health and health care delivery, Develop or strengthen their advocacy skills through collaboration with a partner advocacy organization. Additional information, including a list of past fellows, and application information, is available on our website at http://www.imapny.org/advocacy.
The deadline for short proposals is October 6, 2006.

WHO Foundation: Women Helping Others- Accepting Grant Applications

Grants are provided to organizations serving women and/or children in the United States and Puerto Rico. Specific projects and programs addressing health, education, and social service needs are the foundation's priority. The foundation recognizes the value of new programs created to respond to changing needs and will consider funding projects of an original or pioneering nature within an existing organization. In order to qualify for funding, organizations must have 501(c)(3) nonprofit status under the U.S. Internal Revenue Code and be qualified to receive deductible charitable contributions. Organizations that have received a WHO Foundation grant in the past should wait three years before applying again.
Deadline: September 12, 2006
For more information go to: http://fconline.foundationcenter.org/pnd/10002943/whofoundation
For additional RFPs in Women, visit: http://foundationcenter.org/pnd/rfp/cat_women.jhtml

OVC Professional Development Scholarships are available!

Scholarships provide up to $1,000 for individuals and up to $5,000 for multidisciplinary teams of victim service professionals seeking continuing education opportunities. To determine whether you or your team are eligible for a scholarship, visit the OVC.
For more information go to: http://www.ovcttac.org/calendar/training.cfm.

Mary Kay Ash Charitable Foundation -- Break the Silence Against Violence

Description: The goal of the Mary Kay Ash Charitable Foundation is to eliminate domestic violence. As part of this effort, the foundation wishes to donate funds to worthwhile organizations that aid the victims of domestic violence.
Who May Apply: Shelters for victims of domestic violence
Funding Amount: In 2005, the foundation distributed $20,000 grants to 150 shelters.
Application Deadline: September 1, 2006
For more information, go to: http://www.mkacf.org/BreakTheSilence.html

The J. Jill Compassion Fund

Description: The J. Jill Group considers written proposals for cash grants from nonprofit organizations within the United States only. Organizations serving homeless or at-risk women and children by providing job training, transitional and/or affordable housing, education, emergency shelter, or other types of aid will be considered upon submission of a grant proposal.
Who May Apply: Organizations requesting grants must provide proof of 501(c)(3) IRS tax-exempt status, a mission statement, an annual report, a budget for the specific program for which it is requesting funding, and a description of all services and programs it provides.
Funding Amount: The J. Jill Group will consider recommending grants only for existing programs. Grant requests should be between $250 and $15,000. All grants are made on a one-time basis.
For more information, go to: http://www.jjill.com/about/community.asp?AreaID=OL
Application Deadline: December 15, annually
For more information, go to: http://www.jjill.com/about/community.asp?AreaID=OL

VAWnet Special Announcement: Grants & Funding (August 2006)

Special Announcement
Newly-Enhanced Grants & Funding Area
August 2006
- Current Funding Database: This database provides a synopsis of the currently available fellowships, scholarships, and grants that may be used to address domestic violence, dating violence, sexual violence, and stalking for which the application deadlines have not yet passed. The funding announcements are arranged by Government Grants for Programs, Private Grants for Programs, Research and Evaluation, Fellowships, and Scholarships, and each includes a brief description and links to more detailed application information.
- Funding Alerts: The Funding Alert provides a weekly synopsis of current fellowships, scholarships, and grants that may be used to address domestic violence, dating violence, sexual violence, and stalking. The two most recent Funding Alerts are posted here, along with an archive of past Alerts.
Access the enhanced area at: http://new.vawnet.org/category/index_pages?category_id=5

EVENTS/CONFERENCES

Violence Prevention: Promoting Health Communities: Morehouse School of Medicine

Morehouse School of Medicine (MSM) and the Hamilton Fish Institute are proud to announce a conference entitled Violence Prevention: Promoting Health Communities to be held from September 25- 26th, 2006 in Atlanta, Georgia. The Hamilton Fish Institute on School and Community Violence is a national resource for the research and development of school violence prevention strategies. The conference aims to provide training and increase awareness among practitioners and community stakeholders about violence prevention and the new strategies that are rapidly growing in programs across the United States. Local and national leaders will be present to talk about successful activities and programs in their communities to deter violence.
For more information go to: http://www.msm.edu/ViolenceConference/Violence.htm or call Dr. Katherine Erwin for additional information at (404) 756-5278 or Dr. Kisha Braithwaite at (404) 756-8923, Monday through Friday, between the hours of 9:00 am and 5:00.

Mental Health Response to Mass Violence and Trauma: Office for Victims of Crime

Every year the Office for Victims of Crime (OVC) sponsors training workshops for victim service professionals. From October 3-5, 2006 they will host a workshop entitled "Mental Health Response to Mass Violence and Trauma" in Phoenix, Arizona. Workshops are designed to build practical technical skills and enhance knowledge of victim service issues. The Fall/Winter schedule offers several new workshops as well as favorites from years past.
For more information go to: http://www.ovcttac.org/calendar/training.cfm

Bridging the Gap: Reaching Across Cultures and Disciplines: Colorado Coalition Against Sexual Assault

"Bridging the Gap: Reaching Across Cultures and Disciplines" will be held on September 5-7th, 2006 in Denver, CO. The focus for the 2006 Sexual Assault Conference is two-fold; 1) reaching underserved victims with prevention and effective intervention and 2) how to create a sustainable inclusive organizations. This can include, but is not limited to, trafficking, people with disabilities, elderly, rural communities, bi- and monolingual communities, the homeless, LGBTQ, immigrant populations, incarcerated individuals, sex workers, etc.
For more information, go to: http://www.ojp.usdoj.gov/nij/events/nij_conference2006.html

Hospital-based Domestic Violence Programs: An effective Response to a Public Health Epedemic

Anne Arundel Medical Center
Tuesday, October 10, 2006
830am – 330pm
Purpose:
Identify the value and benefits of a hospital based domestic violence program.
Learn strategies for developing an in house program.
Identify benefits for the medical staff.
Ascertain the best ways to meet JCAHO standards.
Improve patient care.
Identify cost benefits and learn about funding options.
Learn about various program models.
For more information contact 443 481 1209 or DVcoalition@medchi.org

The National Center for Victims of Crime

The National Center for Victims of Crime is pleased to announce the 2006 Training Institute which offers the best in high quality training for victim service providers, law enforcement professionals, mental health professionals, youth workers, and others involved in supporting victims of crime. The Training Institute is coming to: Seattle, WA (September 25-27, 2006) and Cincinnati, OH (October 3-5, 2006). The Training Institute has been approved by the National Board of Certified Counselors for continuing education units for professional counselors. Registration is $180 for National Center members and $235 for non-members.
For more information and to register on-line, visit: http://www.ncvc.org/ncvc/main.aspx?dbID=DB_TrainingInstitute104

2007 National Conference on Health and Domestic Violence

Pre-conference Institutes: March 15, 2007
Conference: March 16 - March 17, 2007
Registration Opens Online: September 30, 2006 at http://www.endabuse.org/ Location: Grand Hyatt San Francisco, California, USA

The 4th Biennial National Conference on Health and Domestic Violence aims to advance the health care system's response to domestic violence. The conference attracts the nation's leading medical, public health and family violence experts from across the U.S. with increased international participation. Workshops and plenary sessions highlight the latest research and most innovative clinical responses to domestic violence, with a focus on the work being done by physicians, physician assistants, dentists, nurses, nurse midwives, mental and behavioral health providers, social workers, domestic violence experts, and others.
For more information, please contact Julie Varghese at Julie@endabuse.org, phone (415) 252-8900.

Health e-News is a monthly electronic news digest focusing on health care and domestic violence policy, research, prevention and advocacy. Health e-News is available in both text and html formats. To subscribe Click Here.

We encourage you to use Health e-News to share news, views, and experiences concerning your projects and activities on addressing domestic violence as a health care issue. To post an announcement or ask a question, send an e-mail to HealthE-News@endabuse.org. The digest is facilitated by Julie Varghese, julie@endabuse.org, with the Family Violence Prevention Fund.

Thank you for your ongoing commitment to end domestic violence!

Be sure to visit our website http://endabuse.org/health to learn more about our programs, products, and campaigns!