Health Stu Fac

August 2006

In the News
  • Some of the Biggest Victims of Domestic Violence are the Smallest
    • Research
  • Evaluation of a Women's Safe Shelter Experience to Teach Internal Medicine Residents About Intimate Partner Violence - A Randomized Controlled Trial
  • Using Patient Narrative to Educate Physicians about Domestic Violence
  • Teaching Trust - A New Approach to Domestic Violence Education?
  • Hidden from Plain Sight: Residents' Domestic Violence Screening Attitudes and Reported Practices
    • Announcements
  • Health Cares About Domestic Violence Day: Wednesday, October 11th
  • Reminder: DATE HAS CHANGED! 2007 National Conference on Health and Domestic Violence
  • Community-Campus Partnerships for Health 10th Anniversary Conference

    In the News

    Some of the Biggest Victims of Domestic Violence are the Smallest

    In a recent study published by UNICEF and The Body Shop International, researchers enumerated the impact of domestic violence on children. The report finds that "watching, hearing, or otherwise being aware of domestic violence can impact children's physical, emotional, and social development, both during childhood and later in life." From data collected globally by the UN Secretary-General's Study on Violence Against Children, an estimated 275 million children are exposed to domestic violence. This fact, compounded with that of domestic violence being chronically underreported, leaves a staggering number of children, worldwide, being raised in violent homes. The report finds that about 40% of child-abuse sufferers have concomitant domestic violence in their home. But even when children are not being directly abused, the exposure to violence alone can have lasting effects. Young children are more likely to be exposed to domestic violence than older children, which can stunt their emotional and mental growth. Older children are equally impacted, however, for they are at greater risk for "substance abuse, teenage pregnancy, and delinquent behavior." The study urges society and government to take action via raising awareness, the creation of protective policy and laws, and improved social services. The Body Shop is currently leading the way with its 2006 Stop Violence in the Home Campaign, focusing on the forgotten victims - the children.

    To find out more please visit http://www.unicef.org/ or http://www.thebodyshopinternational.com/web/tbsglunder "Behind Closed Doors: The Impact of Domestic Violence on Children"

    Research

    In the world of medical education, the importance of teaching about domestic violence is unarguable. To know how to compassionately and competently screen for and respond to victims of violence is a tool the every physician must posses. What is debatable is the how - how best do we teach future physicians to deal with domestic violence. How do we best equip the next generation of doctors to be discreet on one hand yet discerning on the other? How do we teach about domestic violence both effectively and efficiently?

    Evaluation of a Women's Safe Shelter Experience to Teach Internal Medicine Residents About Intimate Partner Violence - A Randomized Controlled Trial

    The authors of this study, based out of Yale, hypothesized that "an educational experience for residents at a women's safe shelter would have significantly greater impact on IPV competencies, screening, and care for victims than a workshop seminar alone." They conducted a randomized controlled trial in which residents were either trained about Intimate Partner Violence via a workshop or a workshop plus an experience at a women's shelter. Following the respective trainings, the residents' competencies were assessed by a written questionnaire which evaluated "knowledge, skills, attitudes, resource awareness, and screening behaviors." The study found that compared to those trained in the workshop, those exposed to the shelter experience scored significantly higher on the knowledge composite scale. However, there were no significant differences between the two groups in terms of skills, attitudes or resource awareness. Consequently, visiting a shelter may be narratively more impactful, however the statistical benefit was small, if any, over workshop training alone.

    For more information please see The Journal of General Internal Medicine 2005; 20:536-54

    Using Patient Narrative to Educate Physicians about Domestic Violence

    In the development of medical education materials interviews were conducted with 21 domestic violence survivors, asking them what they wanted to teach physicians. Four main themes emerged - "domestic violence is universal, it is more than just physical assaults, it is all about power and control, and it affects the entire family." This research then went on to show that survivor needs were based on the stage of their abuse. Recommendations for physician action was made based on 5 common situations: "when a patient may not yet recognize the abuse, when he or she may not be ready or able to disclose the abuse, when he or she chooses to remain in an abusive relationship, when he or she is seeking care for an acute assault, and when her or she has left the relationship but not yet healed." Interview excerpts based on these themes were melded to create "Voices of Survivors" a 30-minute educational documentary, a tool used in the education of physicians.

    For one free copy of "Voices of Survivors" please visit the FVPF store at http://www.endabuse.org/

    For more information please see The Journal of General Internal Medicine 2002: 17: 117-124

    Teaching Trust - A New Approach to Domestic Violence Education?

    Much of physician education in the realm of Domestic Violence focuses on teaching epidemiology, screening techniques, and resources awareness. However training physicians in a more subtle, emotional way may prove useful as well:

    Researchers, led by Dr. Tracy Battaglia, set out to identify "characteristics that facilitate trust in the patient-provider relationship among survivors of intimate partner violence." Twenty-seven female survivors of IPV participated in open-ended interviews regarding their attitudes on trust. Transcripts from the interviews were analyzed by a community group of advocates, counselors and IPV survivors. Five dimensions of provider behavior proved unique to the building of trust between physicians and IPV survivors: "Communication about abuse: the provider was willing to openly discus abuse; 2) professional competency: the provider asked about abuse when appropriate and was familiar with medical and social histories; 3) practice style: the provider was consistently accessible, respected confidentiality, and shared decision making; 4) caring: the provider demonstrated personal concern beyond biomedical role through nonjudgmental and compassionate gestures, empowering statements, and persistent, committed behaviors; 5) emotional equality: the provider shared personal information and feelings and was perceived by the participant as a friend." Consequently, teaching along these lines and developing these skills in future physicians could greatly enhance the doctor-patient relationship enabling physicians to better identify and assist victims of intimate partner violence.

    For more information please see The Journal of General Internal Medicine 2003: 18:617-623

    Hidden from Plain Sight: Residents' Domestic Violence Screening Attitudes and Reported Practices

    FIt is well established that domestic violence is prevalent "across all racial and socioeconomic classes in the United states." Recently researchers, led by Dr. Baig, looked into whether physicians preferentially screened based on a patient's race or SES. 167 residents across 6 specialties were asked to respond to an online survey regarding their attitudes and practices of DV screening. The results proved uplifting: The residents screened African-American and Caucasian women, as well as women of high and low socioeconomic status at similar rates. However, 37% of residents incorrectly believed that reported rates of DV were higher among African Americans than Caucasians. 66% of residents incorrectly stated that reported rates of DV were higher among lower SES women than women of a higher socioeconomic status. Consequently, the study concluded that although residents have an incorrect epidemiological idea of DV prevalence, they are not screening based on their misperceptions.

    For more information please see The Journal of General Internal Medicine 2006; 21:949-954

    Announcements

    Health Cares about Domestic Violence Day

    Domestic Violence is a Health Care Issue.

    Are you interested in being part of a nationally coordinated effort to support, educate and empower providers to assess for abuse in your community?

    Would you like the work you are already doing to contribute to a nation-wide push to improve healthcare's response to domestic violence?

    Then join us for the eighth annual Health Cares About Domestic Violence Day (HCADV Day) on October 11, 2006!

    HCADV Day is a nationally recognized awareness-raising day that takes place annually on the second Wednesday of October. Organized by the Family Violence Prevention Fund, with co-sponsorship from AMSA, HCADV Day aims to reach members of the healthcare community and educate them about the critical importance of assessing for domestic violence, as well as the long term health implications of domestic violence and lifetime exposure to violence.

    There are many ways that you can provide leadership on your campus as part of HCADV Day and the Family Violence Prevention Fund has an Organizing Packet (Click here for the Packet) to help you get started. Consider writing a newsletter article (Click here for a sample article) or an op ed for a local paper; providing information to your classmates and faculty on routine assessment for domestic violence; and passing out (free!) buttons, patient education brochures and training tools to your classmates and faculty. Visit http://www.endabuse.org/hcadvd/ for more information.

    If you have any questions about your involvement, email Anna Marjavi anna@endabuse.org

    DATE HAS CHANGED! Family Violence Prevention Fund's 2007 National Conference on Health and Domestic Violence

    Registration Opens Online
    September 30, 2006
    Pre-conference sessions: March 15, 2007
    Conference: March 16 - March 17, 2007

    Location:
    Grand Hyatt San Francisco
    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.

    The Family Violence Prevention Fund is especially encouraging Health Professional Students to submit abstracts reflecting student-led research, domestic violence campus reforms, and collaborative student/advocacy programs. A pre-conference session specifically focusing on professional health students and domestic violence activism will be held on March 15, 2007. Students will receive a reduced conference registration price and are eligible for scholarships. Please contact Anna Marjavi (anna@endabuse.org p:415-252-8900) with further questions.

    View Conference Purpose and Goals

    Registration opens September 30, 2006 online: http://www.endabuse.org/health/conference/

    View content from our 2004 National Conference on Health Care and Domestic Violence in Boston, MA.

     

    Community-Campus Partnerships for Health 10th Anniversary Conference

    "Mobilizing Partnerships for Social Change"

    April 11 - 14, 2007 in Toronto ON Canada

    Call for Proposals due October 6! - The conference planning committee is looking for proposals that address one or more of these sub-themes: Understanding and Addressing the Social Determinants of Health, From Grassroots Movements to Policy Change, Communities as Centers of Learning, Discovery and Engagement, Developing the Science of Community-Based or Practice-Based Evidence.

    For more information please visit: http://www.ccph.info/

    Health Students and Faculty Against Domestic Violence is a monthly listserv aimed to network health students and faculty from across the country who are interested in improving the health sector response to domestic violence. To subscribe visit http://www.endabuse.org/programs/healthcare/, click on 'Read More' under Join Monthly Listservs , and click on 'Subscribe' under Health Students and Faculty Against Domestic Violence Listserv.

    We encourage you to use this listserv to announce upcoming events you are planning or to pose questions to the group. To post an announcement or ask a question, send an e-mail to anita.nageswaran@gmail.com.

    The listserv is moderated by Anita Nageswaran, Health Intern with the Family Violence Prevention Fund and Second Year Medical Student at the University of California, San Francisco

    Thank you for contributing to our community!

    To learn more please visit our website http://www.endabuse.org/health