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Who is identified by screening for intimate partner violence?
Womens Health Issues. 2008 Nov-Dec; 18(6):423-32.WH

Abstract

BACKGROUND

Intimate partner violence (IPV) against women is prevalent and has significant physical and mental health consequences; accurate identification of IPV in health settings can be an important first step in appropriate response and referral to services for women.

METHODS

As part of a randomized controlled trial assessing IPV screening, we assessed exposure to IPV in the past year in 5,607 women visiting one of 26 health care sites across Ontario, Canada, between August 2005 and December 2006. Women completed both the brief (8-item) Woman Abuse Screening Tool (WAST) and the longer (30-item) Composite Abuse Scale (CAS), which served as the criterion standard. This paper describes the agreement between these 2 instruments, and identifies covariates associated with being positive on both the screen and the criterion standard versus positive on the screen only.

RESULTS

The WAST identified 22.1% of women as experiencing past year abuse, in contrast with the CAS, which identified 14.4% (kappa = .63; standard error [SE], .01). Women were more likely to have the following characteristics when identified as IPV positive on both the WAST and CAS than on the WAST alone: being married (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.3-5.5; p = .009), having a mental health issue (OR, 2.3; 95% CI, 1.3-4.0; p = .002), having a drug problem (OR, 1.7; 95% CI, 1.1-2.9; p = .036), and having a partner with a substance problem (OR, 2.0; 95% CI, 1.2-3.2; p = .006).

CONCLUSION

Screening in health care settings may overidentify IPV and care needs to be taken in decisions regarding how abuse is identified. However, screening alone may underidentify specific characteristics of women, partners, and relationships that could enable more accurate identification of abuse and specific mental health concerns through clinical case finding.

Authors+Show Affiliations

Faculty of Information & Media Studies, The University of Western Ontario, London, Ontario, Canada. nwathen@uwo.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Validation Study

Language

eng

PubMed ID

19041594

Citation

Wathen, C Nadine, et al. "Who Is Identified By Screening for Intimate Partner Violence?" Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, vol. 18, no. 6, 2008, pp. 423-32.
Wathen CN, Jamieson E, MacMillan HL, et al. Who is identified by screening for intimate partner violence? Womens Health Issues. 2008;18(6):423-32.
Wathen, C. N., Jamieson, E., & MacMillan, H. L. (2008). Who is identified by screening for intimate partner violence? Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, 18(6), 423-32. https://doi.org/10.1016/j.whi.2008.08.003
Wathen CN, et al. Who Is Identified By Screening for Intimate Partner Violence. Womens Health Issues. 2008 Nov-Dec;18(6):423-32. PubMed PMID: 19041594.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Who is identified by screening for intimate partner violence? AU - Wathen,C Nadine, AU - Jamieson,Ellen, AU - MacMillan,Harriet L, AU - ,, PY - 2007/12/21/received PY - 2008/08/12/revised PY - 2008/08/13/accepted PY - 2008/12/2/pubmed PY - 2009/3/12/medline PY - 2008/12/2/entrez SP - 423 EP - 32 JF - Women's health issues : official publication of the Jacobs Institute of Women's Health JO - Womens Health Issues VL - 18 IS - 6 N2 - BACKGROUND: Intimate partner violence (IPV) against women is prevalent and has significant physical and mental health consequences; accurate identification of IPV in health settings can be an important first step in appropriate response and referral to services for women. METHODS: As part of a randomized controlled trial assessing IPV screening, we assessed exposure to IPV in the past year in 5,607 women visiting one of 26 health care sites across Ontario, Canada, between August 2005 and December 2006. Women completed both the brief (8-item) Woman Abuse Screening Tool (WAST) and the longer (30-item) Composite Abuse Scale (CAS), which served as the criterion standard. This paper describes the agreement between these 2 instruments, and identifies covariates associated with being positive on both the screen and the criterion standard versus positive on the screen only. RESULTS: The WAST identified 22.1% of women as experiencing past year abuse, in contrast with the CAS, which identified 14.4% (kappa = .63; standard error [SE], .01). Women were more likely to have the following characteristics when identified as IPV positive on both the WAST and CAS than on the WAST alone: being married (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.3-5.5; p = .009), having a mental health issue (OR, 2.3; 95% CI, 1.3-4.0; p = .002), having a drug problem (OR, 1.7; 95% CI, 1.1-2.9; p = .036), and having a partner with a substance problem (OR, 2.0; 95% CI, 1.2-3.2; p = .006). CONCLUSION: Screening in health care settings may overidentify IPV and care needs to be taken in decisions regarding how abuse is identified. However, screening alone may underidentify specific characteristics of women, partners, and relationships that could enable more accurate identification of abuse and specific mental health concerns through clinical case finding. SN - 1049-3867 UR - https://www.unboundmedicine.com/medline/citation/19041594/Who_is_identified_by_screening_for_intimate_partner_violence L2 - https://linkinghub.elsevier.com/retrieve/pii/S1049-3867(08)00113-8 DB - PRIME DP - Unbound Medicine ER -