Research In Action
Research In Action
Moderator's Note: Ashlee Murray, Center for Violence Prevention practice scholar and attending physician in the Division of Emergency Medicine, was recently featured in a CHOP Research Institute Cornerstone blog post that highlights her research on intimate partner violence. Below is an excerpt of the blog post.
What does it mean to be a CVP Practice-based Scholar, and how does it impact your research?
Practice-based means I am a clinician, which lends itself to having a closer glimpse at the lived experiences of families and patients. These intimate insights support many of the problems that CVP tries to address. An experience I had as a resident almost 15 years ago propelled my interest in pursuing this career path. I wanted to improve how we care for families coming in with similar experiences at CHOP, and that’s the practice basis. With that comes research, as you discover and think about questions with the families you work with.
Another aspect of practice-based research is understanding the day-to-day operations of clinical medicine and what families experience in the medical space. In the space of DV and intimate partner violence (IPV), it’s also important to know the policies and procedures that the hospital follows so we can ensure they are trauma-informed.
Your Interdisciplinary Research Leaders project, “Centering Survivor Voices to Improve Medical-Community Partnerships Addressing Intimate Partner Violence,” is a wonderful example of community partnerships in research. Why is it important to form these partnerships, especially when studying IPV?
Everything we do is survivor-centered because the community knows the lived experiences of these survivors better than we do, and has been supporting them for decades. Our job is to help fill the gaps if one of our community partners has a research question. As researchers and clinicians, we must listen to what the community needs because otherwise, we're coming in with our own priorities in mind.
Our team was awarded the Foerderer grant last year, which is an internally funded award designed to allow ongoing research to move into new and productive areas, to support a community needs assessment to better under gaps and challenges in supporting parent survivors in Philadelphia. Our community partner was involved from the beginning and throughout the entire project, including active recruitment, helping us develop the interview guides, summarizing the findings, as well as dissemination. Survivor participants through the form of focus groups shared their real-world challenges and successes. These insights have subsequently informed the STOP IPV Program's future directions in survivor programming and research endeavors.
You were one of the original developers of the STOP IPV Program in 2014. How has this initiative grown in the last decade?
Through STOP IPV, CHOP partners with IPV agencies to promote universal assessment and resource allocation by pediatric healthcare providers for intimate partner violence and teen dating violence and referral to on-site specialists who can help. The program started with one part-time medical advocate, an IPV specialist from Lutheran Settlement House (LSH) who worked on-site at CHOP. Now we have two full-time advocates from LSH and a part-time advocate from Laurel House in Montgomery County who serves the King of Prussia campus. This service is available for free and is entirely confidential, and we’ve seen more employees using our resources because of this. If someone needs to take DV leave with Human Resources, our advocates can support them through that training. We're training hundreds of providers every year, and that number continues to grow along with our referral numbers, which are upwards of almost 350 per year.
Prior to last year, a referral could only come through a provider such as a physician, nurse, or social worker, but that situation could make people uncomfortable. Now we've updated our materials so patients, families, and employees can refer themselves without going through a provider.
We also now offer routine education and screening in the Emergency Department, as well as in Karabots and South Philly primary care centers. We’re becoming more prevalent and consistent in different places, and our goal is to become even more expansive. In the last year, we got involved in the Well Baby Nursery at the Hospital of the University of Pennsylvania to help integrate IPV referrals and resources as a routine part of their practice.
In addition to expansion of the program, we have also grown in our research productivity and interests. We have published several key manuscripts sharing how we used quality improvement to increase screening and universal education rates in the Emergency Department (ED). We conducted a 5-year follow up studying post-program implementation in the ED to better understand the cultural shift as well as continued challenges of the program. Most recently, we published a manuscript discussing disparities in screening and how best we can improve the system to address these disparities.
What is your role in Students Talking about Relationships (STAR), and what are your hopes for the program?
LSH culturally adapted STAR to better fit the Philadelphia area from Safe Dates, which is an evidence-based teen dating violence prevention program developed in the 90s. LSH has been implementing STAR in Philadelphia high schools for many years, but they've never studied it.
They asked me how they could create sustainable funding for the program by showing that the culturally adapted program was effective. While LSH comprises experts in the delivery of the program, I was brought on as a research consultant to help them understand the implementation process. We have a three-year grant that ends this July that is helping us implement STAR in 10 high schools in Philadelphia. We're collecting data on implementation measures like feasibility, fidelity, and reach. The second piece involves measuring the effectiveness of the program to determine if the program does what it sets out to do, which is to look at knowledge and help-seeking behavior.
