Recently, my colleague in CHOP’s Emergency Department and Violence Prevention Initiative (VPI) Fellow, Ashlee Murray, MD, MPH, authored an in-depth blog on screening for intimate partner violence (IPV) in the healthcare setting. Dr. Murray reviews the prevalence of IPV, current recommendations surrounding best practice, and CHOP’s approach through VPI’s participation and leadership in the STOP IPV program.
An abbreviated version of Dr. Murray’s’ blog post is included below. Click here to read the full blog on CHOP PolicyLab’s website.
In light of the recent #MeToo movement—as a pediatrician, public health advocate and mother—I find myself overwhelmed by the burden and threat that intimate partner violence (IPV) has on my patients and family. Every day I learn of more and more friends, coworkers and caregivers that have been victims of IPV within their lifetime. #MeToo has allowed these and many other survivors the platform to speak up and get help. Finally, this topic is getting the legal and media attention it needs to incite change.
IPV, a form of domestic violence, is a serious public health problem that impacts 1 in 3 women and 1 in 4 men in their lifetime. This includes physical violence (32 percent of women, 28 percent of men), sexual violence (16 percent of women, 7 percent of men) and stalking by a current or former intimate partner (10 percent of women, 2 percent of men). Even more alarming is that many of these victims are experiencing IPV before the age of 18 (7 percent or an estimated 8.6 million women).
Nationwide, more than 10 percent of students have been forced to do sexual things that they did not want to do and nearly one in 10 have been physically hurt on purpose by someone they were dating. Such exposure to IPV during adolescence has been associated with increased risk of adverse short- and long-term outcomes including substance-use, mental health disorders and re-victimization in the future.
Current Practice at Children’s Hospital of Philadelphia
Studies show that women support screening, there is no harm in screening, interventions improve the health and safety of victims and missed opportunities can result in devastating consequences. Therefore, here at Children's Hospital of Philadelphia (CHOP) we have decided to make every attempt to tackle this problem within our own community.
Approximately five years ago as part of the Violence Prevention Initiative, we implemented the STOP IPV program (formerly known as the Children’s and Mom’s Project). STOP IPV exists because of a strong collaborative community partnership with Lutheran Settlement House (LSH) and their Bilingual Domestic Violence Program (BDVP), which serves children, adults and families living in Philadelphia. LSH and BDVP offer individual counseling, support groups, legal advocacy, education and training and transitional housing, just to list a few of the amazing services they offer our community.
This project continues to evolve, but since this partnership was established CHOP has taken great strides to connect our patients and families with BDVP. We currently have two full-time, on-site IPV specialists from LSH that are available for patients, caregivers and employees. Our multi-disciplinary, hospital-wide task force dedicated to solving this problem consists of over 30 employees from across the institution. Because of their efforts, universal IPV screening has been implemented in CHOP’s emergency department, resulting in more than 80,000 caregivers screened and more than 200 referrals to our on-site IPV specialist in the past two years.
Furthermore, plans to expand universal IPV screening to CHOP’s outpatient practices, including Karabots Pediatric Care Center and CHOP’s Pediatric Transplant Center, will begin this summer. By shifting the culture and creating more screening points within one health care system, our patients and families will now have more opportunities to seek support when they are ready.
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