Original Article

Brief Intervention for Perpetration of Intimate Partner Violence (IPV): Simulation Versus Instruction Alone

Authors: Amy A. Ernst, MD, FACEP, Steven J. Weiss, MD, FACP, FACEP, Kenlyn Hobley, MD, Ian Medoro, MD, Joe (Jebb) Baker, MD, Julie Kanter, MD

Abstract

Objective: To compare two brief randomized computer-based interventions about perpetration of intimate partner violence (IPV).


Methods: The study was a prospective cross-sectional cohort study of patients during randomized 4-hour shifts in an urban hospital-based emergency department setting with an emergency medicine residency. The site is a level 1 trauma center emergency department with an annual census of 60,000 adults. A touch-screen computer program was developed in Visual Basic 2005 Studio with consecutive data entry screens. A series of questions to evaluative IPV knowledge, attitude, and practices (KAP) was given before and after the brief intervention. The subjects were randomized to one of two intervention groups. Both groups were shown a set of PowerPoint slides addressing IPV prevention, which was followed by either a control group with nothing further (control) or a five-minute simulation video depicting IPV perpetration in adults (SIM). The main outcome was the net improvement in KAP scores defined as number who improved minus number who did worse. Perpetrators and victims were assessed separately. Demographics were also obtained. For demographics, descriptive statistics and percentages were used. Wilcoxon signed rank test was used for pre-post test paired data.


Results: A total of 239 patients, presenting during 52 randomized four-hour shifts, completed the study; 118 were in the control group, 121 in SIM; 115 (48%) were male and 124 (51 %) female (9 unknown). Most participants were from 21 to 30 years old (38%); 77 (32%) were Hispanic and 100 (42%) were white. There was an overall improvement in responses to KAP questions with correct answers to all questions in 46% before vs 59% after the computer intervention (Diff 13% 95% confidence interval [CI] 4-22). The net improvement in KAP score in the control group was 8% and in the SIM group it was 22% (Diff = 15%, 95% CI = 6-24). Forty subjects (17%, 95% CI = 12-21) were perpetrators and 52 subjects (22%, 95% CI = 17-27) were victims. KAP scores were not significantly improved in the SIM group over the control for either perpetrators or victims.


Conclusion: An IPV simulation video resulted in a greater percent of subjects showing improvement in knowledge, attitudes, and practices about IPV perpetration. A brief IPV simulation video intervention can be performed in a busy emergency department setting.

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References

1. Family Violence Prevention Fund. Available at: http://www.endabuse.org. Accessed December 10, 2010.
 
2. Ernst AA, Weiss SJ, Cham E, et al. Detecting ongoing intimate partner violence in the emergency department using a simple 4-question screen: the OVAT. Viol Vict 2004;19:375-384.
 
3. Ernst AA, Weiss SJ, Cham E, et al. Comparison of three instruments for assessing ongoing intimate partner violence. Med Sci Monit 2002;8:197-201.
 
4. Ernst AA, Weiss SJ, Morgan-Edwards S, et al. Validation of a short ED screen for perpetrators of IPV: the PErpetrator RaPid Scale (PERPS). J Emerg Med In press.
 
5. Weiss SJ, Ernst AA, Cham E, et al. Development of a screen for ongoing intimate partner violence. Viol Vict 2003;18:131-141.
 
6. Weiss SJ, Garza A, Casaletto J, et al. The out of hospital use of a domestic violence screen for assessing patient risk. Prehospital Emerg Care 2000;4:24-27.
 
7. Briere J. Predicting self-reported likelihood of battering: attitudes and childhood experiences. J Res Pers 1987;21:61-69.
 
8. Garner JW, Hudson WW. The Physical Abuse of Partner Scale (PAPS). In: Corcoran K, Fischer J, eds. Volume I. Couples Families, and Children. Instruments for Couples. Physical Abuse of Partner Scale (PAPS) Measures for Clinical Practice: A Sourcebook. New York, NY, The Free Press, 2000:154-164.
 
9. Cronholm P. Intimate partner violence and men's health. Prim Care Clin Office Pract 2006;33:199-209.
 
10. Lipsky S, Ceatano R, Field C, et al. Violence-related injury and intimate partner violence in an urban emergency department. J Trauma 2004;57:352-359.
 
11. Tjaden P, Thoennes N. Prevalence and consequences of male-to-female and female-to-male intimate partner violence as measured by the national violence against women survey. Viol Against Women 2000;6:142-161.
 
12. Cascardi M, Langhinrichsen J, Vivian D. Marital aggression: impact, injury, and health correlates for husbands and wives. Arch Intern Med 1992;152:1178-1184.
 
13. Pico-Alfonso MA. Psychological intimate partner violence: the major predictor of posttraumatic stress disorder in abused women. Neurosci Biobehav Rev 2005;29:181-193.
 
14. National Online Resource Center on Violence Against Women. Available at: http://www.vawnet.org. Accessed December 10, 2010.
 
15. Centers for Disease Control and Prevention Injury Prevention and Control: Violence Prevention. Available at: http://www.cdc.gov/ViolencePrevention/pdf/IPV_Strategic_Direction_Full-Doc-a.pdf. Accessed December 10, 2010.
 
16. D'Onofrio GD, Pantalon MV, Degutis LC, et al. Brief intervention for hazardous and harmful drinkers in the emergency department. Acad Emerg Med 2008;51:742-750.
 
17. Abbott J. Injuries and illnesses of domestic violence. Ann Emerg Med 1997;29:781-785.
 
18. DAIP Domestic Abuse Intervention Program. Available at: http://www.theduluthmodel.org/. Accessed December 10, 2010.
 
19. Smedslund G, Dalsbø TK, Steiro AK, et al. Cognitive behavioral therapy for men who physically abuse their female partner. Cochrane Database Syst Rev 2007;18:CD006048.
 
20. Ernst A, Weiss S, Goldstein L, et al. Computer versus paper format for intimate partner violence screening. Acad Emerg Med 2007;14:S44.
 
21. Ernst AA, Weiss SJ, Del Castillo C, et al. Witnessing intimate partner violence as a child does not increase the likelihood of becoming an adult intimate partner violence victim. Acad Emerg Med2007;14:411-418.
 
22. Rhodes KV, Lauderdale DS, He T, et al. "Between me and the computer": increased detection of intimate partner violence using a computer questionnaire. Ann Emerg Med 2002;40:476-484.
 
23. Campbell JC. Health consequences of intimate partner violence. Lancet 2002;359:1331-1336.