Approximately 6,328 patients were triaged to the waiting room during our study hours, and 5,473 were approached to participate in the study. Four thousand four hundred twenty-five patients were eligible for survey participation and 3,083 (69.6%) consented to participate. No differences existed for race or chief complaint between participants and nonparticipants, although participants tended to be younger and women. Overall, of the initial 3,083 consenting participants: 47% were women, 88% were black, and 71% were single. Of these participants, 2,737 (88.7%) completed the entire survey; however, we included the answered fields on the incomplete surveys. Nine hundred thirty-six participants were not in a relationship in the previous year, and thus they were not asked the intimate partner violence screening questions; 13 participants quit the survey before answering the relationship questions, so intimate partner violence status was not assessed. Of the 2,134 men and women in a recent relationship, 548 (25.7%) disclosed victimization within the past year. details the characteristics of the 2,134 participants who responded to the intimate partner violence questions.
Characteristics of participants by intimate partner violence status.
Five hundred forty-eight participants were eligible for 1-week follow-up. demonstrates demographic differences between those eligible (intimate partner violence victims) and not eligible (in a relationship in the past year but not meeting intimate partner violence victimization criteria) for follow-up. Intimate partner violence victims tended to be younger, women, and unemployed; to use street drugs and smoke; and to have mental health symptoms. Within the past year among the intimate partner violence victims (n=548), 318 disclosed physical violence, 132 experienced sexual violence, 120 were threatened with a weapon by their partner, 168 were afraid their partner would physically hurt them, and 412 stated their partner used words or yelled at them in a way that frightened them.
Of the 548 interviewed, 430 intimate partner violence victims consented to follow-up, and 281 (65.3% of those consenting, 51% of those interviewed) participated in a 1-week interview, 216 in person and 65 by telephone. One hundred forty-nine participants were lost to follow-up. A higher proportion of participants who disclosed moderate to severe depressive or posttraumatic stress disorder symptoms participated in follow-up interviews than those with low levels of symptoms. In addition, a higher proportion of participants who did not have people to talk to about problems or anyone to stay with in an emergency participated in follow-up interviews than those with social resources. No differences emerged with regard to sex, race, marital status, employment, or substance abuse. further illustrates this information.
In response to our first study objective, none of the participants (n=3,083), both those who disclosed intimate partner violence and those who did not disclose intimate partner violence, had any safety issues in the ED after participating in the computer screening.
Next, we sought to answer our second study objective about safety issues during the follow-up period. We found that only 2 of our intimate partner violence victims reported any safety concerns or emotional distress during their follow-up in-person interviews (n=216). Of these, both reported recurring emotional thoughts about the abuse after disclosing intimate partner violence during screening. Only 1 participant reported during the telephone follow-up interview (n=65) that there were issues associated with study participation. This participant related an incident in which she and her partner argued after she got home, mostly related to household chores.
We were able to review 911 calls for 34% of the initial consenting participants in the ED (N=1,037/3,083). We received information on 1,285 addresses, but we excluded 248 of these addresses (77 were shelters, 105 addresses were apartment complexes that did not have an apartment number noted, and the remainder were either the wrong county or the address did not exist). Of the 1,037 participants with addresses in the call district, 224 (21.6%) screened positive for intimate partner violence and 911 call information was available on 103 participants who completed a 1-week follow-up interview and 65 participants who participated in the 3-month follow-up assessment. The median number of total 911 calls for all participants did not change between 6 months before (0) and 6 months after (0) the index ED visit. There was no increase in the proportion of participants who called 911 after the index ED visit. In fact, there was a trend toward fewer 911 calls by intimate partner violence victims for all calls and violence-related reasons. illustrates this in detail.
Comparison of 911 calls made from residences of 1,037 participants in 1 call district, 6 months before and after ED visit.
We also reviewed acts of violence and the severity of the most recent abuse in those intimate partner violence victims who had recent contact with a partner 1 week before the ED visit (n=234), at the 1-week assessment (n=152), and at the 3-month assessment (n=102). Most victims who had contact with a partner reported reduced emotional and physical intimate partner violence at 1 week after screening. However, most of these levels returned to the initial reported levels by 3 months ().
Changes in intimate partner violence behaviors for those with recent contact with partner.
In regard to the impact of ED screening and referral on resource use and safety measures, 95% of intimate partner violence victims stated they benefited from project participation. Eighty-six percent of intimate partner violence victims contacted by telephone still reported that they had the resource information. In addition, 83% of intimate partner violence victims self-reported that they kept the resource information and 62% reported they had read the intimate partner violence information by their 1-week interview. At 1 week after the ED visit, 15% of participants had reported contacting one of the resources and 35% reported contacting a resource by 3 months. lists the most commonly accessed resources and the most frequent safety measures taken.
Top 5 most frequent used resources and safety measures.