TY - JOUR
T1 - Intimate Partner Violence
T2 - Barriers to Action and Opportunities for Intervention Among Health Care Providers in São Paulo, Brazil
AU - Evans, Dabney P.
AU - Shojaie, Danielle Z.
AU - Sahay, Kashika M.
AU - DeSousa, Nancy Williams
AU - Hall, Casey D.
AU - Vertamatti, Maria A.F.
N1 - Funding Information:
https://orcid.org/0000-0002-2201-5655 Evans Dabney P. PhD, MPH 1 Shojaie Danielle Z. MPH 1 Sahay Kashika M. PhD, MPH 2 DeSousa Nancy Williams PhD, MPH 1 https://orcid.org/0000-0003-1658-3717 Hall Casey D. PhD, MPH 1 Vertamatti Maria A. F. MD, PhD 3 1 Emory University, Atlanta, GA, USA 2 The University of North Carolina at Chapel Hill, USA 3 Faculdade de Medicina do ABC, Santo André, Brazil Dabney P. Evans, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Mailstop 1518-002-7BB, Atlanta, GA 30322, USA. Email: Dabney.evans@emory.edu 10 2019 0886260519881004 © The Author(s) 2019 2019 SAGE Publications Health care providers (HCPs) who directly interact with women play a critical role in intimate partner violence (IPV) prevention and response. The aim of this study was to identify the structural and interpersonal barriers to IPV response among HCPs working in public health clinics in Santo André, Brazil. Eligible participants included all HCPs providing direct care to individuals at three public health clinics. Participants self-administered an adapted Knowledge, Attitudes, and Practices survey on IPV. Data were analyzed using Epi Info 7 and SAS 9.4. 114 HCPs completed surveys. Less than half of HCPs (41%, n = 34) reported ever having asked a woman about abuse in the past year. HCPs who perceived fewer barriers were more likely to report asking about IPV. The top three reported barriers to asking women about IPV included the following: few opportunities for one-on-one interaction (77%, n = 65), a lack of privacy (71%, n = 60), and fear of offending women (71%, n = 60). Fewer providers who perceived the barriers of lack of privacy asked about IPV (50.8%, n = 33 compared with 84.2%, n = 16; p < .05); less providers who perceived few opportunities for private patient interactions asked about IPV (48.3%, n = 29 compared with 75.0%, n = 18; p < .05). Our results support the need for a systems approach of institution-wide reforms altering the health care environment and avoiding missed opportunities in IPV screening and referring women to appropriate resources or care. Two of the most frequently reported barriers to asking IPV were structural in nature, pointing to the need for policies that protect privacy and confidentiality. Within the Brazilian context, our research highlights the role of HCPs in the design and implementation of IPV interventions that both strengthen health systems and enable providers to address IPV. assessment domestic violence disclosure of domestic violence cultural contexts perceptions of domestic violence university research committee, emory university https://doi.org/10.13039/100013116 emory university https://doi.org/10.13039/100006939 edited-state corrected-proof The authors are grateful to Danielle Matias Dantas for her assistance with data collection and Maryclaire Regan for her editorial support. The authors would like to express their thanks to the health care professionals who participated in this research as well as the Santo André Ministry of Health who facilitated access to our data-collection locations. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was funded by the Emory University Global Health Institute and the Emory University Research Committee. ORCID iDs Dabney P. Evans https://orcid.org/0000-0002-2201-5655 Casey D. Hall https://orcid.org/0000-0003-1658-3717
Publisher Copyright:
© The Author(s) 2019.
PY - 2021/11
Y1 - 2021/11
N2 - Health care providers (HCPs) who directly interact with women play a critical role in intimate partner violence (IPV) prevention and response. The aim of this study was to identify the structural and interpersonal barriers to IPV response among HCPs working in public health clinics in Santo André, Brazil. Eligible participants included all HCPs providing direct care to individuals at three public health clinics. Participants self-administered an adapted Knowledge, Attitudes, and Practices survey on IPV. Data were analyzed using Epi Info 7 and SAS 9.4. 114 HCPs completed surveys. Less than half of HCPs (41%, n = 34) reported ever having asked a woman about abuse in the past year. HCPs who perceived fewer barriers were more likely to report asking about IPV. The top three reported barriers to asking women about IPV included the following: few opportunities for one-on-one interaction (77%, n = 65), a lack of privacy (71%, n = 60), and fear of offending women (71%, n = 60). Fewer providers who perceived the barriers of lack of privacy asked about IPV (50.8%, n = 33 compared with 84.2%, n = 16; p <.05); less providers who perceived few opportunities for private patient interactions asked about IPV (48.3%, n = 29 compared with 75.0%, n = 18; p <.05). Our results support the need for a systems approach of institution-wide reforms altering the health care environment and avoiding missed opportunities in IPV screening and referring women to appropriate resources or care. Two of the most frequently reported barriers to asking IPV were structural in nature, pointing to the need for policies that protect privacy and confidentiality. Within the Brazilian context, our research highlights the role of HCPs in the design and implementation of IPV interventions that both strengthen health systems and enable providers to address IPV.
AB - Health care providers (HCPs) who directly interact with women play a critical role in intimate partner violence (IPV) prevention and response. The aim of this study was to identify the structural and interpersonal barriers to IPV response among HCPs working in public health clinics in Santo André, Brazil. Eligible participants included all HCPs providing direct care to individuals at three public health clinics. Participants self-administered an adapted Knowledge, Attitudes, and Practices survey on IPV. Data were analyzed using Epi Info 7 and SAS 9.4. 114 HCPs completed surveys. Less than half of HCPs (41%, n = 34) reported ever having asked a woman about abuse in the past year. HCPs who perceived fewer barriers were more likely to report asking about IPV. The top three reported barriers to asking women about IPV included the following: few opportunities for one-on-one interaction (77%, n = 65), a lack of privacy (71%, n = 60), and fear of offending women (71%, n = 60). Fewer providers who perceived the barriers of lack of privacy asked about IPV (50.8%, n = 33 compared with 84.2%, n = 16; p <.05); less providers who perceived few opportunities for private patient interactions asked about IPV (48.3%, n = 29 compared with 75.0%, n = 18; p <.05). Our results support the need for a systems approach of institution-wide reforms altering the health care environment and avoiding missed opportunities in IPV screening and referring women to appropriate resources or care. Two of the most frequently reported barriers to asking IPV were structural in nature, pointing to the need for policies that protect privacy and confidentiality. Within the Brazilian context, our research highlights the role of HCPs in the design and implementation of IPV interventions that both strengthen health systems and enable providers to address IPV.
KW - assessment
KW - cultural contexts
KW - disclosure of domestic violence
KW - domestic violence
KW - perceptions of domestic violence
UR - http://www.scopus.com/inward/record.url?scp=85074332932&partnerID=8YFLogxK
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U2 - 10.1177/0886260519881004
DO - 10.1177/0886260519881004
M3 - Article
C2 - 31608805
AN - SCOPUS:85074332932
VL - 36
SP - 9941
EP - 9955
JO - Journal of Interpersonal Violence
JF - Journal of Interpersonal Violence
SN - 0886-2605
IS - 21-22
ER -
