Women Exposed to Intimate Partner Violence: an in Depth Look at Correlates of Preventive

Women Exposed to Intimate Partner Violence: An in depth look at correlates of preventive healthcare utilization

Carly Chornobil, MPH candidate
Peter F. Cronholm, MD MSCE, Capstone Mentor

1 Master of Public Health, University of Pennsylvania, Philadelphia, Pennsylvania; 2 Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania

ABSTRACT

Purpose We wanted to compare US Preventive Services Task Force-defined, age-appropriate preventive healthcare utilization among women exposed to intimate partner violence (IPV) to those who are not. A second aim of this study was to explore the dynamics of IPV exposure and preventive healthcare utilization by assessing barriers in access to care as well as other factors that affect healthcare utilization.

Methods A mixed method approach was used to better understand the dynamics of IPV exposure and preventive healthcare utilization. Two samples, each limited to women 18 years of age or older with a previous history of violence, were targeted. The first sample was derived from the Public Health Management Corporation’s (PHMC) survey, which examines the health and healthcare experiences of residents in the Philadelphia area. Logistic regression was used to compute adjusted and unadjusted odds ratios (OR) assessing the association between exposure to violence and age-appropriate preventive healthcare utilization. A second sample, obtained from the Women Against Abuse IPV shelter, used a focus group discussion tofurther explore the relationship between exposure to IPV and factors affecting preventive healthcare utilization.

Results Differencesamong women exposed to IPVcomparedto those without were indicated with an OR >1 or <1, however, none were statisticallysignificant.Womenwho reported exposure to violence are 3.11 times more likely to have a fair/poor health status (95% CI 0.20-0.52).Focus group results highlight women’s dissatisfaction with their patient-provider relationship, but also suggest ways in which providers can talk to patients about IPV. Participants also pointed out the lack of effective screening and interventions for victims of IPV.

ConclusionsNostatistically significant differences for age-appropriate preventive healthcare utilization was observedin the PHMC survey betweenwomen who reported exposure to IPV compared to women who didnot.Focus group results highlight impediments in the healthcare system andsuggest ways to address the issues. Results of this study signify a need for further studies to evaluate age-appropriate healthcare access and utilization for victims of IPV.