Study Questions Value of Universal, Computer-Assisted Screening for Partner Violence

August 15, 2012 — Computer-assisted screening for intimate partner violence does not result in better health, improved quality of life or reduced violence, according to a study published Wednesday in the Journal of the American Medical Association, MedPage Today reports (Petrochko, MedPage Today, 8/14).

Lead author Joanne Klevens of the Centers for Disease Control and Prevention said the findings suggest that "[j]ust providing passive referral resources probably isn't enough" and should not be taken to mean that doctors should stop asking women questions about partner violence. About 25% of U.S. women have experienced severe physical abuse by a partner at some point, according to a 2010 survey by the CDC. While experts agree that psychological and physical abuse in relationships is a significant public health concern, they have not resolved how to best identify and treat abuse survivors, according to Reuters.

In June, the U.S. Preventive Services Task Force issued draft recommendations that health care providers screen women for intimate partner violence and refer those who need help to appropriate services (Pittman, Reuters, 8/14). The Institute of Medicine and other medical groups also support the use of screening at routine health appointments, according to the Washington Times.

Study Details

For the study, CDC researchers created three random groups among more than 2,000 women who visited health facilities in Chicago from May 2009 through April 2010. One group completed a computer-assisted screening test consisting of three questions: had the participant been "hit, kicked, punched or otherwise hurt by someone within the past year," did she "feel safe" in her relationship and was a past partner currently making her feel unsafe. Women who answered "yes" to any of the questions were shown a video about how to get help and given materials about social services.

The second group was not screened but was given information about partner abuse and social services. The third group was given general information on social services but was not screened or given specific resources on partner abuse.

At a follow-up one year later, the researchers found no significant differences in health or quality of life outcomes among the three groups (Wetzstein, Washington Times, 8/14).

In total, nearly 10% of women said they experienced partner violence between the initial study period and the follow-up assessment (MacVean, "Booster Shots," Los Angeles Times, 8/14). The rate of recurrent violence was 68%, with no meaningful variation between the groups. Participants reported an average of 0.7 days of missed work and two days of missed household activities. Two-thirds of the women remembered receiving the referral list, but only 6.3% contacted any of the resources (MedPage Today, 8/14).

Accompanying Editorial

In an accompanying editorial, Nadine Wathen -- a faculty member at the University of Western Ontario and co-author of a 2009 study on universal screening -- said the findings suggest that providers should focus on treating those "who show signs and symptoms of abuse" rather than on universal screening (Washington Times, 8/14).