Individualized performance feedback to increase prenatal domestic violence screening

Mary M. Duncan, Patricia A. McIntosh, Catherine D. Stayton, Charles B. Hall

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objectives: Universal domestic violence (DV) screening once per trimester of pregnancy is recommended but rarely accomplished. Clinical leaders in this setting sought to improve adherence with this protocol. This prospective study used medical record audit and individualized performance feedback with peer comparison (IPF) to improve DV screening among first and second year obstetrics and gynecology (ob/gyn) residents. Methods: The setting is a northeastern, urban, hospital-based, prenatal clinic serving low-income women. Most patients are Latina (75%); 11% are black and 9% are white. Few begin care in the first trimester (8.5%). We gave all residents DV training. Next we gave IPF-four reports at seven-week intervals. We reviewed medical record notes on patient visits corresponding to the first medical encounter and week 16 and week 28 of pregnancy. We used this data to compare screening immediately before IPF and following each IPF report. Results: Screening increased steadily over time, from 60% of appropriate visits before IPF to 91% after the fourth report (Chi Square 28.4, p < .001). Adjusting for key factors, the odds of screening after the last IPF report were seven and a half times greater than the odds of screening before IPF (Odds Ratio: 7.6; 95% Confidence Interval: 3.0, 19.0). Conclusions: IPF was associated with increased DV screening among first and second year ob/gyn residents in this setting. Increased screening improved compliance with the clinic protocol and increased opportunities for patient disclosure, education, and treatment, critical public health objectives.

Original languageEnglish (US)
Pages (from-to)443-449
Number of pages7
JournalMaternal and Child Health Journal
Volume10
Issue number5
DOIs
StatePublished - Sep 2006

Fingerprint

Domestic Violence
Gynecology
Obstetrics
Medical Records
Medical Audit
Pregnancy Trimesters
Urban Hospitals
Disclosure
Patient Education
First Pregnancy Trimester
Hispanic Americans
Public Health
Odds Ratio
Prospective Studies
Confidence Intervals
Pregnancy
Therapeutics

Keywords

  • Audit with feedback
  • Domestic violence
  • Guideline adherence
  • Prenatal care
  • Screening

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Individualized performance feedback to increase prenatal domestic violence screening. / Duncan, Mary M.; McIntosh, Patricia A.; Stayton, Catherine D.; Hall, Charles B.

In: Maternal and Child Health Journal, Vol. 10, No. 5, 09.2006, p. 443-449.

Research output: Contribution to journalArticle

Duncan, Mary M. ; McIntosh, Patricia A. ; Stayton, Catherine D. ; Hall, Charles B. / Individualized performance feedback to increase prenatal domestic violence screening. In: Maternal and Child Health Journal. 2006 ; Vol. 10, No. 5. pp. 443-449.
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