Pregnant Teens & Intimate Partner Violence
Patient-Computer-Provider Collaboration
Background
Pregnant teens are at elevated risk for abuse
•During pregnancy, 21% of teens experienced IPV compared
to 14% of adult women.1
Abuse harms mother and baby
• Pregnancy complications such as low maternal weight gain,
anemia,
infections, and 1st/2nd
trimester bleeding
is
significantly higher in abused women. Low birth weight
occurs 50% more often in abused women when holding other
risk factors constant.1 Abused teens are more likely (22%)
than non-abused teens (7.5%) to not initiate prenatal care
until the third trimester.2
Early detection likely important for mother and baby
•The US Preventive Services Task Force reports that both
brief and sustained interventions during and after pregnancy
reduce the impact of domestic violence on infants.
Most providers do not screen for IPV
•Nationwide survey reveals only 17% of prenatal providers
routinely screen for IPV on the first visit, and only 5% screen
on follow-up visits.3
•Providers report lack of time, lack of patient disclosure, and
lack of effective interventions as reasons for not screening.4
Provider screening makes a difference
• 2006 randomized control
trial
indicates that simple
screening for IPV is as effective as more in-depth intervention
for increasing safety behaviors and decreasing IPV. 5
•Most women (75%) want providers to ask about IPV to
provide options, sense of control, and a listening ear.6
Computer-based screening promotes collaboration
•Teens report not feeling comfortable discussing personal
information with providers, requiring repeated screenings.7
•Teens and adults are significantly more likely to report
physical or sexual abuse to a computer, and most report
feeling comfortable discussing follow-up questions with a
nurse. Majority of teens (71%) prefer computer-assisted
health visits to regular clinic visits.8,9
Proposal
Study Design: 1-year Prospective Cohort Feasibility
Study
Population: Pregnant teen women
Setting: Sc