Article Figures & Data
Figures
- Figure 1.
Qualitative data analysis steps.
Tables
- Table 1.
Definitions of Intimate Partner Violence Screening Implementation Strategies Used
Implementation Strategies Definitions Access new funding Access new or existing money to facilitate IPV screening implementation Audit and provide feedback, with relay of clinical data to providers Collect and summarize clinical performance data over a specified time period about key measures of process/outcomes, then give it to clinicians and administrators to modify provider behavior and promote use of IPV screening practices Change record systems to remind clinicians Change record systems to allow better assessment of implementation or clinical outcomes (eg, clinical reminder, note templates) and to prompt clinicians to use the IPV screening clinical innovation Conduct IPV educational meetings and educational outreach visits Hold meetings led by a trained person and targeted toward different stakeholder groups (eg, providers, administrators, other organizational stakeholders, and community, patient/consumer, and family stakeholders) to teach them about IPV and IPV screening Conduct ongoing IPV trainings Plan for and conduct IPV trainings in an ongoing way Create a learning collaborative through advisory boards or workgroups Facilitate the formation of groups of providers and other kinds of stakeholders' groups that foster a collaborative learning environment, to provide input and advice on implementation efforts and improve IPV screening implementation Develop and distribute IPV educational materials Develop and format IPV guidelines, manuals, toolkits, and other supporting materials in ways that make it easier for stakeholders to learn about IPV, then distribute these materials in person, by mail, and/or electronically to enable staff and clinicians to learn how to deliver IPV screening Identify and prepare champions Identify and prepare individuals who dedicate themselves to supporting, marketing, and driving through IPV screening implementation, overcoming indifference or resistance that the intervention may provoke within the medical center IPV, intimate partner violence.
Adapted from Powell et al.31
- Table 2.
Intimate Partner Violence Screening Implementation Strategies with Exemplar Quotes for Strategies Across Early and Late-Adopting Sites, and Early Adopting Sites Only
Implementation Strategies Exemplar Quotes Implementation Strategies across Early and Late-Adopting Sites Conduct ongoing IPV trainings “I thought that the primary care social worker could have used a little more training early on, so I sat down with her and did some more training.” –IPV Assistance Program Coordinator, early adopting site “All the consistent training I've been doing for the past 1.5 years is working because now the calls I'm getting from providers are consultation calls and not calls of ‘I don't know what to do with this, I don't know what the resources are, can you help them, can you fix it?’ It's more of, ‘I did this, this, and this and now, I'm still concerned about how we can help her with x, y, and z.’” –IPV Assistance Program Coordinator, late-adopting site Conduct educational meetings and educational outreach visits “I present whenever I can, so I present at our town hall meetings, I present at the nurses/RN awareness week, and then social work week. I really try to be as active as I can with supervisors, and then going down the line in the actual clinic.” –IPV Assistance Program Coordinator, early adopting site “We have focused on staff education where I've gone to and given presentations on this to the social work line, to our mental health line, to mental health nurses, etc as much as possible within my own clinic, and so we focused on staff education." –IPV Assistance Program Coordinator, late-adopting site Develop and distribute IPV educational materials "One of the things that the IPV Coordinator did do when she first came on was she put together a resource list, both for the two counties that the two medical centers are in, and also through all the counties that the 7 community-based outpatient clinics are in…and I think she sent it out to everybody." –Women Veterans Program Manager, late-adopting site “We have handouts and posters in the waiting rooms, in the clinic, at our community-based outpatient clinics…we've really made an effort to spread the word in the VA system.” –Women's Health Medical Director and Primary Care Physician, early adopting site Implementation Strategies across Early Adopting Sites Only Identify and prepare champions “[IPV Coordinator] is a powerhouse, and she has been able to make things happen that nobody else before her was able to do…she was such a work horse that we all kind of looked up, and there it was. She's the one that put this into place and made it happen. She gave us the ability to train the people with whom we work. IPV screening necessitates a warm handoff to a social worker if it's positive, so getting everyone trained and the ability to train others has been an important part of putting it into place.” –Primary Care Social Worker Change record systems to remind clinicians "It initially got started as a clinical reminder that the licensed practice nurse would complete during their intake phase, and then if it screened positive, it would go to the provider to do more assessment." –Primary Care Physician Create a learning collaborative through advisory boards or workgroups "I got people from primary care, I got the chaplain involved, I got the police department involved, I got a nurse from the [emergency department], social work got involved, psychiatry got involved, [human resources] got involved,…and it's 1 hour bimonthly and it's very planned so they get an agenda about what we'll be talking about and we stick pretty firm to that and I ask how they might be available to help…that's actually how I got the pledge screening signed." –IPV Assistance Program Coordinator Audit and provide feedback, with relay of clinical data to providers “That was something that I started sending out to clinics, saying, ‘This is where your clinic is at, this is where it's not.’ Because I think numbers speak more than what I can, and so when I came on board, we were only at 32% hospital wide. And I have received them every month now for a little over a year, and they went from 32% to 77%.” –IPV Assistance Program Coordinator Access new funding “Then she applied for the second grant, and with the second grant, it was the implementation of the actual clinical reminder, the computer version of the recommended screening tool." –Women Veterans Program Manager IPV, intimate partner violence.
- Table 3.
Implementation Strategies Across Sites by Intimate Partner Violence Screening Adoption Status
Implementation Strategies All Sites (n = 11) Variation by IPV Screening Adoption Status Early Adopting Sites (n = 6) Late-Adopting Sites (n = 5) Conduct ongoing IPV trainings 8 sites 6 sites 2 sites Conduct educational meetings and outreach visits* 6 sites 4 sites 2 sites Develop and distribute IPV educational materials* 8 sites 4 sites 4 sites Identify and prepare champions 6 sites 6 sites None Change record systems to remind clinicians* 5 sites 5 sites None Create a learning collaborative through advisory board or workgroups 5 sites 5 sites None Audit and provide feedback, with relay of clinical data to providers 4 sites 4 sites None Access new funding 3 sites 3 sites None IPV, intimate partner violence.
↵* Some late-adopting sites were not included because they mentioned these implementation strategies as plans but not actual actions yet.
Mean implementation strategies used per site:
Across all sites, 5.62 implementation strategies.
For early adopting sites, 4.25 implementation strategies.
For late-adopting sites, 2.67 implementation strategies.
