Omonyêlé L. Adjognon, ScM; Julianne E. Brady, MA; Megan R. Gerber, MD, MPH; Melissa E. Dichter, PhD, MSW; Alessandra R. Grillo, BS; Alison B. Hamilton, PhD, MPH; Shannon Wiltsey Stirman, PhD; Katherine M. Iverson, PhD
Corresponding Author: Omonyêlé Adjognon, ScM; VA Boston Healthcare System. Email: omonyele.adjognon@va.gov
Section: Original Research
Publication: 3/26/2021
Background: Evidence supports the clinical effectiveness of intimate partner violence (IPV) screening programs, but less is known about how to fully implement and sustain them. This qualitative study identified implementation strategies used to integrate IPV screening programs within Veterans Health Administration (VHA) women’s health primary care. Methods: Thirty-two administrators and clinician key informants from 11 VHA facilities participated in semi-structured interviews. Implementation strategies were identified using established definitions from the implementation science literature (i.e., Expert Recommendations for Implementing Change project), through a multi-step content analysis, involving site comparisons by implementation status (early vs. late adoption). Results: We identified 8 strategies used, 3 of which were present across all sites: 1) conduct ongoing IPV trainings, 2) conduct educational meetings and outreach visits, and 3) develop and distribute IPV educational materials. Five strategies were unique to early-adopting sites: 4) identify and prepare champions, 5) change record systems to remind clinicians, 6) create a learning collaborative through advisory boards or workgroups, 7) audit and feedback with relay of clinical data to providers, and 8) access new funding. Discussion: Strategies align with and extend literature identifying barriers to IPV screening implementation. Evidence that sites used multiple strategies to support implementation, with early-adopting sites using more strategies than late-adopting sites, reinforces the notion that effective IPV screening implementation in primary care requires a bundle of well-defined, carefully selected implementation strategies. Conclusions: Implementation strategies used collectively can enable integration of IPV screening programs in primary care, thereby actualizing the benefits of these practices on women’s health.