Read "Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence" at NAP.edu

Page 269 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Appendix F
Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence

Page 270 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Medical students (Ernst et al., 1998, 2000)	Type: Didactic Length: 3 hrs. Clinical aids: None		One group	Knowledge re IPV	Self-report (14 items)
Medical students (Haase et al., 1999)	Type: Mixed Length: 9 hrs. over 6 weeks Clinical aids: None	None	Two groups (one comparison group)	Perceived comfort, preparedness, questioning habits, and knowledge of resources re IPV	Self-report (five items, a = 0.70

Page 271 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	1	24	Eligible = 148 Pre = 144 Post = 141 (98%) FU = 104 (72%)		I_post>I_pre* (6 items) I_FU >I_pre* (5 items) I_FU <I_post* (2 items) I_FU =I_post (8 items)		Within-group comparisons were not based on matched groups (e.g., those with complete data and on all measurement waves) due to the Institutional Review Board’s requirement that participants be anonymous. Thus, the comparisons should be interpreted with caution.
No	24		Eligible = Not reported Post = 29	Eligible = Not reported Post = 86		I_post>C_post*	Although the training was a formal elective course, groups were created by self-report on the posttest rather than known course enrollment. The analysis controlled for gender. Analyses of individual items indicated that group differences were in knowledge and reported questioning habits rather than comfort and preparedness.

Page 272 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Medical students (Jonassen et al., 1999)	Type: Mixed Length: 2-3.5 days		One group	Knowledge re IPV	Self-report (10 items)
	Clinical aids: Materials on local resources; screening algorithm			Attitudes re IPV	Self-report (26 items)
				Clinical skills and experience	Self-report (10 items)
Medical students (Short et al., 2000)	Type: Mixed Length: 4-week module Clinical aids: None	One lecture	Two groups (one comparison group)	Knowledge, attitudes, and behavioral intentions about IPV	Self-report (37 items, a = 0.80, test-retest = 0.87)
				Appropriateness of intervening	Self-report (3-item subscale, a = 0.51, test-retest = 0.64)
				Physician responsibility for IPV	Self-report (8-item subscale, a = 0.69, test-retest = 0.82)
				Victim autonomy for decisions	Self-report (3-item subscale, a = 0.54, test-retest = 0.69)

Page 273 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	Immediately after training	6	Eligible = 205 Pre, Post, and FU = 144 (70%)		I_post >I_pre* I_FU >I_pre*		Test reliability was reported as adequate.
					I_post >I_pre* I_FU >I_pre* I_post >I_pre* I_FU >I_pre*		Results pertain to comparisons for two separate cohorts.
Yes	1		Eligible = 149 Pre = 124 Post = 87 (70%)	Eligible = 97 Pre = 88 Post = 66 (75%)	I_post >I_pre*	I_post >C_post*
					I_post < I_pre	I_post <C_post
					I_post >I_pre	I_post >C_post
					I_post >I_pre	I_post >C_post

Page 274 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
				Self-efficacy for detecting IPV	Self-report (6-item subscale, a = 0.72, test-retest = 0.72)
				Behavioral intentions to screen	Self-report (6-item subscale, a = 0.66, test-retest = 0.83)
Residents in all specialties (Coonrod et al., 2000)	Type: Mixed Length: 20 min. Clinical aids: Articles and pocket information cards	Didactic educational session on unrelated topic Length: 20 min. Clinical aids: Articles and pocket information cards on topic	Two groups (randomized)	Knowledge of IPV	Self-report (5-item subscale)

Page 275 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
					I_post >I_pre*	I_post >C_post*
					I_post >I_pre*	I_post >C_post*
Yes	9-10		Eligible = 24 Pre = 24 Post = 12 (50%)	Eligible = 22 Pre = 22 Post = 11 (50%)		I_post >C_post*	Analysis controlled for pretest score. Results

Page 276 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Residents in internal medicine (Knight et al., 2000)	Type: Didactic Length: 105 min. Clinical aids: Local resource list; laminated card of screening questions and resource contacts		One group	Beliefs re IPV (including selfefficacy of victims)	Self-report (31 items)
Residents in internal medicine (Kripke et al., 1998)	Type: Mixed Length: 4 hrs. Clinical aids: None		One group	Knowledge re IPV	Self-report (10 items)
				Attitudes re IPV	Self-report (25 items)
				Perceptions re skills	Self-report (10 items)

Page 277 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	Immediately after training		Eligible = 45 Pre = 45 Post = 45 (100%)		I_post =I_pre		Measures used were those developed by Varvaro et al. (1997), who reported internal consistencies ranging from 0.62 to 0.90, depending on the subscale of interest. Results were affected by residents = complaints about the lengthiness of the survey and their careless responding.
Yes	Immediately after training	6	Eligible = 55 Pre = 55 Post = 55 (100%) FU = 55 (100%)		I_post >I_pre* I_FU >I_pre* I_post >I_pre* I_FU >I_pre* I_post >I_pre* I_FU =I_pre		The differences would have been statistically significant if a one-tailed test had been used.

Page 278 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
ED staff and emergency medical technicians (Allert et al., 1997)	Type: Didactic Length: 90 min. Clinical aids: Copy of care guidelines; list of local resources		One group	Knowledge of written protocol, reporting requirements, and documentation	Self-report (4 items)
ED nurses (Bokunewicz & Copel, 1992)	Type: Didactic Length: 60 min. Clinical aids: None		One group	Beliefs re IPV	Self-report (questions on a scenario, a = 0.79)
ED staff, including physicians, nurses, and social workers (Campbell et al., in press)	Type: Mixed Length: 2 days Clinical aids: Technical assistance if requested	Usual or available training	Two groups (group randomized)	Knowledge and attitudes about IPV	Self-report (23 items, a = 0.73)

Page 279 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	Immediately after training	3	Eligible = 329 Pre = 266 Post = 266 (100%) FU = 213 (80%)		I_post >I_pre* (6 items) I_FU >I_pre* (6 items)		Total number of items in the instrument was not specified. The follow-up was done by telephone to a random sample, but the response rate was not reported. It is unclear whether the statistical tests took into account repeated measures.
Yes	Immediately after training		Eligible = 42 Pre = 18 Post = 18 (100%)		I_post >I_pre*
Yes	18-24		3 EDs Eligible = Not reported Pre = Not reported Post = 330	3 EDs Eligible = Not reported Pre = Not reported Post = 319	I_post >I_pre*	I_post >C_post*	An overall response rate for the posttest was 75%, but no information was provided regarding differential response rates for the two groups. The analyses controlled for gender, state, and pretest standing.

Page 280 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Trauma center staff, including residents in surgery and emergency medicine, medical students, and surgeons (Davis et al., 2000)	Type: Didactic Length: Unclear Clinical aids: None		One group	Knowledge re IPV	Self-report (18 items)
ED staff, including physicians, interns, and nurses (Roberts et al., 1997b)	Type: Didactic Length: 1 hr. Clinical aids: Poster (protocol); pocket cards		One group	Knowledge of IPV	Self-report (43 items)

Page 281 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	Immediately after training		Eligible = Not reported Pre = 92 Post = 92 (100%)		I_post >I_pre*
Yes	Immediately after training		Physicians Eligible = 72 Pre = 31 Post = 20 (65%) Nurses Eligible = 91 Pre = 69 Post = 48 (70%)		I_post >I_pre*		There were significant changes for the combined group of physicians and nurses, but nurses increased more than physicians. Overall, physicians incrased significantly but only in terms of knowledge of legal aspects of IPV.

Page 282 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
				Attitudes toward IPV	Self-report (10 items)
ED, critical care, and perinatal hospital staff (Short et al., in press)	Type: Length: Clinical aids: Protocol	Usual and available	Two groups (one comparison group)	Knowledge, attitudes, and behavioral intentions about IPV	Self-report (51 items)
				Understanding of abusive relationships	Self-report
				Beliefs about staff preparation and ability for addressing IPV

Page 283 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
					I_post >I_pre		After training, 35% of physicians believed that there was little a doctor or nurse could do to stop IPV, 50% believed that victims did not want to discuss IPV with a health professional, and 45% did not know that emotional abuse is generally viewed as worse than physical abuse by victims.
Yes	12	12	Eligible = 417 Pre = 200 Post =	Eligible = 265 Pre = 127 Post =	I_FU2 >I_pre	I_FU2 >C_FU2*	Although exact results were not provided, the authors reported that psychometric analyses found the scales were internally consistent. A total of 211 individuals had complete data for the outcome
					I_FU2 >I_pre	I_FU2 <C_FU2
					I_FU2 >I_pre	I_FU2 >C_FU2*

Page 284 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
ED, critical care, and perinatal hospital staff				Victim autonomy for decisions	Self-report
				Staff responsibility to address domestic violence	Self-report
				Self-efficacy for detecting IPV and interacting with victims	Self-report
				Self-efficacy for referral and services	Self-report
				Own behaviors re screening and documentation	Self-report

Page 285 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
					I_FU2 >I_pre	I_FU2 > C_FU2*	analyses, yielding an overall response rate for the posttest of 65%. The extent to which differential attrition occurred between groups was not reported. Analyses controlled for age, gender, position, department, exposure to training, and pretest score.
					I_FU2 >I_pre	I_FU2 >C_FU2
					I_FU2 >I_pre*	I_FU2 >C_FU2
					I_FU2 >I_pre*	I_FU2 >C_FU2
					I_FU2 >I_pre*	I_FU2 >C_FU2*

Page 286 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
ED house staff (Varvaro et al., 1997)	Group 1 Type: Didactic Length: 1 hr. Clinical aids: None Group 2 Type: Didactic Length: 1 hr. Clinical aids: pocket IPV training manual	Usual and available	Two groups (one comparison group)	Beliefs about IPV	Self-report (12 items, a = 0.89)
				Attitudes re IPV (self-efficacy in IPV victims)	Self-report (31 items, as ranged from 0.62 to 0.90 for subscales)

Page 287 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	0.5		Group 1 Eligible = Not reported Pre = 13 Post = 13 (100%)	Eligible = Not reported Pre = 11 Post = 11 (100%)	I_post =I_pre	I_post =C_post	The lecture-only and the lecture plus manual groups differed on specific items regarding perceived self-efficacy at the posttest, but the differences did not consistently favor one group. No comparisons were made between these two groups and the control group. The ability to detect within-group changes and relative group differences was handicapped by the small sample sizes.
			Group 2 Eligible = Not reported Pre = 13 Post = 13 (100%)	I_post >I_pres (5 of 12 items)

Page 288 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Community health center staff, including physicians, midlevel practitioners, social workers, and psychologists (Harwell et al., 1998)	Type: Mixed Length: 3-6 hrs. Clinical aids: IPV screening pocket card; IPV assessment form; stamp to indicate screening and suspected or confirmed abuse; patient card of resources and safety tips; additional tailored follow-up training to some CHCs		One group	Knowledge of IPV	Self-report (13 items, a = 0.91)
				Attitudes (comfort with IPV)	Self-report (4 items, a = 0.82)
Nurse-midwives (Paluzzi et al., 2000)	Type: Unclear Length: 8 hrs. Clinical aids: None		One group	Knowledge re IPV	Self-report (a = 0.80)
				Attitudes re IPV	Self-report (a = 0.61)
				Level of comfort in working with victims	Self-report (a = 0.59)
				Perceived cultural competence	Self-report (a = 0.96)

Page 289 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	Immediately after training	3	Eligible = 108 Pre = 108 Post = 108 (100%) FU = 23 of 66 eligible (35%)		I_post >I_pre* I_FU >I_pre* I_FU <I_pre		Analyses were restricted to the direct care providers who received the training. Table 2 is not clear as to whether results at all waves were only for 23 in the follow-up.
					I_post >I_pre* I_FU >I_pre I_FU <I_post
Yes	6	12	Eligible = Not reported Pre = 165 Post = 80 (48%) FU = 23 (14%)		I_post >I_pre* I_FU >I_post
					I_post >I_pre* I_FU >I_post
					I_post >I_pre* I_FU >I_post
					I_post >I_pre* I_FU >I_post

Page 290 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Knowledge, Attitudes, and Beliefs Outcome

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Primary care team members (Thompson et al., 2000)	Type: Mixed Length: two half-day sessions over 12 months Clinical aids: Posters; provider cue cards; routine exam forms; feedback	Usual and available training (e.g., manual)	Two groups (group randomized)	Self-efficacy re detecting IPV	Self-report (7-item subscale, a = 0.73)
				System support	Self-report (4-item subscale, a = 0.73)
				Blaming the victim	Self-report (7-item subscale, a = 0.80)
				Fear of offending	Self-report (7-item subscale, a = 0.80)
				Safety concerns	Self-report (8-item subscale, a = 0.91)

Page 291 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	9	21	Two clinics Eligible = Not reported Pre = 91 Post = Not reported FU =Not reported	Three clinics Eligible = Not reported Pre =88 Post =Not reported FU =Not reported	I_post >I_pre* I_FU >I_pre*	I_post >C_post* I_FU >C_FU*	Total number of eligible participants in all clinics was 208 of which 179 (86%) responded to the pretest.At the posttest and follow-up,there were 190 eligible providers of which 79% responded,and the corresponding figures for the follow-up were 171 and 82%.The extent to which the two groups differed with regard to attrition was not reported. Outcome analyses were adjusted for pretest and clustering.
					I_post >I_pre I_FU =I_pre	I_post >C_post I_FU >C_FU
					I_post >I_pre I_FU =I_pre	I_post >C_post I_FU >C_FU
					I_post >I_pre* I_FU >I_pre*	I_post >C_post I_FU >C_FU*
					I_post >I_pre* I_FU >I_pre*	I_post >C_post I_FU >C_FU*

Page 292 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Outcomes Related to Clinical Intervention Practices

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Residents in internal medicine and family practice (Saunders et al.,1993)	Type: Mixed Length: Two 50-min. sessions or one 2-hr. session Clinical aids: None Number of participants: 17	Usual and available	Two groups, randomized	% covering psychosocial issues in patient interview	Standardized patient visit
				Extent to which history was taken during patient interview	Standardized patient visit
				Extent of planning conducted during patient interview	Standardized patient visit
ED staff, including physicians, nurses, and social workers (Campbell et al., in press)	Type: Mixed Length: 2 days Clinical aids: Technical assistance if requested	Usual or available training	Two groups (group randomized)	% of identified IPV cases with more appropriate interventions	Chart review
				Patient satisfaction with care received	Self-report of patients
				Commitment by EDs to detecting and treating IPV victims	Researcher ratings
ED staff (Fanslow et al. 1998, 1999)	Type: Didactic Length: 1 or 4 hrs. Clinical aids: Protocols; forms; body map; checklist; contact cards Number of participants: 33 nurses and 11 medical staff		Cohort	% of IPV cases where interventions were used (e.g., referrals)	Chart review

Page 293 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
No	6		Post = 15	Post = 20		I_post =C_post
						Unclear
						Unclear
Yes	12	18	3 hospitals: Pre = 600 Post = 600 FU = 600	3 hospitals: Pre = 600 Post = 600 FU = 600		I_post =C_post
						I_post >C_post*
					I_post >I_pre* I_FUt>I_pre*	I_post >C_post* I_FUt>C_FUt*
Yes	12		Pre = 21 Post = 34	Pre = 26 Post = 13	I_post >I_pre*	I_post >C_post* I_FU =C_FU	There was a difference in the number of interventions at the baseline.

Page 294 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Outcomes Related to Clinical Intervention Practices

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Community health center staff, including physicians, midlevel practitioners, social workers, and psychologists (Harwell et al., 1998)	Type: Mixed Length: 3-6 hrs. Clinical aids: IPV screening pocket card; IPV assessment form; stamp to indicate screening and suspected or confirmed abuse; patient card of resources and safety tips; additional tailored followup training to some CHCs Number of participants: 108		Cohort	% of all cases with a completed safety assessment	Chart review
				% of all cases where a body map was completed	Chart review
				% of all cases with referral to CHC staff	Chart review
				% of all cases with referrals to outside agencies	Chart review
Public health nurses (Shepard et al., 1999)	Type: Mixed Length: 4 hrs. Clinical aids: Protocol and follow-ups Number of participants: Unclear		Cohort	% of identified IPV cases who were provided information	Chart review
				% of identified IPV cases who were directly referred to	Chart review services

Page 295 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	6		Pre = 251 Post = 255		I_post >I_pre*
					I_post =I_pre
					I_post >I_pre
					I_post >I_pre*
Yes	12	24	Pre = 31 Post = 23 FU = 18		I_post >I_pre* I_FU >I_pre*		Analyses controlled for age of patients.
					I_post >I_pre I_FU >I_pre

Page 296 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Outcomes Related to Clinical Intervention Practices

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
ED, critical care, and perinatal hospital staff (Short et al., in press)	Type: Length: Clinical aids: Protocol	Usual and available	Two groups (one comparison group)	% of cases with documentation of relevant social history	Chart review
				% of cases with documentation	Chart review
				% of documented referrals for IPV cases	Chart review
Primary care team members (Thompson et al., 2000)	Type: Mixed Length: 2 halfday sessions over 12 months Clinical aids: Posters; provider cue cards;routine exam firms; feedback Number of participants: Unclear	Usual and available training (e.g., manual)	Two groups (group randomized)	% of identified IPV cases whose quality of care was judged good or excellent	Chart review
Prenatal health clinic staff, including physicians, nurses, nutritionists, counselors, and clerical staff (Wist & McFarlane, 1999)	Type: Didactic Length: 90 min. Clinical aids: Protocol; follow-up Number of participants: Unclear	No protocol in one clinic	Two groups (one comparison group)	% of identified IPV cases who received referrals to outside agencies	Chart review

Page 297 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
	15	18 21 24	Post, FU1, FU2, FU3 = Not reported	Post, FU1, FU2, FU3 = Not reported		I_FU3 > C_FU3*	A total of 2,531 charts were reviewed, but the numbers were not reported for each data collection wave.
						I_FU3>C_FU3
						I_FU3>C_FU3*
Yes	9-10		2 clinics Pre = 27 Post = 37	3 clinics Pre = 32 Post = 35	I_post =I_pre C_post =C_pre	I_post =C_post
Yes	3	12	Pre = 3 Post = 9 FU = 17	Pre = 0 Post = 0 FU = 0	I_FU >I_pre*

Page 298 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Screening, Identification, and Detection of Intimate Partner Violence

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Medical students (Jonassen et al., 1999)	Type: Mixed Length: 2-3.5 days Clinical aids: Materials on local resources; screening algorithm	Earlier cohort of third-year medical students who did not participate in the clerkship	Three groups (one comparison group)	Screening skills	Standardized patient
Medical students (Short et al., 2000)	Type: Mixed Length: 4-week module Clinical aids: None	One lecture	Two groups (one comparison group)	% correctly identifying IPV in patient	Vignettes
Medical students (Short et al., 2000)	Type: Mixed Length: 4-week module Clinical aids: None	One lecture	Two groups (one comparison group)	% correctly identifying IPV in patient	Standardized patient
Residents in family practice (Bolin & Elliott, 1996)	Type: Didactic Length: 2 hrs. Clinical aids: List of contacts; button	Type: Didactic Length: 2 hrs. Clinical aids: List of contacts	Two groups, randomized	No. of days that resident had conversations with patients about IPV	Self-report of residents (daily diary)
Residents in internal medicine (Knight et al., 2000)	Type: Didactic Length: 105 mins. Clinical aids: Local resource list; laminated card of screening questions and resource contacts Number of participants: 45		1 group	% of patients reporting that resident had asked about IPV	Patient exit interview (one item)

Page 299 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
	9		Eligible = 205 Post = 205 (100%)	Eligible = 93 Post = 93 (100%)		I_post >C_pre*	Test reliability was reported as adequate. Results pertain to two separate cohorts who received the training.
Yes	1		Eligible = 149 Pre = 124 Post = 88 (71%)	Eligible (97) Pre = 88 Post = 66 (75%)	I_post <I_pre*	I_post =C_post	The standardized patient was designed as test of interview techniques.
No	1					I_post =C_post
No	1		Eligible = Not reported Post = 6	Eligible = Not reported Post = 5		I_post >C_post*
Yes	4 days		Pre = 122 Post = 116		I_post >I_pre*		Analyses were adjusted for patient age, income, and education, along with physician race.

Page 300 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Screening, Identification, and Detection of Intimate Partner Violence

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Residents in internal medicine (Kripke et al., 1998)	Type: Mixed Length: 4 hrs. Clinical aids: None Number of participants: 55		One group	% of cases seen where patient was asked about IPV	Chart review
Residents in internal medicine (Kripke et al., 1998)			One group	% of cases where patient was identified as IPV victim	Chart review
Residents in family practice (Mandel & Marcotte, 1983)	Type: Mixed Length: Two sessions over 4 months Clinical aids: Checklist on appropriate practices Number of participants: 16	Usual and available	Two groups (one comparison group)	% identifying IPV	Standardized patient visit

Page 301 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	6		Pre = 693 Post = 277		I_post >I_pre
					I_post <I_pre
	4		Eligible = Not reported Post = 10	Eligible = Not reported Post = 6		I_post =C_post	Due to the small sample sizes, no statistical tests were performed.

Page 302 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Screening, Identification, and Detection of Intimate Partner Violence

Nature of Training Provided

Expected Outcomes and Measure

Target Population (study citation)

Intervention Group

Comparison Group (if applicable)

Study Design

Major Outcomes

Measure

Residents in internal medicine and family practice (Saunders et al., 1993)

Type: Mixed

Length: Two 50-min. sessions or one 2-hr. session

Clinical aids: None

Number of participants: 17

Usual and available

Two groups, randomized

Time needed to detect IPV in interview

Standardized patient visit

Page 303 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing

Sample Size and Attrition from Measurement

Results

I = Intervention Group

C = Comparison Group

Pre = Baseline or Pretest

Post = Posttest

FU = Follow-up

Baseline

Posttest (months)

Follow-ups (months)

Intervention

Comparison

Within-Group Change

Relative Group Difference

Comment

No

6

Eligible = Not reported

Post = 15

Eligible = Not reported

Post = 20

I_post =C_post

Randomization was done by team in one site, and those who did not attend training were placed randomly in rotation sites. The outcome was in the expected direction but was not significant after physician gender, prior professional exposure, and number of IPV victims known were controlled for.

Page 304 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Screening, Identification, and Detection of Intimate Partner Violence

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
ED staff, including physicians, nurses, and social workers (Campbell et al., in press)	Type: Mixed Length: 2 days Clinical aids: Technical assistance if requested	Usual or available training	Two groups (groups randomized)	% of women who asked about IPV	Self-report of patients
		Usual or available training	Two groups (groups randomized)	% of self-identified IPV victims documented as such on medical record	Chart review
ED psychiatric staff, including residents, medical students, and other staff (Currier & Briere, 2000)	Type: Didactic Length: 1 hr. Clinical aids: Protocol Number of participants: 10	Protocol only (8 staff)	Two groups, randomized	% of patients seen by staff where history of adult spouse abuse was identified in chart	Chart review

Page 305 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	9-12	18-24	Pre = Not reported Post = 330	Pre = Not reported FU2 = 319	I_FU >I_pre*	I_post <C_post I_FU >C_FU	Analyses controlled for baseline differences. Although not statistically significant due to low statistical power, the ratio of self-reported IPV cases by patients to those documented in the medical record increased in the experimental hospitals but decreased in the comparison hospitals.
						I_post >C_post I_FU >C_FU
No	Unclear		Post = 84 patients	Post = 78 patients		I_post >C_post*

Page 306 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Screening, Identification, and Detection of Intimate Partner Violence

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
ED staff (Fanslow et al., 1998, 1999)	Type: Didactic Length: 1 or 4 hrs. Clinical aids: Protocols; forms; body map; checklist; contact cards Number of participants: 33 nurses and 11 medical staff		Cohort	% of all cases identified as IPV victims	Chart review
				% of possible IPV cases that were confirmed	Chart review
				% of possible IPV cases with documentation	Chart review
ED staff (McLeer et al., 1989)	Type: Unclear Length: Unclear Clinical aids: Protocol Number of participants: Not clear		Cohort	% of all cases identified as IPV	Chart review
ED physicians (Olson et al., 1996)	Type: Didactic Length: 1 hr. Clinical aids: Stamped query on patient form Number of participants: Unclear		Cohort	% of all cases identified as IPV	Chart review

Page 307 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	1-3	12-15	Pre = 2276 Post = 2287 FU = 1598	Pre = 1768 Post = 1720 FU = 1312	I_post =I_pre	I_post =C_post I_FU =C_FU	The analyses did not incorporate additional variables (e.g., patient characteristics).
			Pre = 57 Post = 53 FU = 17	Pre = 54 Post = 45 FU = 30	I_post >I_pre*	I_post > C_post* I_FU =C_FU
			Pre = 57 Post = 53 FU = 17	Pre = 54 Post = 45 FU = 17	I_post >I_pre*I	_post >C_post* I_FU =C_FU	Routine screening not adopted by ED staff.
Yes	12	96	Pre = 359 Post = 412 FU2 = 470		I_post >I_pre* I_FU >I_pre I_FU < I_post*		At follow-up, the protocol was no longer in use nor any other formal assessment procedure.
	1 mo. prior	1	Pre = 1,272 Stamp-only = 1,444 Stamp & training = 1,356		I_post >I_pre* I_FU >I_post		A significant increase in identification rates occurred after introduction of the stamp, but there was no change when education was added.

Page 308 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Screening, Identification, and Detection of Intimate Partner Violence

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
ED staff, including physicians, residents, interns, and nurses (Roberts et al., 1997a)	Type: Unclear (workshops and case presentations) Length: Unclear Clinical aids: None Number of participants: Unclear		Cohort	% of self-reported IPV victims who were noted as such on chart within 24 hours after presentation	Chart review
ED, critical care, and perinatal hospital staff (Short et al., in press)	Type: Length: Clinical aids: Protocol	Usual and available	Two groups (one comparison group)	% of cases with documentation of definite IPV	Chart review
	Type: Length: Clinical aids: Protocol	Usual and available	Two groups (one comparison group)	% of cases with documentation of suspected IPV	Chart review
ED nurses (Tilden & Shepherd, 1987)	Type: Didactic Length: 4 hrs. Clinical aids: Protocol and forms Number of participants: 22		Cohort	% of all cases identified as IPV	Chart review

Page 309 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	12		Pre = 141 Post = 183			I_post =C_post	Low attendance at training and lack of social work referral services at times when victims showed in the emergency room may have contributed to the lack of differences.
	15	18 21 24	Post = FU1 = FU2 = FU3 =	Post = FU1 = FU2 = FU3 =		I_FU3 > C_FU3*	A total of 2,531 charts were reviewed, but the numbers were not reported for each data collection wave.
						I_FU3 > C_FU3*
Yes	4		Pre = 447 Post = 445		I_post >I_pre*

Page 310 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Screening, Identification, and Detection of Intimate Partner Violence

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Maternity care coordinators in county health departments (Covington et al., 1997a)	Type: Didactic Length: Unclear Clinical aids: Protocol Number of participants:		Cohort	% of pregnant adolescents reporting IPV at first visit	Self-report of adolescent patients
				% of pregnant adolescents reporting IPV at any visit	Self-report of adolescent patients
Maternity care coordinators in county health departments (Covington et al., 1997b)	Type: Didactic Length: Unclear Clinical aids: Protocol Number of partcipants: Unclear		Cohort	% of pregnant adult clients reporting IPV at first visit	Self-report of pregnant patients
				% of pregnant adult clients reporting IPV at any visit	Self-report of pregnant patients

Page 311 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	12		Pre = 129 Post = 117		I_post >I_pre		Analyses controlled for differences in race/ethnicity between the two patient cohorts. Although the rate of identification at the first visit doubled between baseline and the posttest, this was not a statistically reliable difference due to the small sample size.
					I_post >I_pre*
Yes	12		Pre = 1,056 Post = 384		I_post >I_pre*		Analyses controlled for differences in race/ethnicity and age between the two patient cohorts. The baseline review of charts covered a 36-month time span, and no differences were found in identification rates among the three years.
					I_post >I_pre*

Page 312 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Screening, Identification, and Detection of Intimate Partner Violence

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Community health center staff, including physicians, mid-level practitioners, social workers, and psychologists (Harwell et al., 1998)	Type: Mixed Length: 3-6 hrs. Clinical aids: IPV screening pocket card; IPV assessment form; stamp to indicate screening and suspected or confirmed abuse; patient card of resources and safety tips; additional tailored followup training to some CHCs Number of participants: 108		Cohort	% of cases screened for IPV	Chart review
				% of cases where IPV was suspected	Chart review
				% of cases where IPV was confirmed	Chart review
Public health nurses (Shepard et al., 1999)	Type: Mixed Length: 4 hrs. Clinical aids: Protocol Follow-ups Number of participants:12		Cohort	% of cases identified as IPV	Chart review

Page 313 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	6		Pre = 251 Post = 255		I_post >I_pre*		There was no significant change in positive identification of IPV victims in the chart.
					I_post >I_pre*
					I_post >I_pre
Yes	12	24	Pre = 546 Post = 442 FU = 372		I_post >I_pre I_FU1 >I_pre		Differences in identification rates were not significant when age was controlled (although they were marginally significant).

Page 314 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Screening, Identification, and Detection of Intimate Partner Violence

	Nature of Training Provided			Expected Outcomes and Measure
Target Population (study citation)	Intervention Group	Comparison Group (if applicable)	Study Design	Major Outcomes	Measure
Primary care team members (Thompson et al., 2000)	Type: Mixed Length: 2 half-day sessions over 12 months Clinical aids: Posters; provider cue cards; routine exam forms; feedback	Usual and available training (e.g., manual)	Two groups (group randomized)	% asking about IPV	Provider self-report (one item)
				% of patients who were asked about IPV	Chart review
				% of patients who were victims of IPV	Chart review
Prenatal health clinic staff, including physicians, nurses, nutritionists, counselors, and clerical staff (Wist & McFarlane, 1999)	Type: Didactic Length: 90 min. Clinical aids: Protocol; follow-up	No protocol in one clinic	Two groups (one comparison group)	% of patients identified as IPV	Chart review

Page 315 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.

Timing			Sample Size and Attrition from Measurement		Results I = Intervention Group C = Comparison Group Pre = Baseline or Pretest Post = Posttest FU = Follow-up
Baseline	Posttest (months)	Follow-ups (months)	Intervention	Comparison	Within-Group Change	Relative Group Difference	Comment
Yes	9		2 clinics Eligible = ? Pre = Post = 91	3 clinics Eligible = ? Pre = Post = 88	I_post >I_pre*	I_post > C_post* I_FU >C_FU I_post > C_post*	Differences in recorded asking occurred among those who had physical exams and screening questionnaire.
Yes	9		2 clinics Eligible = ? Pre = Post = 91	3 clinics Eligible = ? Pre = Post = 88	I_post >I_pre*
Yes			Pre = 1,590 Post = 1,372 Same	Pre = 2,205 Post = 2,020 Same
Yes					I_post >I_pre	I_post >C_post
Yes	3		15	Pre = 360 Post = 110 FU2 = 250	Pre = 180 Post = 55 FU2 = 125	I_(post+FU) >	I_FU >C_FU* I_post > C_post*	The percent of charts at the intervention site that contained an abuse screen declined from 95% at the 3-month posttest to 85% at the 15-month follow-up.

Page 316 Cite Bookmark

Suggested Citation: "Appendix F Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.