One in four Canadian women will face physical, sexual and/or psychological violence from an intimate partner in her lifetime. It often takes time – and sometimes, the escalation of violence – for people to accept that they are in an unsafe relationship and need support.
Unfortunately, screening for partner violence is very rarely, if ever, a routine part of a clinic visit. When screening does happen, it’s not always a private process nor are the ‘right’ questions being asked.
How can we make it easier for women to get screened for intimate-partner violence, and make the process more discreet?
Identifying red flags early and providing safety resources: New intimate-partner violence screening web-apps.
Using an Implementation Science approach which promotes the adoption and integration of evidence-based interventions, we partnered with the Fracture Clinic at St. Michael’s Hospital to design and implement a screening web-app tailored specifically for use within the Fracture Clinic. It’s now available to all of the clinic’s female patients.
The WITHWomen app is now available to all female patients in the clinic. Patients are asked to fill out an online survey, on their own and close to the clinic’s registration desk. An ‘escape’ function transforms the violence questionnaire into one about bone health, hiding the content about intimate-partner violence.
The web-app contains nine questions that were developed for their acceptability in partnership with people with lived experience of intimate-partner violence. The questions focus on identifying emotional violence and controlling behaviours, sexual violence as well as physical violence. A more comprehensive screening web-app, WITHWomen app , is available for use by women in the general public.
Once screening becomes part of routine practice at the clinic, plans include expanding screening to male patients as well. The same nine screening questions have been tested and found to be acceptable to men.
A complementary web-app, WITHWomen Pathways, creates personalized safety plans for those have identified as being in an unsafe relationship.
The next steps are to make them accessible to diverse populations, including men and patients who identify as LGBTQ+, and translate them to other languages. The resources and supports listed in the apps are all GTA- and Hamilton-based; we plan to expand the app’s geographical reach as well.
We are evaluating these interventions using a refined, rigorous, single-case experimental design.