“Si Usted Quiere, Aqui Estoy”: A Special Studies Project Supporting IPV Care Provision in One Centro de Salud Familiar in Santiago, Chile Open Access

Buchloh, Grace (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/tt44pn943?locale=en


IPV is a global public health concern, as it is one of the leading causes of injury and disability for women, and has long-term intergenerational consequences for the health and wellbeing of children and families. To combat the global epidemic of intimate partner violence (IPV), screening procedures have been designed and implemented in a wide variety of clinical contexts, and Chile is no exception. This project aims to bolster screening and referral consistency, efficiency, and efficacy at CESFAM Recoleta, a public, primary care center, in Santiago, Chile, by 1) Mapping the current IPV screening and referral process used by clinic midwives and making targeted process improvement recommendations and 2) Using the perspectives garnered in the formative research project from summer 2019 to inform the creation of training content for providers and outreach materials for patients. The research team conducted semi-structured, in-depth, key informant interviews with seven staff members at the CESFAM Recoleta clinic (five midwives, one social worker, one psychologist) and three pregnant or formerly pregnant patients with either current or past experience of IPV. The qualitative, key-informant interviews conducted highlighted some general themes around IPV care provision in the CESFAM. The themes were compiled, along with formal recommendations, and relevant training resources, in a IPV Manual for CESFAM Recoleta. The approach and process changes recommended are slated to improve the consistency and standard of care through routine training of providers and standardization of competencies and IPV referral processes. Shifts in the clinic’s approach to and readiness for care may reduce rates of provider burnout, and improve disclosure rates and health outcomes for patients.

Table of Contents

Chapter 1: Introduction and Project Background 1


Project Background7

Problem Statement8

Purpose Statement9


Significance Statement9

Chapter 2: Literature Review11


IPV & Health12

Clinic-Based Screenings for IPV13

Conducting Clinic-Based Screenings16

Best Practices for Providers17


Chapter 3: IPV Manual for CESFAM Recoleta20

Manual Overview23


Assessment Findings24

Proposed IPV Clinic Competencies45

Recommendations for Quality Improvement46

Appendix A51

Appendix B53

Appendix C56

Chapter 4: Discussion, Recommendations, and Conclusion58

Discussion of the Product58

Recommendations for Use60



Implementation and Evaluation67

PH Implications68

Future Steps and Conclusion69

References 71

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