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

Abstract

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

Rationale1

Project Background7

Problem Statement8

Purpose Statement9

Objectives9

Significance Statement9

Chapter 2: Literature Review11

Introduction11

IPV & Health12

Clinic-Based Screenings for IPV13

Conducting Clinic-Based Screenings16

Best Practices for Providers17

Conclusion18

Chapter 3: IPV Manual for CESFAM Recoleta20

Manual Overview23

Methods24

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

Strengths65

Limitations66

Implementation and Evaluation67

PH Implications68

Future Steps and Conclusion69

References 71

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Education Health Sciences, Nursing Health Sciences, Public Health
Stichwort	screening violence IPV DV
Committee Chair / Thesis Advisor	Sydney Spangler, Emory University

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