Advisor/Chair: Dr. Robert S. Gold
Committee Members: Dr. Elizabeth M. Aparicio
Dr. Kerry M. Green
Dr. Min Qi Wang
Dean's Representative: Dr. Elaine A. Anderson
Title: COMMUNITY HEALTH WORKERS MANAGING INTIMATE PARTNER VIOLENCE: CURRENT PRACTICE AND PROMISE
Abstract:
Intimate partner violence (IPV) is a significant public health problem that affects more women than men, both nationally and globally. It is projected that more than 1 in 3 women and 1 in 7 men in the United States will experience physical, sexual, psychological violence or stalking throughout their lifetime. IPV is associated with a host of physical and mental consequences, many of which can influence the inter-generational cycles of violence. According to the Health Resource and Service Administration (HRSA), the top priority is to train the nation’s healthcare and public health workforce in addressing IPV at community and health systems levels. Women are more likely to leave abusive partners if they have a trusting relationship with healthcare professionals. Community health workers (CHWs) are trusted frontline public health workers that serve as liaisons between the healthcare system and the communities they serve, and therefore play a unique role in providing care to clients with various chronic diseases. Despite their effectiveness, there is a dearth of literature examining the provision of care to victims of IPV by CHWs.
The following study utilized a multiple methods design to determine the current practice and promise of CHWs managing clients who are victims of IPV. This dissertation research occurred in multiple phases. The preparation phase consisted of modifying the PREMIS survey, a validated tool that has been used to assess physician readiness to manage IPV, and subsequently making it is more appropriate for CHWs using expert feedback. Study 1 involved the administration of the modified PREMIS for CHWs survey to a sample of currently practicing CHWs (n=152), followed by psychometric analyses. Study 2 utilized semi-structured interviews with a panel of experts (i.e., experienced CHWs, CHW trainers, CHW supervisors, CHW Advisory Committee members) (n=10) to determine appropriate roles of CHWs in addressing IPV
Most sub-scales in study 1 yielded moderate to high reliability (0.57<α’s<0.97), and construct validity was established for several of the subscales. On average, many CHWs had low scores on objective knowledge (mean=15.4 out of 26), perceived preparation to manage IPV (mean=3.8 out of 7), and perceived knowledge (mean=3.7 out of 7). Adjusted regression models indicated that staff capabilities and staff preparation were significant predictors of perceived preparedness to manage IPV (all p’s<.05). Study 2 identified 8 themes and 5 sub-themes on potential roles that CHWs can take in managing clients who are victims of IPV. Results of this study provide valuable insight on IPV training and credentialing opportunities for CHWs.