Authors: Anisa Ali, MA, Futures Without Violence; Kimberly S.G. Chang, MD, MPH, Asian Health Services
Did you know that October is Domestic Violence Awareness Month? We are 100% certain that every single health center cares for people who have been affected by domestic violence.
Domestic violence is common: 1 in 4 women in the United States have reported experiencing intimate partner violence in their lifetime, and 1 in 7 men have reported experiencing severe physical violence by an intimate partner.[i] Rates of violence are even higher in LGBTQ communities: 44% of lesbian women and 26% of gay men experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime,[ii] and transgender individuals are 1.7 times more likely to experience domestic violence.[iii]
And now during COVID-19, rates of domestic violence are on the rise, as survivors are now confined to their homes with their abusers.[iv]
How can health centers respond?
For many survivors, seeing a health provider may be a lifeline. A provider may be the only person they speak to outside of the home, and the only kind words they hear. Providers can use the four simple steps of the CUES approach to initiate conversations with their patients about domestic violence, how it can impact health, and where to go for support.
The CUES approach works—just take a look at this first-hand report from Eastern Iowa Health Center, who participated in a training led by Futures Without Violence on using the CUES approach in health centers to address domestic violence:
A patient dropped into the health center for an asthma flare-up. Upon history, she told her provider it was triggered by her partner’s strong cologne. When the provider asked if the patient suggest her partner to not wear the cologne around her, the patient replied that her partner intentionally wore the cologne to aggravate her asthma. Because of the CUES approach training, the provider recognized this behavior as a sign of abuse and then talked with the patient about how relationships can affect health, ultimately connecting the patient to a local DV program for support. The patient later disclosed additional abusive behaviors by her partner.
When providers initiate conversations about domestic violence with their patients, they provide crucial support for survivors. Your health center too can make a difference!
New opportunities for health centers
Your health center can also take part in our efforts at Futures Without Violence, and can learn about the CUES approach and other strategies to help your patients and communities end domestic violence. We recently launched the National Health Network on Intimate Partner Violence and Human Trafficking, to collaborate with health centers to support those at risk of or surviving intimate partner violence or human trafficking, and to bolster prevention efforts. The National Health Network on Intimate Partner Violence and Human Trafficking is launching its series of learning collaboratives to help health centers address intimate partner violence (IPV) and human trafficking. Each learning collaborative will be composed of 10 health centers, and with different topic areas. See the info below to apply:
- Healing Centered Engagement for Patients Experiencing Intimate Partner Violence: This learning collaborative will increase health center staff capacity to best support their patients experiencing IPV, which is critical now more than ever with increased rates of IPV during the time of COVID-19. This will include training on the CUES approach, offering warm referrals to community-based DV programs for safety planning, and other well-being support in the time of COVID-19. This learning collaborative will take place November 2020-January 2021.
- Adapting and Formalizing Health Center Protocols on Intimate Partner Violence and Human Trafficking in Partnership with Community-based DV Programs: The goal of this learning collaborative is to work with 10 health centers and 10 community-based DV programs to help the development of a new national protocol on IPV and trafficking. The new national protocol will include guidance on implementing the CUES approach, the new Uniform Data System (UDS) measures and ICD-10 codes on IPV and trafficking, and building meaningful partnerships with community-based DV programs. This learning collaborative will take place February-April 2021.
- Strengthening Patient and Provider Responses to Intimate Partner Violence and Human Trafficking: This learning collaborative will work with health centers to adapt a safety card (used in the CUES approach) to craft a new national version specifically for health centers working in partnership with community-based DV programs. This learning collaborative will take place February-April 2021.
For more information on the learning collaboratives and how to apply, visit the National Health Network on Intimate Partner Violence and Human Trafficking.
The National Health Network on Intimate Partner Violence and Human Trafficking will launch additional learning collaboratives early in 2021. To stay updated on new opportunities, please email firstname.lastname@example.org.
For more information on addressing and preventing intimate partner violence and trafficking in health settings, visit our online toolkit: www.IPVHealthPartners.org.
Violence and exploitation in relationships have serious physical, mental, emotional, and behavioral health harms. Health centers can interrupt these cycles and provide that lifeline of support for patients. We are excited to do this work together with you and your health center!
Brief Author Bios:
Anisa Ali, MA, is a Senior Program Specialist at Futures Without Violence in San Francisco, California. She provides technical assistance to health centers working in partnership with domestic violence programs to better address and respond to intimate partner violence and human trafficking through the National Health Network on Intimate Partner Violence and Human Trafficking.
Kimberly S.G. Chang, MD, MPH is a Family Physician and Human Trafficking and Healthcare Policy Fellow at Asian Health Services in Oakland, California. She is also Vice Speaker of the House for NACHC, and a senior advisor to the National Health Network on Intimate Partner Violence and Human Trafficking
This blog post is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $725,000 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
[i] Black MC, Basile KC, Breiding MJ, Smith SG, Walters ML, Merrick MT, Chen J, Stevens R. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Summary Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
[ii] Black MC, Basile KC, Breiding MJ, Smith SG, Walters ML, Merrick MT, Chen J, Stevens R. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Summary Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
[iii] Peitzmeier, Sarah M., Mannat Malik, Shanna K. Kattari, Elliot Marrow, Rob Stephenson, Madina Agénor, and Sari L. Reisner. “Intimate Partner Violence in Transgender Populations: Systematic Review and Meta-Analysis of Prevalence and Correlates.” American Journal of Public Health 110, no. 9 (September 2020). https://doi.org/10.2105/ajph.2020.305774.
[iv] Kofman, Yasmin B., and Dana Rose Garfin. “Home Is Not Always a Haven: The Domestic Violence Crisis amid the COVID-19 Pandemic.” Psychological Trauma: Theory, Research, Practice, and Policy, vol. 12, no. S1, 8 May 2020, doi:10.1037/tra0000866.