The IPV Provider Network: Engaging the Health Care Provider Response to Interpersonal Violence Against Women

• Universal Education (Behavioral): Clinic provider/staff training on implementing universal education into clinical practice to: 1.) provide all women information about IPV/SA, harm reduction, and available safety resources; 2) provide trauma-informed counseling to women who disclose IPV/SA; includes access to the myPlan safety decision aid to develop a tailored safety action plan; 3) provide warm referrals in partnership with local domestic violence and sexual assault (DV/SA) advocacy agencies; 4) integrate documentation and quality improvement templates and measures into clinical settings.

Primary outcomes

• Change in use of safety behaviors [6 months]: Measured by percent of safety behaviors the woman has tried and found helpful on the Safety Behaviors Checklist. The checklist was adapted from Sullivan and colleagues and Parker and colleagues. Includes use of community resources and safety steps (e.g. asked for help, hidden emergency money) and use of formal services (e.g., women's shelter, protection order, mental health services).
• Change in Self-Efficacy to Use Harm Reduction Strategies [6 months]: Measure adapted from Tancredi et al and Hibbard et al, assesses confidence to seek help for abuse, if needed, from a health care provider.
• Provider Behavior [Baseline]: Clinic level measure. Provider Behavior at Visit Survey items administered after the provider visit to assess the provider's adherence to universal education intervention, i.e. discussing healthy and unhealthy relationships during the visit, and referring to resources.

Secondary outcomes

• Change in decisional conflict [6 months]: We have adapted questions from validated subscales of the Decisional Conflict Scale as a measure of decision process. Measures whether the intervention helps a woman to understand the advantages and disadvantages of safety planning options and to know her values related to them. The Decisional Conflict Scale discriminates between people who make decisions and those who delay making decisions.
• Change in Readiness to Take Action [6 months]: 0-10 scale of readiness to make changes to relationship for safety

Sex: Female, ages: 18 Years to 59 Years, accepts healthy volunteers

Inclusion Criteria:

* Seeking healthcare at one of 14 partner clinics
* Ability to complete a survey on a device (computer/tablet/smartphone in English or Spanish)
* Access to safe device (as defined above) if doing surveys online
* Has a safe email address or safe phone number
* Is not acutely ill

Exclusion Criteria:

* Male
* Not seeking healthcare at one of 9 partner clinics
* Younger than 18 years of age
* Older than 59 years of age
* Cannot read/speak English or Spanish
* No access to safe device if doing surveys online
* Does not have a safe email address or safe phone number
* Acutely ill

• Nancy Glass, PhD, MPH, RN, Principal investigator, Johns Hopkins University