An Education Program for Prenatal Patients Aimed Toward Primary Prevention of Domestic Violence...
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An Education Program for Prenatal Patients Aimed Toward Primary Prevention of Domestic Violence Peter Vasilenko, PhD Professor of Obstetrics and Gynecology Michigan State University College of Human Medicine
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Transcript of An Education Program for Prenatal Patients Aimed Toward Primary Prevention of Domestic Violence...
An Education Program for Prenatal Patients Aimed Toward Primary
Prevention of Domestic Violence
Peter Vasilenko, PhD
Professor of Obstetrics and Gynecology
Michigan State University
College of Human Medicine
While much attention has been paid to the secondary prevention of domestic violence and the treatment of abused women, relatively little has been focused on primary prevention.
Pregnancy as an Appropriate Time for Primary Prevention
Women regularly visit their providers for prenatal care
Usually motivated by the pregnancy toward health and education.
Prenatal care education program already in place
Domestic Violence During Pregnancy Violence can begin or escalate during
pregnancy DV can affect the health of
women/mothers DV can affect pregnancy outcome
Late entry / missed appointments Miscarriage / stillbirth Prematurity / low birth weight Fetal injury and death
Our own work has shown
30% of pregnant women screen positive for abuse (majority is physical abuse)
Women with abuse have increased rates of prematurity and low birth weight
Among mothers with infant deaths, ~half have been in recent violent encounters
Description and evaluation of an education program for prenatal patents aimed at primary prevention of domestic violence
Methods
Women were enrolled at first prenatal visit Entry to care was 30 weeks or less Screen negative for physical abuse
Intervention consisted of four 20 minute sessions at four subsequent visits
Evaluation preformed by a pre-test, post-test (completion, 6 weeks, 6 months postpartum)
Interviews for qualitative feedback
Intervention Education Subsets
DV statistics and definitionsVictim behaviorHow to get help / Community
resources
Pre-test / Post-test Evaluation
39 questions Reliability analysis (Cronbach’s alpha)
Entire test = 0.7000 Subsets = 0.5121 – 0.5881
Content Knowledge questions Locus of control Self esteem Attitudes toward DV (Dodge and Green) Women’s Experiencing with Battering (WEB)
Sample
773 women screened for abuse Final enrollment was 282
150 controls / 132 intervention
No important demographic or characteristics differences between Study and non-study patients Control and education groups
Results - Total Score
39.9 41.1 44.7
57.4
45
56
46.7
57
0
10
20
30
40
50
60
Per
cen
t C
orr
ect
Pre Post1 Post2 Post3
Control Education P<0.001
Results – Subset Scores (Post-1)
44.4
54.4
37.7
50.8
62.5
83.8
0
10
20
30
40
50
60
70
80
90
Per
cen
t C
orr
ect
Defintions Resources Victim
Control Education
P<0.001 P<0.001
P<0.001
Statistics Help Behavior
Results – Scales Scores (Post-1)
10.48.9
11.910.2
20.618.5
13.712.8
0
5
10
15
20
25
Per
cen
t C
orr
ect
Self Esteem Attitudes LOC WEB
Control Education
P=0.017 P<0.001
P=0.474
P=0.074
* *
Follow-up Interviews
Overall women were pleased with the education program
They commented that even if the content was not immediately relevant to their personal situation, the knowledge was useful to pass along to family members and friends who were in more difficult situations and relationships.
Summary Women’s knowledge about DV was
significantly improved through a simple prenatal education program
The increase in knowledge was immediately apparent, and maintained through 6 months post-partum
The improvement in knowledge occurred in all three subsets
There was also a moderate effect on self-esteem and attitudes
Conclusions
A simple prenatal care program can increase women’s knowledge about DV
The program can easily be duplicated in other clinics.
The program can be adapted for use in clinics with non-pregnant women
Conclusions
The increased knowledge may empower women to make better decisions about current and future relationships, utilize community resources, and share this knowledge with other women, all of which could serve to directly or indirectly reduce DV in the community.
Peter Vasilenko, PhDProfessor of Obstetrics and GynecologyDirector of ResearchMichigan State UniversityCollege of Human MedicineA209 East Fee HallEast Lansing, Michigan 48824Phone: 517-432-4791Fax: 517-432-8021Email: [email protected]
