Screening women and elderly adults for family and intimate partner violence: a review of the evidence for the U. S. Preventive Services Task Force.

BACKGROUND: Family and intimate partner violence is common in the United States and is often associated with acute and chronic health problems. Although the clinician's role in identification and intervention is considered a professional, ethical, and sometimes legal responsibility, the effectiveness of screening is uncertain.

PURPOSE: To examine evidence on the benefits and harms of screening women and elderly adults in health care settings for family and intimate partner violence.

DATA SOURCES: MEDLINE, PsycINFO, CINAHL, Health & Psychosocial Instruments, AARP Ageline, Cochrane Controlled Trials Register, reference lists, and experts.

STUDY SELECTION: The authors selected English-language studies that included original data focusing on the performance of screening instruments (14 studies for women, 3 for elderly persons) and the effectiveness of interventions based in health care settings (2 studies for women, none for elderly persons).

DATA EXTRACTION: Study design, patient samples and settings, methods of assessment or intervention, and outcome measures were extracted, and a set of criteria was applied to evaluate study quality.

DATA SYNTHESIS: No trials of the effectiveness of screening in a health care setting for reducing harm have been published. Several screening instruments have been developed; some have demonstrated fair to good internal consistency and some have been validated with longer instruments, but none have been evaluated against measurable violence or health outcomes. Few intervention studies have been conducted. Existing intervention studies focused on pregnant women, and study limitations restrict their interpretation.

CONCLUSION: Although the literature on family and intimate partner violence is extensive, few studies provide data on detection and management to guide clinicians.