Evaluation of Children After Caregiver Intimate Partner Violence: A Qualitative Study of Barriers, Facilitators, and Trauma- and Violence-Informed Care

Overview

Journal J Pediatr

Specialty Pediatrics

Date 2023 May 27

PMID 37244576

Authors

Gunjan Tiyyagura

Nicole Clayton

Paula Schaeffer

Marcie Gawel

John M Leventhal

Kristen Hammel

Karen Jubanyik

Destanee Crawley

Ashley Frechette

Daniel M Lindberg

Tami Sullivan

Andrea Asnes

Affiliations

Soon will be listed here.

Abstract

Objective: To identify barriers and facilitators of evaluating children exposed to caregiver intimate partner violence (IPV) and develop a strategy to optimize the evaluation.

Study Design: Using the EPIS (Exploration, Preparation, Implementation, and Sustainment) framework, we conducted qualitative interviews of 49 stakeholders, including emergency department clinicians (n = 18), child abuse pediatricians (n = 15), child protective services staff (n = 12), and caregivers who experienced IPV (n = 4), and reviewed meeting minutes of a family violence community advisory board (CAB). Researchers coded and analyzed interviews and CAB minutes using the constant comparative method of grounded theory. Codes were expanded and revised until a final structure emerged.

Results: Four themes emerged: (1) benefits of evaluation, including the opportunity to assess children for physical abuse and to engage caregivers; (2) barriers, including limited evidence about the risk of abuse in these children, burdening a resource-limited system, and the complexity of IPV; (3) facilitators, including collaboration between medical and IPV providers; and (4) recommendations for trauma- and violence-informed care (TVIC) in which a child's evaluation is leveraged to link caregivers with an IPV advocate to address the caregiver's needs.

Conclusions: Routine evaluation of IPV-exposed children may lead to the detection of physical abuse and linkage to services for the child and the caregiver. Collaboration, improved data on the risk of child physical abuse in the context of IPV and implementation of TVIC may improve outcomes for families experiencing IPV.

Citing Articles

Acceptability and feasibility of trauma- and violence-informed care for intimate partner violence.

Tiyyagura G, Leventhal J, Schaeffer P, Gawel M, Crawley D, Frechette A Child Abuse Negl. 2024; 157:107068.

PMID: 39332141 PMC: 11512670. DOI: 10.1016/j.chiabu.2024.107068.

Frequency of injuries in a voluntary program evaluating young children exposed to intimate partner violence.

Tiyyagura G, Leventhal J, Crawley D, Asnes A Child Abuse Negl. 2023; 144:106385.

PMID: 37541095 PMC: 10529266. DOI: 10.1016/j.chiabu.2023.106385.

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