Intimate Partner Violence

Our Community Advisory Board consists of members from local IPV organizations, the Department of Children and Families, the Yale child abuse team, Yale emergency medicine department, New Haven police department, Yale Child Study Center, and community representatives. Board members ensure a trauma-focused environment for abused caregivers and children exposed to IPV. One project that arose from this collaboration was the idea to link a child’s medical evaluation with an opportunity to connect the child’s caregiver to a community-based IPV advocate. The board’s next project is to implement the evidence-based CUES (Confidentiality, Universal Education & Empowerment, Support) intervention in the Yale-New Haven Health adult and pediatric EDs.

As part of the New Haven Family Violence Community Advisory Board, the FRESH Collaborative recently collaborated on the development of an integrated care program at the South-Central Child Advocacy Center for families living with IPV. Since July 2020, the program has provided medical evaluations for young children exposed to IPV and real-time linkage with an IPV advocate for caregivers. Addressing the child’s safety while optimizing the safety and advocacy of a caregiver may ultimately decrease the child’s exposure to physical harm and reduce the occurrence of IPV. We are examining the acceptability and feasibility of this model and planning a clinical trial to compare the effectiveness of the family-centered care model with usual care.

Children are witnesses to 50% of IPV episodes in the US and are often evaluated after exposure to IPV. Abusers may access the electronic health records (EHRs) of victims and their children and learn of the IPV disclosure, leading to potential threats to safety. Implementation of the 21st Century Cures Act, a federal law mandating that healthcare providers give patients immediate access to electronic clinical notes, has amplified concerns of worsening safety for victims of IPV and their children. We recently completed a study demonstrating that discussions about EHR safety are infrequent when adults and children present after IPV and notes are infrequently unshared even when safety concerns are present. We are evaluating and developing interventions to improve documentation practices for IPV-related care in emergency departments.