Computer superior interviewer for partner violence, new study reports
ATLANTA, GA - According to a new study, women are more likely to report intimate partner violence (IPV) when screened using an audio, computer-assisted self-interview than when a healthcare professional conducts the interview. However, the researchers noted that, regardless of screening method, women utilized referral resources at a low rate. The study was published in the January issue of Women's Health Issues by Joanne Klevens, MD, PhD, MPH and colleagues at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.
The researchers compared screening by a human vs. a computer-assisted system in a trial comprised of English-speaking women at women's health clinics at a public hospital in Chicago, Illinois. The study did not distinguish the sex of the partners.
The women were randomly assigned to one of three groups: human screening and, if positive, referral to IPV resources (46 women); computer-assisted screening with referral by computer printout with HCP encouragement to seek help (37 women); or computer-assisted screening and referral by printout with a short video clip providing support and encouragement to seek help (43 women).Six to nine days later, research assistants interviewed the women by telephone. Of the 126 women enrolled, 102 (81%) completed the telephone interview (from 32 to 36 in each group).
The women were primarily in their mid-30s and predominantly African American; more than 50% lacked health insurance and another 30% received public insurance. There were no demographic differences between the screening-method groups.
A total of 21 women (17%) screened positive for IPV. Women in the two combined computer-assisted screening groups reported IPV at more than twice the rate than did participants screened by humans; however, the difference was not statistically significant. At follow-up, 96% of the women remembered receiving a list of referral resources; however, none of the women who screened positive for IPV used the on-site advocacy service within three months after screening.
Although 41% of the women reported that they had no preference for a screening method, of those who expressed a preference, two thirds preferred the method to which they had been randomly assigned. About 30% of the women reported positive or negative reactions to the screening process; furthermore, no patients reported that they had experienced any problems from being screened.
The investigators concluded that in this randomized trial, there were no differences between the two screening methodologies as well as between the three referral strategies. However, the computer-assisted method screened all women, whereas 11% of the women in the human-screening group reported not being screened. Therefore, the investigators noted that computer-assisted screening may be a useful method and may spare human resources.
Limitations of this study are a small sample size and a low participation rate. The study illustrates women’s reluctance to report incidents of intimate partner violence. Other studies note that an indifferent computer is conducive to openness in regard to sensitive issues. In today’s current medical environment, where time constraints impact interaction between a healthcare professional and a patient, a computer interview can free up invaluable human resources for other tasks. A caring interviewer who spends time with a patient and gently probes for sensitive issues would likely be more effective in many cases. However, an insensitive, rushed interviewer might prove less effective than a computer.
References: Women's Health Issues
See Also: The many benefits of TLC