The National Academies Press

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From page 1... ... had experienced IPV in some form during their lifetime. A substantial body of literature has documented adverse health outcomes associated with experiencing IPV. Read the entire page →
From page 2... ... identified a need to identify the essential health care services related to IPV for women and how to plan for and sustain access to essential health care services related to IPV during PHEs. COMMITTEE'S CHARGE HRSA's OWH contracted with the National Academies of Sciences, Engineering, and Medicine to convene a multidisciplinary panel of experts to address the statement of task (Box S-1) Read the entire page →
From page 3... ... , using an all-hazards approach.a The committee's framework shall: • Identify essential health care services related to IPV in non-PHEs (steady state) based on currently available evidence; • Define essential health care services related to IPV in PHEs based on currently available evidence; • Identify ways to prepare for and prioritize the provision of essential health care services related to IPV before PHEs; • Describe health disparities related to IPV in PHEs; • Identify innovations and best practices to prepare for and opera tionalize the equitable delivery of essential health care services related to IPV during PHEs; • Identify promising practices in the prevention of IPV; and • Develop strategies to overcome barriers faced by HRSA-supported and safety-net care settings in providing essential health care services related to IPV during PHEs, particularly for underserved populations. Read the entire page →
From page 4... ... The Committee's Approach The statement of task emphasized the value of having an overarching conceptual framework to guide the committee's process for identifying essential health care services related to IPV. The committee selected the Social Ecological Model as the conceptual framework to guide their understanding of the health care needs of women experiencing IPV and to identify the essential health care services related to IPV (Figure S-1) Read the entire page →
From page 5... ... Health Care Services Health care services related to IPV are delivered in multiple settings across health care systems, including primary and specialty care, such as practices specific to women's health (e.g., reproductive health care clinics) , perinatal-specific care settings, and orthopedic clinics; emergency departments; and behavioral health care settings. Read the entire page →
From page 6... ... The committee identified the following criteria for identifying essential health care services related to IPV: • evidence-based health care services that address the most common and most serious health outcomes related to experiencing IPV; • preventive services recommended by USPSTF and WPSI; and • specific support services required to meet the basic safety and hous ing needs of people experiencing IPV. This analysis identified several serious and high-prevalence adverse health effects related to experiencing IPV. Read the entire page →
From page 7... ... Safety planning is one of those crucial interventions. This is the process of collaborating with the woman experiencing IPV to empower her to develop strategies that increase safety by enhancing situational awareness of IPV-related risks in a manner that is consistent with her identified concerns and priorities. Read the entire page →
From page 8... ... Maldistribution of health care and mental health providers, in which the distribution of providers does not match the health care needs of a geographic area, has led to health care deserts across the U.S. These health care deserts have created additional barriers for women experiencing IPV to access the care that they need. Health care systems have a responsibility to reduce barriers to IPV care by taking steps informed by the communities that they serve to reduce health inequities. Read the entire page →
From page 9... ... In light of this, as well as the serious adverse health effects associated with experiencing IPV, the committee determined that the essential health care services related to IPV during steady state conditions remained essential during PHEs. The committee sought to address the balance between essential services and the substantial service obstacles created by a PHE. Read the entire page →
From page 10... ... The committee divided the response phase into 3 parts to organize its phased approach to restoration of essential health care services related to IPV during PHEs. 9 For the purposes of this report, disaster health responders are the leaders and staff with expertise in public health and health care who are working and providing care in those settings during response to a PHE. Read the entire page →
From page 11... ... TABLE S-1 Essential Health Care Services for IPV During Public Health Emergencies -- A Phased Return to Steady-State PHASE WHEN SERVICE SHOULD BE RESTORED Essential Health Care Response Initial Stabilization Service operations Universal IPV screening/ inquiry and education Safety planning Forensic medical exams Emergency medical care Treatment of physical injury Gynecologic and reproductive health care Urgent Non-urgent including pregnancy termination Obstetric care Urgent Non-urgent Perinatal home visits Contraceptives Contraception and not requiring All types of emergency contraception procedures or contraceptives immediate follow-up Screening and treatment Treatment and rapid Treatment and of sexually transmitted testing all screening infections, and HIV Substance abuse Withdrawal All treatment treatment mitigation Pharmacy/medication management Primary and specialty care Mental health care Urgent/Crisis Non-urgent Urgent Urgent treatment Dental care treatment for for acute injuries acute injuries Support services including shelter, nutritional assistance, child care Restore services for all patients Selectively restore services for acute needs or restore targeted services Do not restore services during this phase PREPUBLICATION COPY -- Uncorrected Proofs Read the entire page →
From page 12... ... Then, as health care staff and supplies become more available, the full essential health care service can be delivered more broadly. For example, unintended pregnancy, as well as IPV during pregnancy, are associated with serious adverse health outcomes, including fetal death and intimate partner homicide. Read the entire page →
From page 13... ... Some guidance mentioned IPV as part of domestic violence, but that guidance framed violence in the context of families with children, which can lead planners and disaster health responders to overlook the possibility of IPV in families that do not have children, couples that do not live together, or former intimate partners. The public facing federal preparedness and response guidance that did address IPV did not offer specific guidance for development of IPV care protocols, but rather mostly encouraged planners and responders to have domestic violence hotline numbers available and to know the hours and contact information for local domestic violence shelters. Read the entire page →
From page 14... ... RECOMMENDATION 7: HRSA should partner with the Administra tion for Strategic Preparedness and Response (ASPR) to develop and disseminate standardized guidance for developing protocols for IPV care for disaster health responders as well as the essential supplies required for delivering that care. RECOMMENDATION 8: Federal and state, local, tribal, and territorial government emergency response leaders should ensure that coordinated planning and response protocols for sustaining essential health care services related to IPV during PHEs are in place before PHEs occur. Read the entire page →
From page 15... ... RECOMMENDATION 9: Federal, state, local, tribal, and territorial governments' planning should take the following actions to ensure the availability of necessary supplies to deliver essential health care services for IPV during PHEs: • Conduct an annual review of disaster response caches to ensure that appropriate supplies related to IPV are included. • Establish logistics and procurement plans for needed supplies for all entities that will be responsible for delivering that care, includ ing disaster health responders, emergency shelter staff, and com munity-based support service providers engaged in IPV care. PREPUBLICATION COPY -- Uncorrected Proofs Read the entire page →
From page 16... ... HRSA and other federally funded health care agencies can further support better alignment of clinical and survey data in IPV research by requiring use of the recommended data elements in their funded projects. The committee recognized several challenges in conducting high-quality studies involving women experiencing IPV. Read the entire page →
From page 17... ... When IPV occurs in the context of a PHE, the challenges encountered by both the women experiencing IPV and the disaster health responders that must care for them become more complex. The recommendations put forth by this committee outline critical measures that, if acted on, will increase access to essential health care services related to IPV and ultimately save lives. Read the entire page →
From page 18... ... PREPUBLICATION COPY -- Uncorrected Proofs Read the entire page →

From page 1...

... had experienced IPV in some form during their lifetime. A substantial body of literature has documented adverse health outcomes associated with experiencing IPV.

Summary Pages 1-18

Summary
Pages 1-18