Assessing readiness to manage intimate partner violence 12 months after completion of an educational program in fracture clinics: a pretest-posttest study
Background: The aim of the EDUCATE study was to determine whether an intimate partner violence educational program for health care providers working in fracture clinics increased their knowledge about intimate partner violence and their preparedness to discuss this topic with their patients. Here, we present the long-term (12-mo) follow-up data from the EDUCATE study to determine whether improvements in knowledge were maintained.
Methods: For this pretest-posttest study, we enrolled 140 health care providers from 7 academic fracture clinics in Canada and the United States. Training took place between October 2016 and June 2017. We administered the Physician Readiness to Manage Intimate Partner Violence Survey before participants completed the educational program (baseline), immediately after training, and at 3 months and 12 months after training. We used the actual knowledge subscale as the primary outcome for the planned 12-month analyses; we also report on the other subscales of the survey (perceived preparation to manage intimate partner violence, perceived knowledge about the issues, practice issues, preparation, legal requirements, workplace issues, self-efficacy, alcohol or drugs, and victim understanding). We used linear regression models to compare mean 12-month scores with mean baseline scores for each subscale of the survey.
Results: Among the 109 participating health care providers for whom 12-month assessment data were available, we found statistically significant improvements in the actual knowledge about intimate partner violence subscale of the survey (mean difference [MD] 2.50, 95% confidence interval [CI] 1.69 to 3.32). Statistically significant improvements from baseline to 12 months were also observed for 8 of the 9 other subscales of the survey: perceived preparation (MD 2.06, 95% CI 1.88 to 2.24), perceived knowledge (MD 2.14, 95% CI 1.96 to 2.31), practice issues (MD 6.12, 95% CI 4.97 to 7.27), preparation (MD 1.10, 95% CI 0.94 to 1.26), legal requirements (MD 1.57, 95% CI 1.36 to 1.78), workplace issues (MD 1.19, 95% CI 1.04 to 1.35), self-efficacy (MD 0.56, 95% CI 0.46 to 0.67) and alcohol and drugs (MD 0.11, 95% CI 0.02 to 0.21). Improvements relative to baseline were not observed for the victim understanding subscale.
Interpretation: The EDUCATE program led to significant improvements in health care providers’ readiness to manage intimate partner violence, with positive changes being observed 12 months after training. These findings indicate that health care providers who receive this training may be better equipped to manage the care of patients who have experienced intimate partner violence.
Copyright 2020, Joule Inc. or its licensors.
Conflict of interest statement
Competing interests: For activities outside the current work, Mohit Bhandari reports having received grants from Acumed, LLC, Aphria, Ferring Pharmaceuticals, Pendopharm, and Sanofi-Aventis, as well as personal fees from Pendopharm and Sanofi-Aventis. For activities outside the current work, Paula McKay reports having received employment income from Global Research Solutions. For activities outside the current work, Prism Schneider reports having served as an editorial board member for the Canadian Journal of Surgery, having served as a board or committee member for the Canadian Orthopaedic Association and having received personal fees from Stryker and Synthes. For activities outside the current work, Emil Schemitsch reports having received personal fees from Acumed, LLC; Amgen Co.; DePuy, A Johnson & Johnson Company; ITS; Pendopharm; Sanofi-Aventis; Saunders/Mosby-Elsevier; Smith & Nephew; Sringer; Stryker; Swemac; and Zimmer. Emil Schemitsch also reports having received grants from Biocomposites and Smith & Nephew and having served as a board or committee member for the Canadian Orthopaedic Association, the Hip Society, the International Society for Fracture Repair, the Journal of Orthopaedic Trauma, the Orthopaedic Trauma Association, OTA International and the Osteosynthesis & Trauma Care Foundation. For activities outside the current work, Debra Sietsema reports having served as a board or committee member for the American Orthopaedic Association and the National Association of Orthopaedic Nurses. For activities outside the current work, Sheila Sprague reports having received employment income from Global Research Solutions and having served as a board or committee member for BMS Women’s Health. For activities outside the current work, Aaron Nauth reports having received personal fees from Stryker and Smith & Nephew, as well as grants from the Orthopaedic Trauma Association, Canadian Institutes of Health Research, Osteosynthesis and Trauma Care Foundation, and Physician Services Incorporated. No other competing interests were declared.