Accepted for/Published in: JMIR Formative Research
Date Submitted: Feb 22, 2024
Date Accepted: Aug 6, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development and Preliminary Evaluation of a Clinical Decision Support Tool for Intimate Partner Violence Screening Among Women Veterans
ABSTRACT
Background:
Women veterans, compared to civilian women, are especially at risk of experiencing intimate partner violence (IPV), pointing to the critical need for IPV screening and intervention in the Veterans Health Administration.
Objective:
To address IPV screening implementation barriers (e.g., providers’ discomfort addressing IPV and making decisions about the appropriate type or level of intervention), this study developed and tested a novel IPV clinical decision support (CDS) tool for providers in the Women’s Health Clinic (WHC), a primary care clinic within the Veterans Affairs Palo Alto Heath Care System. This tool provides intelligent, evidence-based, step-by-step guidance on how to conduct IPV screening and intervention according to patient factors.
Methods:
Informed by existing CDS development frameworks, developing the IPV CDS tool prototype involved six steps. We then obtained preliminary provider feedback on user experience and clinical utility of the CDS tool by administering the System Usability Scale (SUS) and conducting semi-structured interviews with six WHC providers. SUS results were examined using descriptive statistics. SUS scores above 68 demonstrate above average tool usability. Interviews were analyzed using rapid qualitative analysis to extract actionable feedback to inform design updates and improvements.
Results:
This study includes a detailed description of the IPV CDS tool. Providers indicated good tool usability (SUS score: M = 77.5, SD = 12.75). They found the tool helpful and needed in their practice, and emphasized that it increased their confidence in managing patients reporting IPV. However, providers expressed concerns regarding the tool’s length/workflow integration, flexibility, and specificity of information.
Conclusions:
Provider feedback on the IPV CDS tool is encouraging and will be used to improve the tool. This study offers an example of an IPV CDS tool that clinics can adapt to enhance the quality and efficiency of their IPV screening and intervention process.
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