Health care screening & follow-up for intimate partner violence

Evidence Rating  
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  
Decision Makers
Date last updated

Health care professionals screen female patients about past or present experience of intimate partner violence (IPV) by asking focused questions. Providers may use a structured screening tool, directly ask one question, or ask a series of questions. Screening can occur via in-person communication or computer-based methods and be administered for all female patients or only for high-risk patients. Follow-ups such as counseling, home visiting, mentoring, or referrals for other services are provided to women with positive screening results1.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced intimate partner violence

  • Reduced unhealthy relationships

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Increased awareness of intimate partner violence

What does the research say about effectiveness?

There is some evidence that health care screening for intimate partner violence (IPV) paired with follow-ups such as counseling and home visitation reduce IPV recurrence rates2. Routine screening with counseling can also increase the likelihood that victims will end unhealthy relationships2. Routine screening without follow-up has been shown to increase IPV victim identification1. Additional evidence on best intervention practices is needed to confirm effects.

Women are more likely to disclose IPV when completing a self-administered assessment such as a computerized questionnaire than when questioned face-to-face. HITS (Hurt, Insult, Threaten Scream), the Woman Abuse Screening Tool3, the Ongoing Violence Assessment Tool4, HARK (Humiliation Afraid, Rape, Kick)5, and Slapped, Threatened and Throw2, 6 are examples of screening instruments that accurately identify IPV victims.

Client-centered and supportive IPV screening, prompt follow-up services, culturally sensitive screening plus counseling, and staff and clinician training are recommended in a system-level approach7, 8.

How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples

As of 2012, California, New York, Pennsylvania, and Virginia require health care professionals to provide universal screening for intimate partner violence9.

Implementation Resources

USPSTF-IPV screening - U.S. Preventive Services Task Force (USPSTF). Intimate partner violence (IPV) and abuse of elderly and vulnerable adults: Screening.


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1 Cochrane-O’Doherty 2015 - O’Doherty L, Hegarty K, Ramsay J, et al. Screening women for intimate partner violence in healthcare settings. Cochrane Database of Systematic Reviews. 2015;(7):CD007007.

2 USPSTF-Nelson 2012 - Nelson HD, Bougatsos C, Blazina I. Screening women for intimate partner violence: A systematic review to update the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation. Annals of Internal Medicine. 2012;156(11):796-808.

3 Rabin 2009 - Rabin RF, Jennings JM, Campbell JC, Bair-Merritt MH. Intimate partner violence screening tools: A systematic review. American Journal of Preventive Medicine. 2009;36(5):439-45.e4.

4 Ernst 2004 - Ernst AA, Weiss SJ, Cham E, Hall L, Nick TG. Detecting ongoing intimate partner violence in the emergency department using a simple 4-question screen: The OVAT. Violence and Victims. 2004;19(3):375-84.

5 Sohal 2007 - Sohal H, Eldridge S, Feder G. The sensitivity and specificity of four questions (HARK) to identify intimate partner violence: A diagnostic accuracy study in general practice. BMC Family Practice. 2007;8:49.

6 Paranjape 2006 - Paranjape A, Rask K, Liebschutz J. Utility of STaT for the identification of recent intimate partner violence. Journal of the National Medical Association. 2006;98(10):1663–9.

7 IOM-Preventive women services 2011 - Institute of Medicine (IOM), Board on Population Health and Public Health Practice (BPH). Clinical preventive services for women: Closing the gaps. Washington, D.C.: National Academies Press; 2011.

8 Miller 2015b - Miller E, McCaw B, Humphreys BL, Mitchell C. Integrating intimate partner violence assessment and intervention into healthcare in the United States: a systems approach. Journal of Women's Health. 2015;24(1):92-99.

9 FVPF 2012 - Family Violence Prevention Fund (FVPF). Compendium of state statutes and policies on domestic violence and health care. Washington, D.C.: Administration for Children and Families (ACF); 2012.