10/15/2018 INTIMATE PARTNER I have no disclosers to report. - - PDF document

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10/15/2018 INTIMATE PARTNER I have no disclosers to report. - - PDF document

10/15/2018 INTIMATE PARTNER I have no disclosers to report. VIOLENCE IN ASIAN AMERICANS OCTOBER 12 TH , 2018 NICOLE APPELLE, MD MPH PREVALENCE OF IPV WORLDWIDE OUTLINE Prevalence Screening for IPV Support Documentation


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10/15/2018 1 INTIMATE PARTNER VIOLENCE IN ASIAN AMERICANS

OCTOBER 12TH, 2018 NICOLE APPELLE, MD MPH I have no disclosers to report.

OUTLINE

  • Prevalence
  • Screening for IPV
  • Support
  • Documentation
  • Reporting
  • Resources

PREVALENCE OF IPV WORLDWIDE

WHO (2015). Global and Regional Estimates of violence against women. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/85239/9789241564625_eng.pdf?sequence=1

  • n September 20,2018
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PREVALENCE OF IPV

  • National Violence Against Women finds 20% of woman and 7% of men report lifetime prevalence of

intimate partner violence.

  • National Latino and Asian American ‐1400 Asian partiticpants assessed with inperson interviews in

English, Mandarin, Tagalog, Vietnamese, showed lower rates than those reported in other ethnicities

  • Higher rates of aggressor report than victim reports.

Chang, D. F., Shen, B.‐J., & Takeuchi, D. T. (2009). Prevalence and demographic correlates of intimate partner violence in Asian Americans. International Journal of Law and Psychiatry, 32(3), 167–175. Tjanes, J. ThoennesN. ( 2015)>. Prevalence and Consequences of Male‐to‐female and Female‐to‐male Intimate Partner Violence as Measured by the National Violence Against Women Survey Violence Against Women. Vol 6, Issue 2, pp. 142 ‐ 161

PREVALENCE OF IPV BY ETHNICITY

Leung C & Cheung C. 2008. A prevalence study on partner abuse in six Asian American ethnic groups in the USA. International Social Work. 51(5): 635 – 649.

UNDERREPORTING OF IPV

  • Cultural taboos in seeking help for IPV
  • Stigma for mental health issues
  • Value of family over self
  • Barriers finding culturally appropriate services.

Wang, S. Change, D. (2014). Intimate Partner Violence Among Asian American and Pacific Islander Women. Retrieved from https://aapaonline.org/wp‐content/uploads/2014/06/AA_IPV‐final‐web.pdf on September 20,2018

ATTITUDES TOWARD IPV

Yoshioka MR, DiNoia J, & Ullah K. 2001. Attitudes toward marital violence: An examination of four Asian communities. Violence Against Women. 7(8): 900 – 926

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SCREENING FOR IPV

  • Interview patient alone ( for this part of the interview)
  • Use professional interpreters
  • Ask direct questions: has your partner every hit/ kicked/ threatened you?
  • Ask indirect question: what happens when you and your partner argue?
  • Validated screening tools
  • HITS Hurt, Insult, Threaten, Scream
  • HARK Humiliation, Afraid, Rape, Kick
  • WAST Woman Abuse Screening Tool

SCREENING FOR IPV

  • IPV survivors 20% more likely chronic health issue
  • 80% IPV survivor back pain, chronic headaches, arthritis
  • Mental health

ASSESSMENT

  • Assess current safety risk
  • Danger assessment

DANGER ASSESSMENT DA‐5

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INTERVENTION/ SUPPORT

  • SUPPORT
  • Safety plan
  • Connection to resources
  • Counseling
  • Shelter
  • Police
  • Legal
  • Social work
  • Advocate
  • Community

Image from http://drugfreeva.org/signs‐drug‐alcohol‐abuse/ retrieved on Octover 1, 2018

LEAP SF https://www.leapsf.org/html/safety_plan.shtml available in Chinese, Korean, Mongolian, Thai, Tagalog, Vietnamese LEAP SF https://www.leapsf.org/html/safety_plan.shtml

Developed by the Domestic Violence Project, Kenosha WI. Adopted from the

  • riginal wheel by the Domestic Violence Intervention Project.
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The Missouri Coalition Against Domestic Violence. ( Retrieved from https://www.womenscollegehospital.ca/assets/legacy/wch/pdfs/4084_AdvocacyEmpowermentwheel.pdf on October 1 2018

TRAUMA INFORMED CARE GUIDELINES

  • Realizes the widespread impact of trauma and understands potential pathways for recovery
  • Recognizes the signs and symptoms of trauma in clients, families, staff and others in the system
  • Responds by fully integrating knowledge about trauma into policies , procedures and practices
  • Seeks to actively resist re‐traumatization

PROVIDER DOCUMENTATION

  • Document details: who, what, where, when,
  • Use quotations
  • Physical: photograph any visible injury, describe in detail.
  • SAFETY – consider any possibility of aggressor finding evidence of report.
  • Diagnostic codes
  • EHR portal
  • After visit summary

REPORTING

  • If visible injury, mandatory reporting regardless of patient request.
  • If >65 or dependent adult, report to APS
  • If child witnesses violence or is harmed, report to CPS
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REPORTING: SUSPICIOUS INJURY REPORT REPORTING: SAN FRANCISCO SUPPLEMENT FORM REPORTING: SAN FRANCISCO SUPPLEMENT FORM REPORTING: APS

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RESOURCES

  • Hotline:
  • National Domestic violence hotline 1 800 799 7233
  • Asian Women’s Shelter 1 877 751 0880
  • COUNSELING
  • APA Family services 415 617 0061
  • LEGAL
  • Asian Pacific Islander Legal Outreach 415 567 6255
  • SEARCH ASIAN PACIFIC INSTITUTE http://apigbv.force.com