Ha sentido sola? Culturally competent screening for intimate partner violence in Latina women

John Wrangle, Joslyn W Fisher, Anuradha Paranjape
Journal of Women's Health 2008, 17 (2): 261-8

OBJECTIVE: Intimate partner violence (IPV), a common public health problem, affects women irrespective of ethnicity. Primary care visits provide an excellent opportunity to identify IPV survivors; however, among immigrant Latina women, language can be a barrier. Several IPV screening instruments are available in English, but few are available in Spanish. Therefore, we sought to estimate the screening characteristics of seven validated screening questions translated into Spanish.

METHODS: Participants included 105 Spanish-speaking Latina women, aged 18-64 years, seen for primary care in an urban teaching hospital. Measures used were (1) screening questions: seven dichotomous response-option IPV screening questions, and (2) comparison standard: Index of Spouse Abuse (ISA), adapted for lifetime IPV. All measures were professionally translated into Spanish. Sensitivity and specificity, with 95% confidence intervals (CI), of all questions were estimated using 2 x 2 tables. Sensitivity and specificity with 95% CIs were estimated for the two questions with highest sensitivity.

RESULTS: Mean age was 38.5 years (SD 11.4); 89.5% were uninsured, and 33% reported lifetime IPV. Spanish translations of the following questions: "Have you ever been in a relationship where you have felt controlled by your partner?" and "Have you ever been in a relationship where you have felt lonely?" had the highest individual sensitivity. The sensitivity of an affirmative response to either question was 94% (95% CI 86%, 100%), and the specificity of an affirmative response to both questions was 86% (95% CI 78%, 94%).

CONCLUSIONS: Simple screening questions used in combination are highly sensitive for IPV detection in immigrant Latina women and may assist clinicians caring for them to identify a history of IPV.

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