(PS10-56) Patient Perspectives on Intervention for Intimate Partner Violence and Intimate Partner Violence-related Head Injury Among Women Veterans

Background: Intimate partner violence (IPV) is prevalent in the United States, with elevated lifetime rates reported in military service members, particularly women Veterans (~38%), as compared to civilian women (~24%). A history of IPV is a risk factor for multiple adverse mental health (e.g., PTSD, substance use, suicidal ideation) and medical outcomes including physical injuries to the head, neck, or face, which may result in repeated concussions or hypoxic brain injury. The Veterans Health Administration (VHA) has recognized the importance of detection and intervention for IPV and the wide range of potential healthcare needs experienced by this subset of the population. While effective interventions focused on empowerment and advocacy exist, multiple barriers to accessing care remain. Among potential barriers, inadequate primary prevention strategies, time-intensive protocols, and patient barriers to disclosing IPV (e.g., shame or guilt, varying degrees of readiness to address IPV at the time of clinical assessment). Providers need to consider addressing both proximal needs (immediate health and safety) as well as distal impacts (e.g., secondary effects of chronic head injury) of IPV, and convey a flexible and adaptable intervention approach. While patients and providers alike perceive that additional services embedded within the primary health system would be beneficial, congruent treatment models capable of addressing the variety of concerns experienced by patients with IPV history are presently lacking. Interventions rooted in problem-solving and solution-focused care have shown promise in addressing IPV yet have not been widely adopted in the context of primary health care. The current study engaged women veterans in early-stage intervention adaptation.

Method: Participants were 12 women veterans (Mean age = 45.8) enrolled in VHA care who evidenced history of IPV and potential IPV-related head injuries. Measures included demographics and a semi-structured qualitative interview to describe prior IPV-related treatment experiences, appraise prospective acceptability of a brief problem-solving intervention adaptable for a primary care setting, and identify potential barriers to treatment engagement. Data were collected in the summer of 2023. Rapid qualitative analysis was employed to consolidate patient feedback.

Results: Respondents reported a wide array of prior screening and treatment experiences. Participants generally accepted that screening was part of routine care, though feedback suggested a desire for empathy and patient-centered language in discussing IPV and potentially-related injuries. Variability was present in whether patients felt that their providers followed up sufficiently on potentially-related injuries and in terms of benefit from prior treatments. The majority signaled openness to an individual problem-solving approach that incorporated education and training in cognitive, emotion-regulation, and planning skills. Potential treatment and research engagement barriers included negative prior treatment experiences, assumed inability to relate to providers, and other personal and logistical challenges. Implications for further study will be discussed.