IHS program lauded for anti-domestic abuse efforts

WASHINGTON – New research suggests that a program funded by two federal agencies, and implemented by leading domestic violence organizations, has shown dramatic success in improving the health system’s response to domestic violence in Indian country.

Over the course of the program, known as the Domestic Violence Project, a much larger number of women began receiving interventions focused on improving domestic violence.

Health officials said that when implementation began in 2002, just four percent of women at IHS facilities were screened by doctors and nurses for domestic violence. By 2009, when the program ended, 48 percent of women who sought services at these facilities were being screened.

The program was funded by the Administration for Children and Families of the U.S. Department of Health and Human Services, and IHS. It involved more than 100 Indian, tribal and urban health care facilities as well as domestic violence advocacy programs across the nation.

It was conceptualized and managed by the Family Violence Prevention Fund in partnership with faculty from Sacred Circle and Mending the Sacred Hoop Technical Assistance Project. Indian health centers in 18 of the 35 states with federally recognized tribes participated, and the project included work with the Cherokee, Choctaw and Navajo tribes, among others.

A new report, called “Building Domestic Violence Health Care Responses” and authored by FVPF, highlights the program’s progress and offers a series of recommendations to continue the results.

It’s an area where positive results are desperately needed, as many studies have found that rates of domestic violence are overwhelmingly higher for Native American women than for women of any other race or ethnicity.

“In Indian country, health care providers are often the first responders to domestic violence, and the health care setting offers a critical opportunity for early identification and primary prevention of abuse,” said Anna Marjavi, FVPF program manager and co-author of the “Promising Practices” report.

“This report is designed to share all of our lessons learned from this innovative project. We call on all Indian health and community advocacy programs to use this tool to strengthen their communities’ responses to violence.”

One major finding of the report was that, over the course of the program, annual routine assessment for intimate partner and domestic violence of Native women increased 12-fold. Researchers said that’s because the program offered an effective response to violence, identified best practices to raise awareness, improved clinical responses, and strengthened community partnerships to help victims of domestic and sexual violence.

“The Indian Health Service is proud to have been a part of this groundbreaking project,” said Yvette Roubideaux, director of the Indian Health Service, in a statement.

“As a practicing physician in Arizona, I saw first-hand the effects of domestic violence on my patients, their families and communities. I have real hope that more health care providers and tribal communities will learn from the promising practices identified in this report.”

“The Administration for Children and Families funded this work in conjunction with IHS because it is so important that we find solutions to domestic violence in Native communities,” added Bryan Samuels, commissioner of the Administration on Children, Youth and Families.

“This project offers real hope for Native women facing violence, that their health providers will recognize the abuse and know how to help them and their children.”

In addition to increasing rates of assessment, the IHS/ACF Domestic Violence Project did the following, according to the report:

  • Trained staff members from more than 100 Indian, tribal and urban health care facilities, and domestic violence advocacy programs on domestic violence health system change.
  • Developed community-wide domestic violence response teams that include staff from health care, judicial, law enforcement, community programs and tribal councils.

  • Developed patient education materials including two posters targeting men and boys with prevention messages specific to domestic violence.

  • Tailored the Electronic Health Record to integrate domestic violence routine assessment and implementation of screening reminders.

  • Raised public awareness and promoted social norm change through community walks, billboard campaigns, candlelight vigils, radio/TV shows, public service announcements, and staff participation in health fairs, rodeos and powwows.

  • Helped victims of domestic violence and sexual assault get the help they need to support their healing from the abuse and promote their health and wellness.

“We need to build on the successes of the IHS/ACF Domestic Violence Project and fund more programs to continue this remarkable progress,” said FVPF President Esta Soler.

“Tribal communities will benefit if we replicate the promising practices and materials we’ve developed, continue to integrate domestic violence and sexual assault into trainings that improve the health care responses to violence, and strengthen the tribal response to sexual assault. We also must expand our work to engage men as role models, address the impact of violence on children, and do more to teach the next generation that violence is never the answer.