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|Issue 71||October 2013|
A Systematic Review: Intimate Partner Violence among Veterans and Active Duty Service Members
In the United States, intimate partner violence (IPV) poses a significant public health burden that affects both men and women. More than one-third (36%) of women and one-fourth (29%) of men have experienced rape, physical violence, or stalking by an intimate partner in their lifetime. Outcomes associated with IPV include a wide range of social, physical, and mental issues, such as family dissolution, adverse pregnancy outcomes, mental health issues (depression, PTSD, anxiety), incarceration, and death. Military service has unique psychological, social, and environmental factors that may contribute to elevated risk of IPV among active duty service members and Veterans. For example, multiple deployments, deployment-related head trauma, mental illness, and substance abuse can contribute to elevated risk of IPV among active duty service members, Veterans, and their intimate partners.
In order to support the work of VA's Domestic Violence Task Force, the VA Evidence-Based Synthesis Program located in Durham, NC, conducted a systematic review of the literature on the prevalence of IPV among active duty service members and Veterans (Key Question 1), as well as intervention strategies to address IPV (Key Question 2).
Summary of review results:
Evidence also demonstrates that standardized IPV screening interventions in a healthcare setting increase identification of IPV victimization. Coupled with the prevalence of IPV, these findings support the need to consider adopting standardized IPV screening for use in the VA. However, this evidence review also highlights the need to take a comprehensive approach to implementing such a screening program in the VA. For example, the Institute of Medicine (IOM) recommends that women be screened about current and past violence and abuse in a culturally sensitive and supportive manner, and assuring patient confidentiality and safety is paramount. Additionally, this review highlights the need for developing a detailed plan of action for treatment and follow-up of positive IPV screening results.
Below are more detailed findings from the two Key Questions addressed by this review.
Key Question #1
Of the 25 unique studies of IPV prevalence among U.S. active duty and Veteran populations used in this systematic review, 13 (25 articles) evaluated prevalence among active duty service members and 12 (14 articles) among Veterans. Findings show:
Key Question #2
This literature review identified four good-quality and two fair-quality systematic reviews (SR) that evaluated interventions aimed at decreasing exposure to IPV and its associated harms. Findings show:
This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers — and to disseminate these reports throughout VA.
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This Management eBrief is a product of the HSR&D Evidence Synthesis Program (ESP). ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of the HSR&D Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers - and to disseminate these reports throughout VA.
See all reports online.