M. Diaz Tsuzuki1, H. Decker1, S. Shao1, D. Kaki1, J. Wang1, M. Rosser1, T. Bongiovanni1 1University Of California – San Francisco, Department Of Surgery, San Francisco, CA, USA
Introduction: With a national lifetime prevalence of one in three women, intimate partner violence (IPV) has significant adverse impacts on health. Rates of IPV are disproportionately high among trauma patients. Although universal screening is recommended by trauma and surgical societies, there are significant barriers to real-world implementation including lack of training and education, absence of screening policies, time constraints, and language barriers. We previously found that rates of screening among trauma patients at a large level 1 trauma center did not differ by gender, race, or ethnicity. Of patients successfully screened for IPV, 30% screened positive. While we know that language can affect quality of care for hospitalized patients, little is known about the impact of limited English proficiency (LEP) on screening for IPV among trauma patients.
Methods: We conducted a retrospective cohort study at the only Level 1 Trauma Center in San Francisco City and County over a two-year period from July 2020 to July 2022 following the initiation of a resident-led quality improvement project to increase screening for IPV among all adult trauma patients admitted to the hospital. We examined sociodemographic characteristics, preferred patient language, and the results of the Partner Violence Screen, a validated 3-question screen for IPV detection. We compared rates of screening between cohorts with LEP and cohorts with English proficiency (EP).
Results: Of the 4,147 trauma admissions, 30% were women and 70% were men. The cohort was 46% White, 20% Asian, 15% Black, and 17% other races. Twenty-three percent were Hispanic or Latino/a. Overall, our admitted trauma patients are 16% LEP. Of admitted patients, 19% had IPV screens attempted, with screening completed in 13% of patients for a total of 559 completed IPV screens. Of patients with completed IPV screens, 22% have LEP, with 55% preferring Spanish, 19% preferring Cantonese, 6% preferring Toishanese, 5% preferring Mandarin, and 15% preferring other languages. The percentage of a positive IPV screen among successfully screened patients with LEP was 30% as compared to 29% among patients with EP. The percentage of an attempted but unsuccessful screen was 37% among patients with LEP as compared to 27% among patients with EP.
Conclusion: Our study found that patients with LEP were more likely to be screened, and when they were screened, they were as likely to have a positive screen for IPV as patients with EP. However, patients with LEP were more likely to have an unsuccessful screen, with possible reasons including a lack of interpreter availability. This highlights the need to understand barriers to screening patients with LEP for IPV in trauma settings to ensure implementation of universal screening, equitable detection of IPV, and linkage to appropriate resources in this population.