Interactive Computer screening enhances domestic violence detection in family medical practice

TORONTO - An interactive computer questionnaire may give family doctors a better opportunity to identify and intervene with patients who are victims of domestic violence, according to a new study from the University of Toronto's Dalla Lana School of Public Health.

The research, published July 21 in the Annals of Internal Medicine, found that the computer screening method with risk-reports for physicians increased detection of abuse and provided a better means for family doctors to assist patients who suffered violence at the hands of intimate partners.

Patients at a Toronto inner-city family practice were administered a multi-risk questionnaire using a touch screen computer in the waiting room. The questionnaire covered a broad range of topics and was, for the purpose of the study, designed to disguise the focus on domestic violence. Those results were compared with a control group, who underwent a typical interview.

"In the computer-screened group, detection of domestic violence was 18%, compared to 9% for the usual care group. The opportunity for physicians to discuss domestic violence was 35% for the computer-screened group, compared to 24% with the control group," said lead author Farah Amad, Assistant Professor at Dalla Lana School of Public Health and Associate Scientist, Centre for Research on Inner City Health, St. Michael's Hospital.

The results echo earlier research by Prof. Wendy Levinson, the Sir John & Lady Eaton Professor and Chair of the Department of Medicine, University of Toronto Faculty of Medicine and senior author of the study. Prof. Levinson's work used a similar computer questionnaire in an emergency department setting and found detection of intimate partner violence likewise increased.

"Anonymous modes of inquiry tend to lead to higher disclosure of socially sensitive issues compared with face-to-face interaction. Further, the computer method gives patients the opportunity to consider their disclosure," said Prof. Levinson, who is also Physician In Chief at Sunnybrook Health Sciences Centre.

"Detection of domestic violence by health care providers is never easy. Our research suggests interactive computer screening in the waiting room can help family physicians to address the prevalent issue of partner violence, possibly at an early stage. Doctors found it useful and efficient because the risks were screened and printed for them, while patients were accepting of the technique," Prof. Ahmad said.

The research was funded by the Canadian Institutes of Health Research and Ontario Women's Health Council.