Opportunities for Intimate Partner Violence Disclosure in Adult-Serving Healthy Marriage and Relationship Education (HMRE) Programs

Publication Date: August 18, 2020
Current as of:
This is the cover of Opportunities for Intimate Partner Violence Disclosure in Adult-Serving Healthy Marriage and Relationship Education (HMRE) Programs

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Introduction

Research Questions

  1. How do three tools for inviting IPV disclosure compare in their ability to guide HMRE programs’ responses to participants’ IPV-related needs?
  2. How well do the tools work from the perspectives of program participants, staff, and partners?

Intimate partner violence (IPV) is the most common form of interpersonal violence in the United States. Its consequences can be serious: 41% of female IPV survivors and 14% of male survivors experience physical injuries, and other survivors face acute or long-term physical or behavioral health problems and economic consequences.

Healthy marriage and relationship education (HMRE) initiatives, funded by the Office of Family Assistance (OFA) in the Administration for Children and Families (ACF) at the U.S. Department of Health and Human Services, present an opportunity for reaching adults who are experiencing IPV and connecting them with help. ACF’s Office of Planning, Research and Evaluation contracted with RTI International to conduct the Responding to Intimate Violence in Relationship Programs (RIViR) study.

The overarching objective of the RIViR study was to examine and compare how IPV assessment tools (including questionnaire-style and universal education approaches) work for identifying HMRE program participants who are experiencing IPV so that they can be referred for further services. The study examined both the accuracy of the tools in assessing IPV and the acceptability and feasibility of administering them in HMRE programs, including the conditions needed for their successful use. The RIViR project partnered with three programs—Youth and Family Services of Rapid City, South Dakota; Nepperhan Community Center, Inc., of Yonkers, New York; and Volunteers of America, Dakotas of Sioux Falls, South Dakota—to examine and compare different approaches to recognizing and responding to IPV in the context of OFA-funded HMRE services.
 

Purpose

This report describes the impetus for efforts to recognize and respond to IPV in HMRE programs and gives a brief overview of the RIViR study design and methods; details RIViR study results on building organizational capacity and readiness for addressing IPV, choosing an approach to inviting IPV disclosure, and protecting IPV survivor safety; and summarizes the limitations of the study and key directions for future research and practice.

Key Findings and Highlights

RIViR was the first study to compare IPV assessment approaches (including questionnaire-style tools and universal education tools) in HMRE programs.

All three IPV assessment approaches had high specificity; that is, they were likely to indicate an absence of IPV when a participant had not experienced IPV. The universal education approach was most specific. With regard to sensitivity, they differed more widely: the proportion of IPV survivors who were not identified as such ranged from 88% with the universal education tool to 9% with the Intimate Justice Scale. Overall, the Intimate Justice Scale was the most accurate of the three tools. 

Qualitative and quantitative results indicate both the acceptability and feasibility of implementing IPV assessment and universal education in HMRE programs. HMRE staff and participants each perceived efforts to identify and respond to IPV to be closely aligned with other HMRE program goals and with the needs of participants. Indeed, interviews revealed that participants appreciated IPV-related conversations and that some had enrolled in the HMRE program specifically to get help for a current abusive relationship or gain insight on past abuse. Finally, study results call attention to the critical importance of underlying organizational readiness and capacity for IPV-related work—particularly the presence of active, reciprocal partnerships with local domestic violence organizations—and an ability to meet participants’ cultural and linguistic needs.

Federally funded HMRE programs have an important role to play in identifying and responding to IPV among the diverse communities they serve—including individuals with no other connection to services who are counting on them for help.

Methods

The three HMRE programs selected for the RIViR study delivered relationship education and other services in a variety of community settings. HMRE program staff used three different web-based tools to offer participants an opportunity to share their experiences with IPV in different formats over the course of these services.

Two of the assessments were conducted using traditional, questionnaire-style tools. The third took a universal education approach: a guided, one-on-one conversation between HMRE program staff and each participant about healthy and unhealthy relationships, IPV concerns, and available resources. The three tools were given to participants in random order; each took approximately 5–10 minutes to complete. After completing the third tool, participants self-administered a brief set of survey questions about their responses to the tools, including their comfort, openness, familiarity with available resources, and perceptions of their interactions with HMRE program staff about IPV.

The RIViR study team also conducted on-site qualitative interviews with HMRE program staff, their local domestic violence program partners, and participants in each site. Interviews aimed to understand how participants and service providers saw the tools and the process of implementing them. Interviews were recorded and transcribed.

To address the first research question, the study team conducted a latent class analysis to compare assessment results from all three tools. To address the second research question, the team used regression analysis to compare participants’ responses (comfort, openness, resource knowledge, and perceptions of the interaction with staff) after completion of different tools. The team also conducted a formal, inductive analysis of qualitative interview data in ATLAS.ti to identify major themes.

Recommendations

Findings suggest that HMRE programs working to build organizational capacity and readiness for addressing IPV should do the following:

  • Cultivate reciprocal relationships with local domestic violence programs and other culturally competent local agencies.
  • Involve staff with life experiences similar to those of participants.
  • Create a welcoming, safe, caring, and interactive atmosphere for HMRE services.

To create survivor-centered, trauma-informed opportunities for IPV disclosure, RIViR study results suggest that HMRE programs should do the following:

  • Treat opportunities for IPV-related conversation as an integral part of the program.
  • Address confidentiality protections (and limitations). 
  • Deliver questionnaire-style tools in a conversational spirit.
  • Use brief, plain-language IPV assessment tools.
  • Create repeated opportunities for participant-initiated conversation about IPV.

Finally, results suggest that programs can help to protect the safety of IPV survivors by supporting and informing HMRE program participants who do and do not choose to share their IPV experiences with staff. Healthy relationship programs should do the following:

  • Follow up on what participants share.
  • Work collaboratively and creatively to support survivors in accessing services and staying safe.
  • Make sure all participants know where to find help.
  • Offer a variety of resources.
  • Stay in communication.

Citation

McKay, Tasseli E., Kan, Marni L., Brinton, Julia E., Berzofsky, Marcus E., Biemer, Paul, Edwards, Susan L., Landwehr, Justin, Krieger, Kathleen, Serrata, Josie, Hernandez Martinez, Martha, and Bir, Anupa, 2020. “Opportunities for Intimate Partner Violence Disclosure in Adult-Serving Healthy Marriage and Relationship Education (HMRE) Programs.” OPRE Report 2020-93. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

Glossary

Administration for Children and Families (ACF):
ACF is a division of the U.S. Department of Health & Human Services that promotes the economic and social well-being of families, children, individuals, and communities with partnerships, funding, guidance, training, and technical assistance.
Domestic violence programs:
Often referred to as “domestic violence agencies” or “domestic violence organizations,” domestic violence programs are community-based service organizations that provide a wide variety of direct services for people experiencing IPV. Current ACF-funded HMRE grantees partner with local domestic violence programs to guide their IPV-related activities, such as domestic violence protocol development, staff training on IPV, and referring program participants to services.
Domestic violence protocol:
A domestic violence protocol outlines a program’s plan for identifying and responding to IPV and related issues. Within the context of HMRE programs, a domestic violence protocol can help ensure that IPV issues are safely, routinely, and consistently identified and appropriately addressed. It is a tool to help ensure that adequate supports and safeguards are in place for families or individuals dealing with IPV. The protocol can be an important resource for anyone involved in a program because it provides concrete guidance and clarifies roles and responsibilities for different program partners.
Healthy marriage and relationship education (HMRE) program:
An HMRE program implements curriculum-based relationship education and related activities, such as case management or financial education. ACF has historically funded many HMRE programs, but they also exist outside of ACF funding initiatives.
Intimate partner violence (IPV):
IPV is physical, sexual, or emotional harm by a spouse, partner, or former partner.
Prevalence:
The proportion of a population that has a particular experience (disease, injury, other health condition, or attribute) at a specified point in time or during a specified period.
Reference period:
A reference period is the time frame for which survey respondents are asked to report on a particular experience, such as IPV.
Sensitivity:
For purposes of this study, which was focused on IPV, sensitivity refers to the probability that a tool will indicate the presence of IPV when a participant has experienced IPV.
Specificity:
For purposes of this study, which was focused on IPV, specificity refers to the probability that a tool will indicate the absence of IPV when a participant has not experienced IPV.
Trauma-informed services:
Trauma-informed services are those that take into account the impact of violence, victimization, and other forms of trauma on an individual’s development and life experience.