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>View discussions about this entry País: United States
Organization: Emory University
Focus of activity - Education
Year the initiative began - 2003
Positioning in the Mosaic of solutions
Description of Initiative - What is the main focus (products, services, etc.) of your initiative and how does it contribute to ending or preventing domestic violence? What principal aspect of domestic violence are you addressing? What activities does it involve for your organization? Who are your primary beneficiaries and target groups? This is an educational intervention targeted at screening and identifying male and female victims of domestic violence. We screen all waiting room patients during hours we have research assistants or student volunteers. We initially started off with full time paid research assistants and now operate the project using MPH practicum students and volunteers. All patients who present during the hours we have students and RAs are eligible to participate.
All identified victims are then given information on domestic violence as well as community resource referrals. We also have unique educational interventions and follow up meetings with women who disclose alcohol abuse, drug abuse, and cigarette smoking. The majority of our victims do not have access to care, are uninsured, are female, and are minority. Many victims also have mental health and substance use issues. Innovation - Demonstrate how your approach differs from other programs in the field? Which specific components of your initiative are particularly effective, novel, or unique (e.g., the products and services, the technology used, the delivery, or financing mechanism)? We approach both male and female emergency department waiting room patients regardless of why they are seeking medical care. We use an innovative touch screen computer kiosk based on initial work by Karin Rhodes, a coinvestigator on these federally funded research projects at our site. This delivers specific, targeted information, based on what health risk behaviors the patients disclose.
Delivery Model - How does your initiative reach its target populations? What communications mechanism(s) do you have in place? How do you measure their impact? Patients receive personalized, targeted information based on their responses to the computer kiosk. In addition, African American women with alcohol abuse, drug abuse, cigarette smoking, or partner violence receive a special 2 page educational handout geared towards these specific conditions in culturally sensitive and literacy appropriate language. Most of our domestic violence victims were not aware that they were victims until they participated in our program.
Key Operational Partnerships - What key partnerships have you established to make your model possible or more efficient? Who are your partners (business, social, government, other) and what are their roles? How central are these partnerships for your initiative. The CDC and NIH funded the initial research endeavor. We have partnered with our emergency department nursing staff and social services for immediate support to our victims and we have contacted local community organizations to include them as a referral basis for our patients. In addition, we now have MPH students volunteering as research assistants as part of their practicum experience.
Financial Model - Which mechanisms do you have in place to ensure that your beneficiaries can afford your products or services? Do you have financial schemes or arrangements for low-income and marginalized populations? This intervention is geared towards women in low-income and marginalized populations. This educational intervention is conducted in an inner-city, largely African American and indigent population. All waiting room patients are approached and asked to participate at no cost.
Effectiveness - What has been the concrete impact of your project to date? How many people have benefited from your program in total? What policies, communities, or institutions have been influenced to make fundamental changes because of your work? We have screened approximately 3,000 people for health risk behaviors. Approximately 25% were identified as domestic violence victims.
Scaling up Strategy - What is your priority for the next 3 years and please describe why. We would like to expand this kiosk intervention to other health clinics and community centers. We would also like to change the format to web-based and be able to translate it into different languages. This would allow us to identify and education a larger population, including those who have never accessed the health care system.
Origin of the Initiative - Tell the personal story that will help people connect to your work. How did the initiative start? Was there a particular individual or event driving the idea? Tell the reader the story behind the innovation. Many of our patients were surprised that they were victims of domestic violence. These victims disclosed being hit by their partner, forced to have sex, or threatened with a weapon but didn't realize this was considered abuse. Also, Dr. Rhodes found in an earlier study at a different site that patients were more likely to disclose sensitive information using a computer kiosk. We've had many women leave their partners and change their lives based on this project. One of our patients was even interviewed by a local news affiliate about the project.
Main Obstacles to Scaling Up - List the two (2) main obstacles to scale up your innovation (policy, legal, organizational, people, financial, etc.)? The main obstacle is financial. Without additional resources we will not be able to expand our project.
Main Partnership Challenges - What are your major challenges with partnerships? (E.g., identification of partners, implementation of partnerships, relationship management, etc.) There are not enough community resources available for disadvantaged women.
Contact Information:
Debra Houry
Assistant Professor Emory University (academic program) Discussions about this entry |
Emergency Department Computer Kiosk Intervention for Domestic Violence
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The Emergency Department Kiosk Model is an amazing study design that has already had a huge impact on domestic violence victims. I like that this system is easily accessed by people who are at high risk of being abused. Also, the design of the kiosk system to personalize information based on response enhances participation and follow-up of those being screened. Not only does this model provide a secure method for victims to disclose sensitive information, but it provides resources to enact change. Screening, education, and access to resources are key elements in fighting Domestic Violence--the Computer Kiosk Model powerfully addresses ALL of these items. Just think about the positive changes that are possible if this sytem is nationalized or internationalized!