Exploration of barriers to screening for domestic violence in the perinatal period using an ecological framework

Aims
To explore Australian healthcare providers' perspectives on factors that influence disclosure and domestic violence screening through the lens of Heise's (1998) integrated ecological framework.

Design
This paper reports the findings that were part of a sequential mixed methods study with survey data informing interview questions. Participants for interviews were recruited after expressing an interest after completing surveys, as well as via snowball sampling.

Methods
Semi-structured interviews were undertaken in 2017 with 12 practicing healthcare providers delivering care to women in the perinatal period in Greater Western Sydney, NSW, Australia. Data were analysed using Braun and Clarke's (2006) six-step thematic approach.

Findings
The findings were framed within Heise's integrated ecological framework under four main themes. The main themes were ‘Ontogenic: Factors preventing women from disclosing’; ‘Microsystem: Factors preventing healthcare providers from asking’; ‘Exosystem: Organizational structures not conducive to screening’; and ‘Macrosystem: Cultural attitudes and socioeconomic influences affecting screening’.

Conclusion
Organizational policies are needed for better systems of reminding healthcare providers to enquire for domestic and family violence and mandating this within their practices. Mandatory domestic and family violence education and training that is suitable for the time constraints and learning needs of the healthcare provider is recommended for all healthcare providers caring for perinatal women. Further research is needed in addressing culturally specific barriers for healthcare providers to enquire about domestic and family violence in a culturally appropriate way.

Public and Patient Engagement and Involvement in Research (PPEI)
No Patient or Public Contribution was embedded into the research reported in this paper as this research was specifically exploring healthcare providers’ perspectives on domestic violence screening within their own practice experience.

© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

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