Screening for intimate partner violence in a primary care setting: The validity of "feeling safe at home" and prevalence results

Background: We conducted a study to assess the validity of a screening question commonly used to detect intimate partner violence (IPV) in primary care settings. We also analyzed prevalence and risk factors of IPV. Methods: We used an embedded domestic violence detection instrument in a general health questionnaire at one family medicine clinic. Questionnaire scales included a modified version of the Conflict Tactics Scale (CTS), depression and alcohol use scales, and a personal safety question ("Do you feel safe at home?"). We assessed the sensitivity, specificity, and predictive value of the personal safety question in our sample using responses to the modified CTS and the personal safety question. Three hundred ninety-nine female patients over the age of 18 completed the survey. Results: CTS results revealed 44.3% of women experienced any violence, 43.5% of women experienced psychological violence in the presence or absence of physical violence, and 10.3% experienced physical violence in the presence or absence of psychological violence in the previous 90 days. The sensitivity of a single question used to detect any violence ("Do you feel safe at home?") was 8.8%; the specificity was 91.2%. Racial identity, marital status, and depression influenced the likelihood of IPV. Conclusions: These preliminary results call into question the utility of the safety question "Do you feel safe at home" for detecting cases of intimate partner violence in a primary care sample.