Success reported in creating a domestic violence intervention program
An intervention strategy for intimate partner violence was designed and tested successfully, according to Judy Chang, M.D., MPH, assistant professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine.
To create the program, investigators interviewed 21 women who had reported a past or current history of domestic violence, Dr. Chang noted. They also talked to nine clinicians and held three focus group discussions with participation by nurses, medical assistants and social work professionals.
"Including patients and providers in the project allowed us to tailor an intervention to meet their needs," said Dr. Chang, who also is an assistant investigator at the Magee-Womens Research Institute. "Patients wanted – and used – resource information."
Informational materials including posters, brochures and tear-off fliers were composed and made available for distribution to patients. These materials were monitored weekly for six months to determine how many were taken by patients. In addition, investigators noted calls to a domestic abuse hotline.
"After we began, some 43 brochures and 25 tear-off fliers were taken from the clinic every month," said Dr. Chang. "And in the six months after our program, the local women's center got 12 inquiries from women who had heard about the hotline in the obstetrics-gynecology clinic – up from just one in nine months. Referrals to social workers went up to 12 a month from nine a month."
In addition, investigators designed a useful computerized screening tool to help health care providers identify possible victims of intimate partner violence, Dr. Chang said.
Women found the computerized screening survey easy to complete, and felt more comfortable in such a setting because it provided valuable information while preserving anonymity, a critical factor for many patients, she said.
Additional authors include Sarah H. Scholle, Ph.D.; Patricia A. Cluss, Ph.D.; Lynn W. Hawker, Ph.D.; Diane Dado; Raquel Buranosky, M.D.; Carolyn Hughes, M.S.W.; and Melissa McNeil, M.D., MPH.
The risk of preeclampsia rises with increases in body mass index before pregnancy
Rigorous analysis of data on 1,188 women pregnant with their first child with respect to body mass index (BMI) and risk of preeclampsia reveals a sharp increase in risk from a BMI of 16 to 35, according to Lisa M. Bodnar, Ph.D., MPH, R.D., a postdoctoral fellow at the Magee-Womens Research Institute.
Preeclampsia is a complication of pregnancy that is potentially life threatening to both mother and baby. It affects some 5 percent of first pregnancies. A measure of body fatness, BMI is derived by a formula using weight and height. A BMI of 25 or more is considered overweight for women. A BMI of 30 or higher is considered obese.
"The overall incidence of preeclampsia was 4.2 percent," said Dr. Bodnar. "After adjusting for other factors such as age and smoking, we found that preeclampsia risk increased along with BMI."
Compared with a BMI of 21, preeclampsia risk was two-fold for a woman with a BMI of 26, three-fold for a woman with a BMI of 30 and four-fold for a woman with a BMI of 34, she said.
"With the rate of obesity increasing in the United States, this is a worrisome development," Dr. Bodnar said. "However, our results suggest that it's possible even a small reduction in BMI could reduce preeclampsia risk."
Additional authors include Nina Markovic, Ph.D.; Gail Harger and James M. Roberts, M.D.
CONTACT: Michele D. Baum
Clare Collins
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