Transforming Research to a Global Application for Assessment of Women and Children Exposed to Violence

Thursday, 27 July 2017: 3:50 PM

Judith M. McFarlane, DrPH1
Fuqin Liu, PhD2
Nina Fredland, PhD1
Anne Koci, PhD, FNP-BC, FAAN, WHNP1
Lene Symes, PhD3
(1)College of Nursing, Texas Woman's University, Houston, TX, USA
(2)College of Nursing, Texas Woman's University, Denton, TX, USA
(3)College of Nursing, Texas Woman's University - Nelda C. Stark College of Nursing, Houston, TX, USA

Among women in the United States (U.S.) and worldwide, an estimated 30% have experienced intimate partner violence (WHO 2013). Consequences of violence include acute trauma, poor physical health, and compromised functioning (Ellsberg, Jansen, Heise, Watts Garcia-Moreno, 2008) and is most commonly associated with mental health problems of depression and posttraumatic stress disorder (PTSD) (Symes, McFarlane, Nava, Gilroy, Maddoux, 2013). Recent research indicates the pass through of poor mental health of the mother to behavioral problems of the children (McFarlane, Symes, Binder, Maddoux, Paulson, 2014). To better understand the risk predictors of sustained poor mental health, specifically PTSD, for women reporting intimate partner violence, a multi-year study is underway in Houston, Texas, USA.

Methods of the study include recruitment of 300 mothers reporting intimate partner violence to justice or shelter services for the first time. The women are followed for 7-years to determine the temporal sequencing of how violence impacts women’s mental health and the impact on poor maternal mental health, specifically PTSD, on her children’s functioning. To learn the determinants that mitigate or intensify the impact of violence on mental health, specifically PTSD, measures of mental health are completed every 4-months using validated tools. (One child of each mother is being followed and the child’s behavioral functioning and school performance is measured every four months also).

At year 5 of the study, 94% of the mothers and children are retained. A portfolio of 40 peer-reviewed articles are published, including predictor tools to determine mothers at highest risk to sustained mental health problems, especially PTSD. To transform the research to a smart device, such as a phone and tablet, predictor models were derived and validated for sustained maternal PTSD and sustained child dysfunction and the information programmed to a predictor application. The predictor applications are available in English and Spanish, designed for use on a hand-held device, and disseminated through the World Wide Web at no charge. The predictor tools enable first responders and front line providers to quickly assess and triage women and children exposed to domestic violence to needed services.

The predictor applications, termed FAST (First Assessment Screening Tools) Apps, translate 5-years of research into strategies for practitioners worldwide to optimize health of women and children experiencing domestic violence, by taking into account determinants of health measured through nursing research. The presentation will discuss the continued validation of the First Assessment Screening Tools and uptake internationally of the application. Connection of the FAST application to addressing Sustainable Development Goals 2013 (Transforming Our World, 2016) will be discussed. Additionally, the audience will have the opportunity to download the FAST application and comment on usefulness for best practices during the presentation.