Measuring the impact of the Voices of survivors program on health care workers' attitudes toward survivors of intimate partner violence

BACKGROUND: Most continuing medical education programs on intimate partner violence (IPV) use an expert-driven approach and focus on changing knowledge and screening behaviors. The Voices of Survivors program aims to also improve attitudes and empathy. OBJECTIVES: To test the Attitudes Toward Survivors of IPV (ATSI) survey psychometrically. To assess the effectiveness of the Voices of Survivors program in changing health care workers' responsibility to assess for and counsel about IPV, respect for patient autonomy, empathy toward patients in abusive relationships, barriers, confidence, knowledge, and self-reported assessment behaviors. SETTING: Thirty-one unaffiliated primary care practices in Washington County, Ore. DESIGN: Comparison of ATSI survey results before and after a two-hour workshop including a 30-minute video and an advocate-led discussion. PARTICIPANTS: Convenience sample of primary care providers, medical support staff, and other clinic employees. RESULTS: Two hundred and eighty-four health care workers participated in the training. Two hundred and sixty-seven (94%) completed workshop evaluations and 187 (66%) completed both pre- and postintervention surveys. Cronbach's alpha for all scales ranged from 0.68 to 0.92. Postintervention, participants' summary scores improved for responsibility to assess for IPV (3.96 vs 3.64; P < .0001), respect for patient autonomy (2.78 vs 2.41; P < . 0001), empathy (3.24 vs. 2.99; P = .002), confidence (2.33 vs 2.07; P < .0001), knowledge (2.08 vs 1.64; P < .0001), and self-reported behaviors (3.08 vs 2.53; P = .0001). Barriers related to availability of resources and referrals also improved. CONCLUSIONS: The ATSI scales demonstrated good internal reliability and responsiveness to change in all domains except responsibility to counsel. The Voices of Survivors documentary, along with a workshop based on its companion guide, improved clinic employees' knowledge, attitudes, empathy, and self-reported assessment behaviors about IPV.