A recent study examined the effectiveness of a training program designed to promote the identification and referral of women experiencing domestic violence. Forty-eight general practices in urban areas participated. Half received the training, which included two multidisciplinary sessions for the clinical team that provided information on identifying, supporting, and referring women being abused. Participants attended quarterly or semiannual practice sessions after the initial training. Experienced domestic violence advocates and trainers delivered the training, in collaboration with a family physician or clinical psychologist. They also provided support on the telephone and through e-mail. In addition, one nurse or physician from each practice took part in an eight-hour training session. Administrative staff also received training sessions concerning the confidentiality and safety of patients being abused.

The authors collected data concerning referrals for support services among women 16 years and older for 12 months before and 12 months after the training. According to electronic medical records, physicians at all 48 practices referred 21 patients (12 in the control group and 11 in the intervention group) during the 12 months before training. After the training, records indicated 223 referrals in the intervention group, compared with 12 in the control group. Similarly, there were 641 disclosures of domestic violence recorded in the intervention group and 236 in the control group. In addition, domestic violence agencies received 238 referrals of patients from the intervention practices, compared with 40 from the practices that didn't receive training.

Although the 223 intervention group referrals noted in medical records resulted in only 184 referrals actually received directly from physicians-most likely because some clinicians had considered providing contact information to a patient to be a referral-the 238 referrals received by agencies from the intervention practices represent a rate six times higher than that in the control practices.-SDSJ

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