1. Making the Connection: Intimate Partner Violence (IPV) and Public Health Linda Chamberlain, PhD MPH © 2010 The Family Violence Prevention Fund www.endabuse.org/health

2. For more information and program support, contact the National Health Resource Center on Domestic Violence, a project of the Family Violence Prevention Fund: Monday-Friday (9-5 PST) Toll-free (888) Rx-ABUSE (792-2873) TTY: (800) 595-4889 Online: www.endabuse.org/healthwww.endabuse.org/health In addition, this PowerPoint presentation may be downloaded from the Family Violence Prevention Fund's website: www.endabuse.org/health www.endabuse.org/health

3. The National Health Resource Center on Domestic Violence provides specialized materials and tools including: Consensus Guidelines on Routine Assessment for D.V. Pediatric Guidelines on Routine Assessment for D.V. Business Case for Domestic Violence Multilingual Public Education Materials Training Videos Multi-disciplinary policies and procedures Cultural competency information and materials specific to many communities Online e-Journal: Family Violence Prevention and Health Practice Health Cares About Domestic Violence Day (2 nd Wednesday of October annually) Visit www.endabuse.org/health for more informationwww.endabuse.org/health

4. Linda Chamberlain, PhD MPH IPV and Sexually Transmitted Infections/HIV MENU Overview Regional and Local Data The Impact of IPV on Women’s Health IPV and Behavioral Health IPV and Perinatal Programs IPV, Breastfeeding, and Nutritional Supplement Programs IPV and Child and Adolescent Health ACE Study: Leading Determinants of Health IPV and Injury Prevention IPV and Home Visitation Medical Cost Burden and Health Care Utilization for IPV SELECT FROM THE TOPICS BELOW  IPV and Family Planning, Birth Control Sabotage Pregnancy Pressure, and Unintended Pregnancy

5. Intimate Partner Violence (IPV), Breastfeeding, and Nutritional Supplement Programs

6. 1. Describe the connection between breastfeeding and IPV. 2. Identify two strategies for addressing IPV in a nutritional supplement program such as WIC. 3. Describe two system level responses for addressing IPV. 6

7. 7 Women who experience physical and/or psychological IPV during pregnancy are less likely to initiate breastfeeding. Lau & Chan, 2007

8. Women experiencing physical abuse around the time of pregnancy are: 35%-52% less likely to breastfeed their infants 41%-71% more likely to cease breastfeeding by 4 weeks postpartum 8 Silverman et al, 2006

9. 9 Parkinson et al, 2001 more likely to disclose IPV at well-child visits than women who were not eligible for WIC benefits. Women who were eligible for WIC benefits were

10. 10 Opportunity to screen mothers and children that may have limited access to other services due to violence in the household. Breastfeeding may not be a safe choice for IPV victims and their infants.

11. 11 Abusive partners may use tactics such as withholding food to control a victim. A woman in an abusive relationship may not have control over what she and her children eat. Poor compliance with dietary recommendations may be related to abuse.

12. 12 Integrate IPV screening questions into nutritional assessment forms. Counsel clients about the potential of escalating abuse during breastfeeding and discuss strategies to increase personal safety. Help clients develop strategies to comply with dietary recommendations. Provide ongoing IPV training for staff.

13. 13 Integrate information on IPV and the impact on children into pamphlets, videos, and resources. Conduct research on the impact of IPV on the nutritional status of women, infants, and children.

14. 14 MORE  Partner with an advocacy organization Educational materials, ongoing training Reimbursement strategies Integrate into standardized forms Establish policies and protocols

15. 15 Sponsor conferences, education campaigns Promote cross-training Facilitate research Quality assurance & compliance measures

16. 16 The School of Social Work at Florida State University developed IPV resources for WIC workers, other nutrition staff, and elder care workers: – Online tutorials – Competency-based training manuals Institute for Family Violence Studies

17. Safe environment for disclosure Supportive messages Educate about the health effects of IPV Offer strategies to promote safety Inform about community resources Create a system-wide response 17

18. 18 Family Violence Prevention Fund “ Success is measured by our efforts to reduce isolation and to improve options for safety. “