Development of Verbal HITS for intimate partner violence screening in family medicine

Abstract

Background and objectives: Researchers in intimate partner violence (IPV) screening have developed a short written tool called HITS. The acronym corresponds to questions that elicit information about how often a woman's male partner physically Hurts, Insults, Threatens harm, and Screams at her. The purpose of this study was to develop a verbal form of the HITS and to compare it to the published written version.

Methods: A secondary analysis of data from prior HITS research was conducted. From this, the screening questions were modified for oral presentation so that patients could respond with a yes or no answer. To test the comparability of the two screening formats, 103 adult female patients completed both forms of the HITS during routine office visits. Phase one of this study used Optimal Data Analysis (ODA) on 210 cases from prior HITS research to create a cut score that differentiates clinic patients from self-identified victims of abuse. From this, written HITS questions were modified for verbal administration. Phase two of this study used t test, ANOVA, and classification of two screening formats to compare the written and verbal HITS administered to 103 adult female family medicine patients.

Results: Responses to both types of screening were related. The mean score on the written HITS was statistically higher for respondents who reported "yes" to a Verbal HITS question. This was consistent across all four questions. Also, the mean written HITS score increased linearly as a function of the number of yes answers on the Verbal HITS. The screening classification (positive, negative) from both forms of the HITS was the same for 83% of the respondents.

Conclusions: The verbal and written HITS comprise two ways that clinicians can screen for domestic violence.