Caregiver Intimate Partner Violence and Reported Adverse Physical and Psychosocial Health Outcomes for Caregivers and Their Children in a Pediatric Emergency Department

Background: Literature suggests that caregiver intimate partner violence (IPV) is associated with adverse emotional, behavioral, and physical health outcomes for caregivers that experience the violence as well as their children. This analysis serves to further understand the association of a caregiver's lifetime experience of IPV with their own and their child’s physical and psychosocial health outcomes.

Methods: The objectives were to measure the associations of caregiver IPV with 1) adverse caregiver physical and psychosocial health outcomes; and 2) adverse child physical and psychosocial health outcomes. This was a secondary analysis of data from BearSCREEN, a tablet-based, cross-sectional behavioral and social health risk screening survey of 13 social/behavioral risk domains, including perceived caregiver and child health and a validated 3-question IPV screen. Caregivers presenting to a pediatric emergency department (ED) with patients ages 0-17 years old were eligible for survey completion. We calculated the frequency of caregiver lifetime IPV and performed logistic regression to identify adverse caregiver and child physical and psychosocial health outcomes associated with IPV. Caregiver age, race, gender, and income were covariables.

Results: The majority of caregivers (n=553) were female (79.9%), non-Hispanic Black (58.2%), aged 25-44 years (72.2%), with reported income below $80,000 (55.4%). Nearly 20% of caregivers (n=110) reported lifetime IPV. Caregiver gender (adjusted OR [aOR] 2.5; 95% CI 1.2, 5.2) and yearly income <$25,000 (aOR 2.6; 1.1, 5.8) were associated with IPV (Table 1). Poor perception of caregiver’s own health (aOR 4.3; 2.0, 9.2), caregiver’s diagnosis of a mental health concern (aOR 4.1; 95% Cl 2.5, 6.8), caregiver substance abuse (aOR 2.8; 1.2, 5.2), food insecurity (aOR 4.5; 2.4, 8.6), caregiver’s history of arrest (aOR 3.2; 1.4, 6.9), child’s diagnosis of a mental health concern (aOR 4.1; 1.3, 12.6), child’s exposure/involvement in bullying (aOR; 4.8 1.9, 12.1), and caregiver presenting with the child to the ED with a high-risk chief complaint (aOR 2.4; 1.3, 4.3) were associated with caregiver’s experience of IPV (Table 2).

Conclusion: Nearly 1 in 5 caregivers reported experiencing lifetime IPV. IPV was associated with several adverse health outcomes for caregivers and their children. Our results highlight potential unmet physical and psychosocial needs within caregivers who experience IPV that present to the pediatric ED. Understanding the impact of caregiver IPV on health outcomes for caregivers and their children may inform future screening and intervention efforts.