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HLA House Project: Intimate Partner Violence Trainings for Health Care Professionals

July 10, 2020

Students in the Health Leadership Apprentice Program, divided into “houses,” work alongside Community-Driven Initiatives to help Central Texas community members address health-related issues. This post is by members of the HLA Blue House, which worked with Texas Advocacy Project for their house project.

The HLA Blue House is composed of six students at The University of Texas at Austin: seniors Jazzlynn Derrick, Ethan Devara and Cecilia Domene; junior Victoria Epstein; and sophomores Tanvi Ingle and Alisha Sood. They joined HLA in fall 2019, eager for their chance to help transform health care and make a difference in their community. Uniting their diverse passions, the Blue House elected to work with the Texas Advocacy Project on its initiative to better address health-harming legal needs in Texas.

Texas Advocacy Project is an organization composed of lawyers who have made it their mission to prevent domestic and dating violence, sexual assault and stalking throughout Texas. By providing free legal representation and advocacy, the organization works to advance its stated vision for all Texans to “live free from fear.”

Intimate partner violence is far-reaching. According to the National Intimate Partner and Sexual Violence Survey, more than 1 in 3 women in the U.S. have experienced it. Meanwhile, the National Survey of Children’s Exposure to Violence found that 17.9% of children had been exposed to their parents’ physical intimate partner violence.

To help address this issue in Texas, Texas Advocacy Project submitted a proposal to Community-Driven Initiatives. In it, the organization indicated a desire for a more formal collaborative relationship with medical providers. It aimed to build a partnership with Dell Med to better help patients experiencing intimate partner violence.

Ultimately, Texas Advocacy Project would provide trainings and legal clinics for health care providers to assist them in identifying people in need of legal support and informing them of the best avenues to take. The organization would then provide legal aid to patients as necessary and continue gathering information to refine the process.

Considering Texas Advocacy Project’s goals, the Blue House envisioned establishing a long-term medical-legal partnership, a framework in which lawyers and health care providers systematically work together to address health-harming legal needs. The model has shown great promise: A 2016 National Center for Medical-Legal Partnership survey found that 66% of health care organizations that participate in such a partnership say clinicians report improved patient health outcomes as a result.

With that goal in mind, the Blue House determined the best first course of action would be for Texas Advocacy Project to host a lunch-and-learn training for health care providers to bring attention to the issue’s significance and the next steps to take. The Blue House would handle the logistics of the presentation, securing a date and location and publicizing the event through social media, posters and a series of blog posts.

In addition, it would acquire Continuing Medical Education accreditation for the training and supplement the presentation with its own research: a sequence of “temperature test” surveys noting clinician attitudes and knowledge about domestic violence. These would be distributed both before and after the presentation to measure impact, and the team worked to gain Institutional Review Board approval in hopes of eventually publishing this data.

Things were going smoothly — the training was set for the end of April, the event gained CME accreditation and the IRB application was in review — until the coronavirus response forced the team to rework the timeline. The Blue House put the IRB application on hold and pushed the event to mid-November.

However, the team decided to turn this setback into an opportunity to further improve the presentation. The increased length of time until the presentation has provided the team the chance to gather more data, in the form of a greater number of pilot surveys. Additionally, Texas Advocacy Project offered the team the opportunity to shadow their staff in courts and existing partner clinics over the summer. These experiences may better inform the team’s research, which could be implemented into the training.

Over the course of the project, the Blue House has learned a great deal about what it means to be a team, playing off members’ individual strengths and internalizing the value of communication. The ride wasn’t a smooth one at the beginning, with the team acting as six disjointed parts. But over time, the Blue House learned to rely on each other when they needed help and by the end was able to seamlessly function as an ensemble.

Whether in writing, research or graphic design, the team was able to grow from one another and integrate their unique talents to deliver a result that would have been impossible if even one member had been missing. Each member stepped out of their comfort zone a bit but did so confidently, diving straight into tasks such as acquiring CME accreditation or writing a survey for the IRB.

The Blue House would like to extend a huge thank-you to Steve Steffensen, M.D.; Nitakuwa Barrett, MSN, RN; Denice Richard, M.A.; Sue Peixotto, M.S.; and the HLA coordinators for their guidance throughout the project, as well as to Bronwyn Blake and Amanda Elkanick from Texas Advocacy Project for their counsel and partnership.