snap shot
Community health researcher Dr. Alexa Yakubovich is working more closely with front-line medical professionals at IWK Health to address high rates of violence against women in Nova Scotia.
challenge
This is a public health epidemic that doesn't make headlines like the coronavirus or the opioid crisis. But in the face of the data, it's hard to deny the urgency.
According to Statistics Canada, 44 per cent of women in intimate partner relationships report experiencing abuse. Women in Nova Scotia report higher rates of intimate partner violence than women in other Canadian provinces. This striking difference gives Dalhousie's Dr. Yakubovich a sense of determination in her work to build interventions in women's care that have the potential to improve and save their lives.
“Violence against women has many negative health effects, including injuries, mental health issues, chronic pain, and illness. And medical care is often the only formal service available to victims. ” says Dr. Yakubovich. “This is a really important point of intervention because we know that these women are more likely to access health care, so we can connect them to broader support.”
context
Beyond those directly affected, Dr. Yakubovic says there are huge costs involved for society. The pressure of making multiple visits to medical facilities that are already over capacity. Absenteeism or unemployment. The legacy of trauma in children who experience domestic violence. She says all of this has a corrosive impact on quality of life and productivity far beyond the victims.
To illustrate clearly what happens when intimate partner violence goes unaddressed, she detailed the example of the 2020 mass shooting in Portapique, Nova Scotia. The mass shooting, which started when the gunman assaulted his common-law wife, left 22 people dead.
“The mass shooting provides an example of a situation where there is a history of intimate partner violence. There has been contact with various social, health services and justice systems, but unfortunately there are gaps in the response. “There was,” Dr. Yakubovich said.
“But when it comes to mass shootings, recommendations have been issued in states around how to strengthen their response to violence against women. This gives us more space in terms of what can be done in research, policy and practice. was born.”
solution
To get even closer to this issue, Dr. Yakubovich is developing a new program funded by the Canadian Institutes of Health Research that will incorporate her into IWK Health, a leading provider of health services to women, children and families in Nova Scotia. It has started. Her new partnership will allow her to work on programs that see the most patients experiencing violence.
“Joining the IWK and establishing this formal partnership will facilitate the work needed to get programs and providers on board with the little big changes that are coming,” says Dr. Yakubovich. “This allows us to work directly with providers in their own environments to get buy-in rather than if we were talking to them as an outsider.”
Dr. Yakubovich says health care workers cannot be blamed for not considering the risk of intimate partner violence as a top priority when caring for patients. Their work is very busy and focused on meeting specific needs. The key, she says, is to help children recognize and spot the signs of abuse by creating a process of regularly asking questions about them. Additionally, she says care providers must be equipped with training, information and tools to assist victims and connect them with available supports and services.
Dr. Yakubovich said the main partnership is with the IWK, but it also extends to the Nova Scotia Health Authority and the province, particularly in priority areas such as women's and newborn health, mental health and addictions, primary care, emergency and trauma. He said it has even spread to the government.
The first goal of this work is to understand what efforts are currently underway at IWK and other organizations, and to connect them to maximize their impact. She also aims to develop a process to record reported violence securely and privately in health records. She said this will help shed light on the burden of problems within the health care system, in which programs patients are most likely to experience violence, and how to better connect patients with available supports. says.
Alongside her focus on data collection, she works with IWK and other partners to improve interventions.
“This includes training health care providers and establishing screening and referral interventions so patients are asked questions and health care providers know what to do when they receive answers. ” says Dr. Yakubovich. “Health care providers need to know how to connect patients with supports available within the health care system, such as sexual assault nurse examiners trained to respond to domestic violence and sexual violence.”
impact
Dr. Yakubovich has made partnerships with health care providers and communities a major focus of his research career, saying it is the best way for medical researchers to have a positive impact.
“Ultimately, this way of collaborating with organizations and partners is the best way to create a pathway for research to translate into policy. It is the only way we can put the latest evidence into practice immediately,” she says.
She aims for change enabled by a program to create a new culture in Nova Scotia health care geared to support victims of intimate partner violence. But ultimately her goal is focused on preventing violence from occurring in the first place.
“In 10 years, I would like to see research programs actually progressing. But this also involves other systems. The more we prepare the health system in terms of capacity, the better prepared it will be to play a role in primary prevention strategies.”
