USPSTF announces final research plan for screening for intimate partner violence, elder abuse

The U.S. Preventive Services Task Force has issued its final research plan to update previous recommendations on screening for various forms of abuse with the goal of determining whether screening reduces abuse exposure and if any interventions could cause harm.

The agency will focus on recommendations regarding screening for intimate partner violence, elder abuse and abuse of vulnerable adults.

They plan to focus on the following questions for intimate partner violence:

Does screening for current, past, or increased risk for intimate partner violence (IPV) in adults and adolescents reduce exposure to IPV, physical or mental morbidity, or mortality?
What is the accuracy of screening questionnaires or tools for identifying adults and adolescents with current, past, or increased risk for IPV?
What are the harms of screening for IPV in adults and adolescents?
How well do interventions reduce exposure to IPV, physical or mental morbidity, or mortality among screen-detected adults and adolescents with current, past, or increased risk for IPV?
What are the harms of interventions for IPV in adults and adolescents?

They will also review the following questions in assessing elder abuse and abuse of vulnerable adults:

Does screening in health care settings for current, past, or increased risk for abuse and neglect in older and vulnerable adults reduce exposure to abuse and neglect, physical or mental morbidity, or mortality?
How effective are screening questionnaires or tools in identifying older and vulnerable adults with current, past, or increased risk for abuse and neglect?
What are the harms of screening for abuse and neglect in older and vulnerable adults?
How well do interventions reduce exposure to abuse and neglect, physical or mental morbidity, or mortality among screen-detected older and vulnerable adults with current, past, or increased risk for abuse and neglect?
What are the harms of interventions for abuse and neglect in older and vulnerable adults?

The agency plans to utilize randomized, controlled trials, as well as cross-sectional and cohort studies in adolescents, adults and older adults. Clinical settings will include primary care clinics and other settings that provide primary care services, such as student health centers and emergency rooms.

A draft version of the research plan was available on the USPSTF website earlier this year. The agency made several changes based on comments it received, including:

expanding the population to include searches of various subgroups, including by age, sex, race/ethnicity, LGBTQ identification, pregnancy status, type of abuse, presence of comorbid conditions and history of intimate partner violence;
clarifying that studies involving older and vulnerable adults focused on screening or treatment for intimate partner violence would be eligible;
replacing the term "elderly" with "older adults;"
adding "labeling or stigma" and "retaliation" as a potential harm of screening; and
listing exploitation and financial abuse as a category of abuse.