Domestic violence (DV) is a major, chronic health problem for women with ongoing physical and psychological health consequences. To better diagnose and treat battered women (survivors) clinicians need an effective clinical pathway that recognizes the chronic nature of DV and the differences in survivor's primary motivation for change. This project builds upon a pilot study of the Domestic Violence Survivor Assessment (DVSA) tool which profiles a survivor's perceptions of her relationship, the violence and herself and identifies a survivor's primary motivation for change. This project has three specific aims: 1) To test the validity and reliability of the DVSA using a sample of 250 survivors identified at an urban, suburban or rural health system. 2) To identify preferences for clinician interventions of domestic violence survivors who are primarily motivated to change by family preservation, self- preservation or resolution preservation using qualitative analysis of 9 focus groups across three sites. 3) To achieve consensus of multidisciplinary clinicians through a modified delphi, of a DV clinical pathway incorporating the 1996 Clinical Screening and Intervention Guidelines of the US Prevention Services Task Force and an updated literature review for immediate and follow up interventions sensitive to survivor's primary motivation to change.
