CHATS: a tool to identify troubling symptoms from brain injury to assure accommodations and referrals to safety and health services for domestic violence survivors
Assistant Professor Ohio State University, College of Public Health, Division of Health Behavior and Health Promotion Columbus, Ohio, United States
Research Objectives: More than 70% of domestic violence (DV) survivors accessing safety services have brain injuries (BI) from head trauma and strangulation that have historically gone unidentified. CHATS is a tool to identify possible BI and health concerns that might need to be accommodated in services or directly addressed by a health professional.
Objectives: To determine 1) a preferred way for advocates working with DV survivors to use CHATS (survivor- vs. advocate-administered) and 2) initial reliability of the CHATS measure to assess for exposure to head injury, strangulation, and subsequent altered consciousness.
Design: Cross-sectional surveys.
Setting: Interviews took place at five Ohio programs providing advocacy services to DV survivors.
Participants: Service-seeking DV survivors completed surveys in 2019 (n=46). Participants were randomly assigned to either self-administer or have CHATS interviewer-administered.
Interventions: CHATS is a tool arising from the CARE (Connect, Acknowledge, Respond, and Evaluate) Intervention—a brain injury-informed approach to providing trauma-informed care developed through community-based participatory action research with the Ohio Domestic Violence Network.
Main Outcome Measures: Chi-square and Fisher’s exact tests were used to determine administration type differences. Cohen’s kappa was used to test agreement between CHATS components and other survey items.
Results: CHATS was interview-administered (46%) and self-administered by participants (54%). There were no significant differences by administration type for responses regarding oxygen deprivation (strangulation, suffocation); blunt force head trauma; altered consciousness (dazed, dizzy, loss of memory, blacking out); thoughts of suicide; struggles with alcohol/drugs; or wanting to see a health provider. Acceptable agreement was found between CHATS and other survey items from standardized brain injury measures (C, K=0.86 95%CI [0.68, 1.00]; H, K=0.65 95%CI [0.37,0.92]; A, K=0.47 95%CI [0.19,0.75]).
Conclusions: CHATS can be used flexibly by DV programs to identify troublesome symptoms which may arise from BI; or from mental health, substance use or other health concerns. CHATS information can be used to make accommodations to assure access to DV safety services; and/or to provide brain injury and other healthcare referrals.
Author(s) Disclosures: No disclosures to report. This study was funded by OVC grant 2016-XV-GX-K012 .
Learning Objectives:
Articulate how the CARE is being used to provide brain-injury aware trauma informed care in organizations working with domestic violence survivors.
Describe how the CARE CHATS tool can be used in service provision to assess exposures of brain injury from violence and troublesome physical, cognitive, and emotional symptoms violence survivors report that may be interfering with service access and functioning.
Plan for how the CARE CHATS tool can be used to provide accomodations for service access in a variety of settings where domestic violence survivors seek services.
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