Notes

Web sites and sources listed provide information useful at the time of this writing, but the authors and OVC do not endorse any organization or information that may be listed on these organizations' Web sites, and contact information or web addresses may be subject to change. Read the OVC Web site links disclaimer.

1. In this bulletin, family violence refers to partner abuse, spousal abuse, child abuse, and the abuse of elderly and vulnerable adults.

2. Public awareness campaigns and specialized training programs have educated health care practitioners about their roles in responding to family violence. One notable example is the Family Violence Prevention Fund’s multifaceted efforts to improve health care response to domestic violence since the mid-1990s. Among other resources, they offer a popular resource manual, a companion trainer’s manual, public education materials for providers and patients, and a model health care training program designed to help health care systems create sustainable programs that help victims of domestic violence (see their Web site at http://endabuse.org). In addition, a growing body of literature explores injuries incurred by family violence and the possibilities for clinical intervention in these cases. Also, numerous professional health care associations have developed effective policies, offer literature, and provide continuing education opportunities and other initiatives aimed at promoting effective intervention in family violence, including the American Dental Association, the American Medical Association, the American Academy of Pediatrics, and the American Nursing Association.

3. G. Chiodo, “Dental Health Workers Assess and Manage Family Violence,” faculty page on the University of Oregon Health Science Center Web site, www.ohsu.edu/sod/sod-research/chiodo.html. (Note: This Web site is no longer accessible to the public.) Accessed May 21, 2002.

4. The program is now called the Aurora Center for Advocacy and Education.

5. Electronic communication with Jamie Tiedemann, May 29, 2002.

6. V.P. Tilden, T.A. Schmidt, B.J. Limandri, G.T. Chiodo, M.J. Garland, and P.A. Loveless, 1994, “Factors That Influence Clinicians’ Assessment and Management of Family Violence,” American Journal of Public Health 84(4): 632, as cited in S. Short, J. Tiedemann, and D. Rose, 1997, “Family Violence: An Intervention Model for Dental Professionals,” Northwest Dentistry 76(5)(September– October): 31.

7. See text and references in the American Academy of Pediatrics Policy Statement. “Oral and Dental Aspects of Child Abuse and Neglect (RE9920): Joint Statement of the American Academy of Pediatrics and the American Academy of Pediatric Dentistry,” Pediatrics 104(2)(August)1999: 348–350.

8. D.C. Berrios and D. Grady, 1991, “Domestic Violence: Risk Factors and Outcomes,” Western Journal of Medicine 155(2)(August): 133–135.

9. A. Ochs II, M.C. Neuenshwander, and T.B. Dodson, 1996, “Are Head, Neck and Facial Injuries Markers of Domestic Violence?” Journal of the American Dental Association 127: 757–761. This study of 127 people at a hospital emergency department found that 75 percent had head, neck, or facial injuries. Of those patients, 23 percent were domestic violence victims.

10. M.R. Christiano, E. Pollard, B. Sturdevant, G. Benson, C. Perron, and T.T. Amatruda Jr., 1986, “Battered Women: A Concern for the Medical Profession,” Connecticut Medicine 50(2): 99–103, as cited in Ochs, Neuenshwander, and Dodson: 759.

11. Family Violence: An Intervention and Training Model for Dental Professionals (training manual), 2000, University of Minnesota: 22.

12. C. Love, B. Gerbert, N. Casper, A. Bronstone, D. Perry, and W. Bird, 2001, “Dentists’ Attitudes and Behaviors Regarding Domestic Violence,” Journal of the American Dental Association 132 (January): 86.

13. P. Tjaden and N. Thoennes, Prevalence, Incidence and Consequences of Violence Against Women: Findings from the National Violence Against Women Survey, 1998, National Institute of Justice and Centers for Disease Control and Prevention, Washington, DC, 1998: 6–9, as cited in Love et al.: 85.

14. Love et al.: 91.

15. Tilden et al.: 630. Clinicians sampled in the study included dental hygienists (n=271), dentists (n=247), nurses (n=236), physicians (n=218), psychologists (n=260), and social workers (n=269).

16. Love et al.: 85.

17. Ibid.

18. J.D. McDowell, D.K. Kassebaum, and G.E. Fryer Jr., 1994, “Recognizing and Reporting Domestic Violence: A Survey of Dental Practitioners,” Special Care in Dentistry 14(2): 49.

19. Ibid.

20. Ibid.

21. L.D. Mouden and B. Smedstad, “Reporting Child Abuse and Neglect: The Dental Hygienist’s Role,” Dental Hygienist News, www.dentalcare.com/soap/journals/dh_news/dhn0804/dn01n05.htm. Accessed June 8, 2002.

22. Information in this section related to the pretraining survey was drawn from J. Tiedemann and D. Rose, 2000, “Final Report, Family Violence: An Intervention Model for Dental Professionals,” (USOJ/197–GY–K030), University of Minnesota, unpublished. Approximately 278 surveys were analyzed.

23. Love et al.: 85.

24. S. Short, J. Tiedemann, and D. Rose, 1997, “Family Violence: An Intervention Model for Dental Professionals,” Northwest Dentistry 76(5)(September–October): 32.

25. G.T. Chiodo, V.P. Tilden, B.J. Limandri, and T.A. Schmidt, 1994, “Addressing Family Violence Among Dental Patients: Assessment and Intervention,” Journal of the American Dental Association 125(January): 73.

26. Ibid.

27. Tilden et al. noted that dentists and dental hygienists were most likely to suspect physical spouse abuse, followed by physical or sexual child abuse. Elder abuse was not frequently suspected.

28. After the training, respondents were 50 percent less likely to believe an intervention posed a legal risk to their practice.

29. Tiedemann and Rose, section on “Assessment of a Family Violence Intervention Model for Dental Professionals.”

30. Love et al.: 85.

31. Chiodo.

32. Tilden et al.: 630. Clinicians sampled in the study included dental hygienists, dentists, nurses, physicians, psychologists, and social workers.

33. Love et al.: 91.

34. Ibid.

35. Only a few related educational programs, models, or publications for dental professionals were identified beyond the University of Minnesota’s Family Violence: An Intervention Model for Dental Professionals. The author acknowledges that other useful tools on this topic certainly may exist. Love et al. (see endnote 3) suggest that dentists follow the AVDR model when approaching patients who are battered. AVDR stands for Ask about abuse, provide Validating messages, Document presenting signs, and Refer victims to domestic violence specialists. A Canadian guidebook addresses family violence issues in dental practices, educational settings, professional associations, and the community at large (see D. Denham and J. Gillespie, 1994, Family Violence Handbook for the Dental Community, Mental Health Division and Health Service Systems Division, Health Services Directorate, Health Canada). Another effort, called PANDA (Prevent Abuse and Neglect through Dental Awareness), has coalitions in at least 46 states, as well as Canada, Peru, and Guam, that educate dental professionals about child abuse and neglect and their responsibility to report suspected patient cases. (Information on the number of PANDA programs is available from Judy Siegel-Itzkovick, 2002, “Reading the Signs,” Israel Magazine on the Web, January, www.mfa.gov.il/mfa/go.asp?MFAH01890.) PANDA coalitions typically offer short training sessions for dental staff in their states. In Missouri, the site of the first PANDA coalition, cases of suspected abuse and neglect reported by dentists increased by 160 percent within the program’s first year. Other coalitions have reported similar or greater increases in reporting. (“Detecting Child Abuse and Neglect at your Local Dental Office,” October 25, 2001, press release, CareFirst Web site, www.carefirst.com/media/NewsReleasesDetails/proct252001.htm. Accessed June 8, 2002.)

36. Information on products and accomplishments in this section was drawn from the University of Minnesota project’s final report, first drafts of this bulletin, actual project materials (curriculum, video boxes, etc.), and communications with project investigators.

37. This team can be a formal or informal network of agencies and individuals in a community that works in partnership to offer assistance in cases of family violence and provide education and training on the topic. Although team composition may vary by jurisdiction, a number of core services are essential to a family violence response, including victim advocacy and services with emergency shelter and housing; social services; health care services; and civil and criminal justice intervention. These services may be provided by domestic violence housing and advocacy programs; sexual assault crisis centers; child advocacy programs; programs that advocate for vulnerable adults; child and adult protection, child support and enforcement, foster care, public assistance, and victim compensation offices; law enforcement agencies, prosecution offices, and legal clinics; medical, dental, mental, and public health organizations and practitioners; and school staff. Other agencies that may be part of a response to family violence include organizations that serve underserved populations and civic, faith-based, neighborhood, and youth groups.

38. Short, Tiedemann, and Rose: 33.

39. Ibid.

40. Ibid.

41. Ibid.

42. J. Tiedemann, D. Rose, and S. Short, n.d., “Family Violence: An Intervention Model for Dental Professionals,” early unpublished draft: 8.

43. Short, Tiedemann, and Rose: 34.

44. Ibid.: 35.

45. Ibid.

46. Ibid.

47. Ibid.

48. Ibid.

49. Information for this section was drawn from Tiedemann and Rose: 16–17.

50. Tiedemann and Rose: 16.

51. Communications with Jamie Tiedemann, May 29, 2002.