We Are Public Health
April 2012
We are public health.
We work to prevent domestic violence.
Domestic violence and sexual assault have reached levels described as epidemic in Alaska. Almost 60 percent of Alaskan women surveyed in a 2010 study by the University of Alaska Anchorage Justice Center experienced intimate partner violence, or sexual violence, or both. In response to this crisis, Governor Sean Parnell created Alaska’s Choose Respect initiative in 2010. The initiative addresses issues of domestic violence in three ways, one of which is highly focused on prevention and education—activities that are natural for Alaska public health nurses to be involved in.
That is why public health nurses across the state, from remote wilderness to more populated areas, are taking part in various efforts to reduce domestic violence and sexual assault. In some areas, these efforts began before the launch of Governor Parnell’s initiative.
For example, six years ago, Colleen Watson, PHN III, of Prince of Wales Island, began a practice of including standard screening questions when she saw clients. She says, “When we ask these questions, we often don’t get disclosure, but that’s okay. The clients know we are concerned and hear that violence is not okay or normal and that there are resources available to them if and when they need help.”
Prince of Wales Island is sparsely populated. People live in small, isolated communities. Until recently, someone who needed a safe place to stay had to leave the island first. Now, because of a community-wide effort, there are resources to help on-island. Watson took part in this effort, serving as a member of a community grassroots network that created HOPE (Helping Ourselves Prevent Emergencies) to help victims of domestic violence.
Watson continues, “The community wants more education. They want to raise awareness. They want more social activities to decrease isolation.” The desire for more social connection is consistent with discoveries researchers are making that show when people are connected to healthy social networks, violence decreases.
In contrast to Prince of Wales Island, Fairbanks, Alaska is a relatively large community, but domestic violence is a problem there as well. The Fairbanks Regional Public Health Center run by the Alaska Department of Health and Social Services started using a domestic violence screening protocol in 2007. When clients come in to get refills of tuberculosis medication or birth control refills, nurses administer the HITS (Hurt-Insult-Threaten-Scream) domestic violence screening tool and then chart patient responses.
The clinic monitors feedback from the staff to figure out what is working and not working with this process. Nancy Davidian, PHN III, relates that part of the internal planning at the Fairbanks Regional Public Health Center has been to build in support in the event a disclosure happens. When this happens, it requires back-up staff, extra time with the client, and a general understanding of domestic violence response among all staff.
Staff in Fairbanks have also organized community education projects. Recently, they sponsored a panel discussion for health care providers to talk about the effects of violence on brain development. It is hoped that greater awareness of this research will encourage health care providers in the community to adopt screening protocols.
When asked about plans for the future, Davidian says, “I would love to see us do more around prevention. Part of prevention is bringing this issue out of the closet and making it a community response rather than a private responsibility.” In this way and others, Alaskans seek to reverse high rates of domestic violence and make more families healthy and strong.
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