Is Spanish Language a Barrier to Domestic Violence Assessment?

Background: Domestic violence is the leading cause of injury to premenopausal women and fatal in over 1000 women annually, but few healthcare providers ask about it, citing numerous barriers, including language. This study tested the hypothesis that language does, in fact, pose a barrier to screening and that Spanish-speaking women report lower lifetime screening rates. Methods: This study was part of an ongoing, multiclinic site, cervical cancer prevention trial in which patients completed a baseline survey, available in both Spanish and English, with the question: Has a doctor or other healthcare provider ever asked you about domestic violence? as well as other questions. Results: Of 2591 women, 1017 (39%) chose to complete the survey in Spanish and 1574 (61%) in English. Within the entire group, 1137 (44%) reported having been asked about domestic violence. Among those completing the Spanish survey, this rate was 47% (lifetime assessment), and among English-language respondents, it was surprisingly lower at 42% (p = 0.011). In multivariate analyses, however, this language effect was reduced to nonsignificance. Instead, age (particularly the 28-34-year quartile), having been pregnant, clinic site, and type of medical visit (postpartum) were positively associated with lifetime assessment. Conclusions: This study found a Spanish language preference is not a barrier to domestic violence assessment.