Intimate partner violence (IPV) is a major public health problem with harmful consequences. In Australia, there is no national standard screening tool and screening practice is variable across states. The objectives of this study were to assess in the antenatal healthcare setting: i) the validity of a new IPV brief screening tool and ii) women’s preference for screening response format, screening frequency and comfort level. One thousand sixty-seven antenatal patients in a major metropolitan Victorian hospital in Australia completed a paper-based, self-administered survey. The survey included four screening items about whether they were Afraid/Controlled/Threatened/Slapped or physically hurt (ACTS) by a partner or ex-partner in the last 12 months; and the Composite Abuse Scale (reference standard). The ACTS screen was presented firstly with a binary yes/no response format and then with a five-point ordinal frequency format from ‘never’ (0) to ‘very frequently’ (4). The main outcome measures were test statistics of the four-item ACTS screening tool (sensitivity, specificity, predictive values, and area under the curve) against the reference standard and women’s screening preferences. Twelve-month IPV prevalence varied depending on the ACTS response format with 8% (83) positive on ACTS yes/no format, 12.8% (133) positive on ACTS ordinal frequency format and 10.5% (108) on the reference Composite Abuse Scale. Overall, the ACTS screening tool demonstrated clinical utility for the ordinal frequency format (AUC, 0.80; 95% CI = 0.76 to 0.85) and the binary yes/no format (AUC, 0.74, 95% CI = 0.69 to 0.79). The frequency scale (66%) had greater sensitivity than the yes/no scale (51%). The positive and negative predictive values were 56 and 96% for the frequency scale and 68 and 95% for the yes/no scale. Specificity was high regardless of screening question response options. Half (53%) of the women categorised as abused preferred the yes/no scale. Around half of the women (48%, 472) thought health care providers should ask pregnant women about IPV at every visit. The four-item ACTS tool (using the frequency scale and a cut-off of one on any item) is recommended for written self-administered screening of women to identify those experiencing IPV to enable first-line response and follow-up.

中文翻译：

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ACTS 亲密伴侣暴力筛查在产前保健中的有效性：一项横断面研究

亲密伴侣暴力 (IPV) 是一个具有有害后果的重大公共卫生问题。在澳大利亚，没有国家标准的筛查工具，而且各州的筛查实践各不相同。本研究的目的是在产前保健环境中评估：i) 新 IPV 简要筛查工具的有效性和 ii) 女性对筛查响应形式、筛查频率和舒适度的偏好。澳大利亚维多利亚州一家主要城市医院的 167 名产前患者完成了一项基于纸张的自我管理调查。该调查包括四个筛选项目，即他们在过去 12 个月内是否受到伴侣或前伴侣的恐惧/控制/威胁/耳光或身体伤害 (ACTS)；和综合滥用量表（参考标准）。ACTS 屏幕首先显示二进制是/否响应格式，然后显示从“从不”（0）到“非常频繁”（4）的五点序频率格式。主要结果指标是四项 ACTS 筛查工具（敏感性、特异性、预测值和曲线下面积）相对于参考标准和女性筛查偏好的测试统计数据。12 个月 IPV 流行率因 ACTS 响应格式而异，ACTS 是/否格式为 8% (83) 阳性，ACTS 有序频率格式为 12.8% (133) 阳性，参考综合滥用量表为 10.5% (108)。总体而言，ACTS 筛选工具证明了序数频率格式（AUC，0.80；95% CI = 0.76 至 0.85）和二元是/否格式（AUC，0.74，95% CI = 0.69 至 0.79）的临床效用。频率标度 (66%) 比是/否标度 (51%) 具有更高的灵敏度。频率量表的阳性和阴性预测值为 56% 和 96%，是/否量表的阳性和阴性预测值为 68% 和 95%。无论筛选问题的回答选项如何，特异性都很高。一半 (53%) 被归类为受虐待的女性更喜欢是/否量表。大约一半的女性 (48%, 472) 认为医疗保健提供者应该在每次就诊时询问孕妇有关 IPV 的问题。建议将四项 ACTS 工具（使用频率量表和任何一项的截止值）用于女性的书面自我管理筛查，以识别那些经历 IPV 的女性，以便进行一线响应和随访。无论筛选问题的回答选项如何，特异性都很高。一半 (53%) 被归类为受虐待的女性更喜欢是/否量表。大约一半的女性 (48%, 472) 认为医疗保健提供者应该在每次就诊时询问孕妇有关 IPV 的问题。建议将四项 ACTS 工具（使用频率量表和任何一项的截止值）用于女性的书面自我管理筛查，以识别那些经历 IPV 的女性，以便进行一线响应和随访。无论筛选问题的回答选项如何，特异性都很高。一半 (53%) 被归类为受虐待的女性更喜欢是/否量表。大约一半的女性 (48%, 472) 认为医疗保健提供者应该在每次就诊时询问孕妇有关 IPV 的问题。建议将四项 ACTS 工具（使用频率量表和任何一项的截止值）用于女性的书面自我管理筛查，以识别那些经历 IPV 的女性，以便进行一线响应和随访。