program provides guidance to many educational and health care delivery institutions around the country that are in the process of developing or implementing training programs. The fund’s training materials appear to have been distributed widely and serve as a reference for many health professionals. Plans to evaluate the program are under way. Other advocacy organizations, including provider advocacy organizations such as Physicians for a Violence-free Society and the Nursing Network on Violence Against Women International, have also been active in developing informational and educational materials and programs.
Advocates recognize the health care needs of victims of family violence, but they have also expressed reservations about the health care system’s response, particularly with regard to victims of intimate partner violence. The concerns include: (1) the potential for the system to revictimize or blame female victims of violence (e.g., Faulk, 1974; Snell et al., 1964; Stark et al., 1981); (2) failure to identify victims (e.g., McLeer and Anwar, 1989); (3) the “medicalization” of a problem believed to be rooted in societal norms and systems; (4) interference with the development of strategies to escape from perpetrators; (5) emphasis on a medical solution to intimate partner violence that may enable society to continue to fail to hold perpetrators accountable; (6) insurance discrimination and loss of health care access (Fromson and Durborow, 1998); (7) overreliance on randomized clinical trials and quantitative measurement of outcomes that miss the complex nuances and intricate contexts of victims’ lives (e.g., Campbell et al., 1999; NRC, 1996; Gondolf et al., 1997; NRC and IOM, 1998); and (8) loss of victim autonomy (NRC and IOM, 1998). Victims of both intimate partner violence and childhood sexual abuse have recounted how the health care system has failed them and how individual health care providers have made the situation worse (Herman, 1992; Sipes and Hall, 1996; Yllo and Bograd, 1998).
To address these concerns and to encourage health professional involvement with family violence issues and victims, advocates have been at the forefront in the training of health care professionals about family violence, particularly violence against women. Many training protocols (e.g., the Family Violence Prevention Fund, the Alaska Family Violence Prevention Project) prescribe the participation of advocates (as well as survivors) in training health care professionals. This joint partnership model of training remains to be evaluated for its efficacy.
In addition, advocates have promoted collaborative research involving partnerships with victims of family violence. Many researchers have undertaken this approach, and descriptions of these collaborations are beginning to be seen in the research literature (Campbell et al., 1999, 2001; NRC and IOM, 1998; Dutton et al., 1999; Gondolf et al., 1997).
Victims of family violence are being included in at least some of the research and policy decisions on the health care system’s response to family vio-