2 - (SYM 67) Relationship Health in Integrated Primary Care: Preferences for Relationship Support Services

Background: Romantic relationship health can be an asset to physical health, emotional well-being, and quality of life while intimate partner violence (IPV) can have significant negative impacts on physical and mental health. This would suggest primary care teams can benefit by incorporating relationship health into patient management. But despite this, primary care's role has largely been limited to screening for violence and referral to specialty care. The present study aims to identify a larger potential role for integrated primary care teams by investigating 

Method: In Fall 2019, we sent a mail-in survey assessing relationship healthcare needs to N = 299 Veterans randomly sampled from 20 northeastern VA primary care clinics (oversampling female and younger Veterans). Participants completed mental health and relationship health screens and reported their treatment preferences. We compared those reporting past year use or experience of physical/sexual aggression, threats/coercion, or injury (Severe IPV; 21%), to those only reporting yelling, screaming, and insults (Verbal Conflict; 51%), and denying any IPV (No IPV; 28%).

Results: Participants across groups desired 2–6 sessions of face-to-face treatments focused on addressing physical health, communication, and rekindling love. Participants reporting No IPV were older and preferred treatment in primary care. The Verbal Conflict and Severe IPV groups were both flagged by IPV screens and had similar interest in couple treatment and relationship evaluation.The Severe IPV group had higher rates of harms (e.g., depression, alcohol use disorder, relationship dissatisfaction, fear of partner) and higher interest in addressing safety outside of VA. Exploratory analyses highlighted potential differences based on use vs. experience of Severe IPV.

Discussion: Findings highlight ways integrated primary care teams can differentiate services to address dissatisfaction and conflict and can offer brief services to increase engagement in more intensive programs when needed. Low-risk couples may benefit from couple-based programs managing medical conditions, couples experiencing common conflict may be satisfied with brief relationship support, and couples with higher risk concerns may need initial contacts to increase engagement in more intensive services.