Introduction

The World Health Organization (WHO) has defined Intimate Partner Violence (IPV) as “any intimate relationship that results in physical, psychological or sexual harm to the person in the relationship, including physical, sexual violence, emotional-psychological abuse and deprivation of liberty[1]”. To know what is IPV, it is important to have a clear understanding of the word “intimate partner”, in IPV, the intimate partner refers to heterosexual, homosexual, and bisexual relationships[2],regardless of age, gender, marital status[3]. So the IPV is different from the word “domestic violence”. Domestic violence refers to a series of abuse against children, adults and the elderly, including economic, physical, sexual, emotional and psychological abuse[4]. So, we can conclude that Intimate partner violence (IPV) is domestic violence by a current or former spouse or partner.

Intimate Partner Violence (IPV) is a major public health issue and human rights threat worldwide[5-8]. The World Health Organization reported that 27% of women aged 15-49 have experienced physical and/or sexual violence from their partners, and 13% of women have experienced such events in the past 12 months[9]. In 2018, a study showed that the incidence of psychological violence, physical violence, and sexual violence in China was 77.7%, 40.2%, and 11%, respectively, and 52% of people experienced two or three types of violence during their lifetime[10]. Although most victims of IPV are women and most perpetrators are men[1], men may suffer from IPV in same-sex and heterosexual relationships[1, 9]. More and more studies have found that the prevalence of IPV among gay, bisexual, and other men who have sex with men is at the same or higher level than that of heterosexual women[11-14]. A study in Nigeria investigated[14] the prevalence of IPV among gay, bisexual, and other men who have sex with men and found that the prevalence rates of experiencing emotional, physical, sexual, monitoring, and control behaviors were 45%, 31%, 20%, 55% and 22% respectively. A domestic study[15] found that 26.5% of men who have sex with men have at least one IPV in verbal, physical and sexual violence. Regardless of sex, age, marital status, the status quo of IPV deserves our attention.

IPV is related to a series of adverse health outcomes, including physical, sexual, reproductive health problems, and mental health problems, such as depression, anxiety, drug abuse, and post-traumatic stress disorder[16, 17]. Research has found that the overall depression rate of women experiencing IPV was 65.8%, of which 69.5% experienced physical violence and 75.8% experienced sexual violence, respectively[10]. Many efforts have been made to reduce the effects of IPV. One of the most important findings was that studies have confirmed early screening for people without signs or symptoms of abuse can find the abusive behavior that has not been disclosed separately, and provide opportunities for intervention to reduce future abusive behavior and short-term and long-term adverse health consequences[18, 19]. Therefore, it is very necessary to screen for IPV.

Many researchers have developed IPV screening instruments. In recent years, there have been some IPV screening tools in different countries and languages. However, these tools may be developed for different people and contexts, for example, Hurt, Insult, Threaten, Scream (HITS) can be used for female patients in predominantly Hispanic clinical settings[20] and male patients in clinical settings[21], Abuse Assessment Screen (AAS)[22] was mainly developed to screen abused women during pregnancy and have been used for abused pregnant and non-pregnant African-American, Hispanic, and white women in health and prenatal clinics and emergency departments. As there are too many IPV screening tools, the applicable population and context are different, and the quality of methodology is also uneven, which makes it a difficult problem for a researcher to choose an IPV screening tool with high methodological quality and suitable for their target context. Therefore, it is necessary for us to make a systematic review of the methodological quality of IPV screening tools. At the same time, we also want to provide some suggestions for each person who uses the IPV screening instruments.

Therefore, the overall objective of this systematic review is to strictly describe, appraise and summarize the screening instruments for IPV according to the COSMIN guideline on a systematic review of PROMs[23-25]. The specific aims of the drafted system review are: (1) to identify and describe all existing and validated instruments for screening IPV; (2) to assess the methodological quality of studies on the measurement properties of these instruments; (3) to evaluate and compare the characteristics of these instruments.

This systematic review will answer the following five questions: (1) What are existing screening instruments for people who are experiencing or have experienced IPV? (2) What are the characteristics of these screening instruments? (3) What is the methodological quality of studies on the measurement properties of these screening instruments? (4) What are the measurement properties, internal consistency, construct validity and reliability of these screening instruments? (5) What are the differences and similarities among these screening instruments?

METHODS

Based on the COSMIN guideline for systematic reviews of PROMs, we will adapt the ‘objectives’ section of the 2020 checklist[26, 27] by changing ‘Population(s), Interventions, comparators and Outcomes’ into ‘Construct, Populations, Type of Instruments and Measurement Properties’. We have registered the systematic review in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42022365247. We will conduct this systematic review based on the COSMIN guideline for systematic review PROMs and report it following the 2020 checklist. The process of conducting a systematic review of PROMs is shown in Figure 1.

Inclusion and exclusion criteria of the studies

Studies will be included if they: (1) report screening IPV instruments designed for people suffering or suffered from IPV; (2) describe the processes of development and/or evaluation of one or more measurement properties for eligible instrument(s); (3) have full-text availability and (4) published in English.

Studies will be excluded if they: (1) do not report the complete data; (2) are not primary studies (e.g. Discussion papers, letters, and editorials) or case studies; (3) reports that use the screening instruments only for outcome measurement; (4) repeated publication of studies.

Search strategy

Using an appropriate and comprehensive search strategy that combines medical subject headings and free test words, we will search five databases, including PubMed, EMBASE, Web of Science, ProQuest Dissertations & Theses Global (PQDT Global), EBSCO PBSC (Psychology Behavioral Sciences Collection). The search time will end on November 10, 2022. The main search concepts will be the consequences of IPV(Construct), people who are suffering or suffered from IPV(Population), PROMs(Type of instrument(s)), and measurement properties. Therefore, our strategy for this search will be to use 'intimate partner violence' (medical subject headings), ‘mass screening’ (medical subject headings), ‘multiphasic screening’ (medical subject headings), and the subordinate word and entry terms, ‘IPV’ (acronym), ‘screening instrument*’ (free test word), ‘screening tool*’ (free test word) using 'AND' and 'OR' operators to identify relevant articles to enter the search. An example of the search strategies used in PUBMED is presented in Table 1. The reference lists of included articles will also be manually searched to identify any potentially relevant studies. Our team members will develop a search strategy through constant discussion and ultimately determine the final search plan with the help of librarians. We will also periodically review updates to database articles and, if so, we will re-implement the above search strategy to identify new eligible studies and will promptly update the content of the systematic review.

Study screening

Endnote[28] will be used to manage reference filtering. First, we'll use Endnote to identify and remove duplicates, and We will group articles from different databases and implement manual filtering. After the initial screening, the title, abstract, and full-text articles will be independently reviewed and screened by two researchers based on the inclusion and exclusion criteria to identify any potentially relevant study. Any disagreements will be resolved through discussion. If necessary, a third researcher will be sought. The reference list of all qualified articles will also be screened according to the inclusion and exclusion criteria mentioned earlier. The process of research screening is shown in Figure 2.

Data extraction

According to the purpose of this study, we will formulate a data extraction table through group discussion. The data extraction table contents will be included (1) general information about the included studies (including publication year, journal, DOI number, and first author name); (2) basic characteristics of the identified instruments (including the name of the instrument, developer(s) or developed year, number of items, score range, original language, and available language, structure); (3) consequences of measurement properties of the identified instruments (including validity, reliability, internal consistency); (4) feasibility. The two researchers will extract the data separately, and finally, determine the extracted data through group discussion. The third researcher will review the extracted data and resolve the differences between the two researchers in the process of extracting data.

Quality appraisal

The quality evaluation for included studies and instruments will be done by two researchers independently using the corresponding COSMIN box according to COSMIN guideline for systematic reviews of. If there is no consensus in this course, we will discuss it with the third researcher. We will evaluate the quality of each instrument on a measurement property separately, using the corresponding COSMIN box[23]. To ascertain the overall rating of the quality of each instrument on a measurement property, take the lowest rating of any standard in the box, which is the worst score counts principle. Finally, each instrument will be graded as high, moderate, low, or very low quality.

Data synthesis

In the first step, we have determined that four measurement properties of all included instruments will be evaluated, which are validity, reliability, internal consistency, feasibility. The COSMIN Risk of Bias checklist[24] will be used when we start to evaluate the methodological quality of per measurement property of per included instrument. In this step, we will use an excel sheet file named “COSMIN Box Score” to sort out the evaluation scores. The results on the consequences of the methodological quality will be presented in table.

In the second step, the updated COSMIN quality criteria for good measurement properties[23] will be used to assess the consequences of all measurement properties of per included instrument.

In the third step, we will statistically pool or qualitatively summarize the consequences of measurement properties of per included instrument from different studies. The pooled or summarized results will be present in a table in the review. If necessary, we will use a meta-analysis approach (weighted means and 95% CI). The pooled or summarized results per measurement property for each PROM will be rated against the updated COSMIN quality criteria for good measurement properties.

Finally, we will summarize the evidence and grade the quality of the evidence by using the GRADE[23] (Grading of Recommendations Assessment, Development, and Evaluation) approach developed by the COSMIN guideline for systematic review of PROMs. The quality of the evidence refers to confidence if the pooled or summarized results are trustworthy. The quality of the evidence was rated as high, moderate, low, and very low evidence four levels in total according to the GRADE approach.

Conclusions

As far as we know, this will be the first systematic review of screening IPV instruments for people who are experiencing or have experienced IPV based on PRISMA and COSMIN guidelines. This review will identify, describe, appraise, and compare all included instruments. We will use the COSMIN guideline for the systematic review of PROMs to evaluate the methodological quality of all included studies on the measurement properties of all included instruments and the psychometric properties of all included instruments. Through these findings, we can formulate a suggestion on the usage of existing qualified target screening instruments, which can help medical workers, psychological practitioners, and community workers better screen IPV victims. This systematic review may support future research, facilitate screening for future researchers before the intervention, and provide suggestions and support for future researchers to improve and further develop these screening instruments.

Author Contributions

S.T. led the design of the protocol, reviewing, and revisions of the manuscript. J.C. participated in providing statistical recommendations, drafting, and revisions the manuscript. Y.L. participated in the conception and design of the protocol, drafting, and revisions of the manuscript. K. Z participated in the formulation and revisions of search strategies, drafting, and revisions of manuscripts. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by Changsha Natural Science Foundation grant number kq2202114. This research was funded by Hunan Natural Science Foundation grant number 2022JJ40641.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Not applicable.

Acknowledgments

The authors would like to thank Xiaoting Huang (Librarian of Central South University) for her help with determining the final search strategy for this study. The authors would like to thank Chongmei Huang (The third researcher) for helping us review the extracted data and resolve the disputes arising in the process of data synthesis and extraction.

Conflicts of Interest

The authors declare no conflict of interest.

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