Background: Women who experience intimate partner violence (IPV) are at a high risk for traumatic brain injury (TBI). Women’s shelters that provide support to women experiencing IPV may be an ideal location for TBI screening and resource delivery. However, little to no TBI screening is being done at women’s shelters. Behavior change theory has potential to help us understand factors that influence screening at women’s shelters and develop interventions to promote screening.

Objective: To use behavior change theory to understand current practices for and factors influencing screening for TBI among staff that work at Women’s Shelters across Canada. 

Methods: Participants were staff who work at women’s shelters across Canada and attended the National Women’s Shelters Canada National Conference. Upon registration, participants completed an online survey that assessed current TBI screening behaviours, knowledge of TBIs, theoretical factors influencing screening (rated on 7-point Likert scale), and demographic and job details. Surveys were co-designed with a decision maker in a women’s shelter and informed by the Theoretical Domains Framework.

Results: Fifty-five participants responded to the survey (Mean age = 45.93 years, SD = 11.03; 100% women).  On average, participants worked with clients who have experienced IPV for 15.26 years (SD = 9.66). Only 20.40% of participants had ever screened for TBIs in their work. On average, participants scored 68.21% (SD = 9.39) on the assessment that examined knowledge of TBI signs and symptoms and facts. Regarding factors that support screening, findings indicate that participants want to screen for TBI (Mean = 4.09; SD = 2.63), see screening as a part of their role (Mean = 4.26; SD = 2.45), are confident in their ability to screen (Mean = 4.52; SD = 2.47), and believe that screening will benefit their clients (Mean = 5.70; SD = 1.96).  Regarding factors hindering screening, findings indicate that participants are nervous to screen (Mean = 4.50; SD = 2.48), and lack resources (Mean = 3.00; SD = 2.39), training (Mean = 2.21; SD = 2.03), rewards (Mean = 2.33; SD = 2.24), and knowledge (Mean = 2.94; SD = 2.22). 

Conclusions: Screening for TBI in women’s shelters is rare and staff’s knowledge about TBIs is lacking. While motivation to screen is present, interventions are needed to promote screening among women’s shelter staff. Interventions need to focus on providing training, resources, and incentives to screen.  Interventions will also need to address participants’ worries about screening clients for TBI. Findings will be used to co-develop interventions to support screening of TBIs among women’s shelter staff across Canada. Ultimately, findings may help to improve the support given to women who have experienced IPV and TBI.

Using Behaviour Change Theory to Understand Factors Influencing Screening of Traumatic Brain Injuries Among Women Who Have Experienced Intimate Partner Violence