A Novel Application of Theoretical Models to Intimate Partner Violence Survivors’ Help-Seeking

Introduction: Intimate partner violence (IPV) survivors’ help-seeking is influenced by a complex interplay of barriers and facilitators. This includes both internal and external factors that affect a survivor’s decision to seek and ability to obtain resources. While understanding these factors is crucial to ensuring appropriate care, there is currently no agreed upon, comprehensive framework for capturing IPV survivors’ help-seeking.

Objectives: We seek to answer the question: How can the Three Delays Model (3DM) and the Behavioral Model of Health Services Use (BMHSU), as well as proposed adaptations of these models, provide a framework for understanding barriers and facilitators of IPV survivors’ help-seeking?

Methods: This secondary qualitative analysis was performed on transcripts from nine focus groups obtained as part of a larger study on IPV survivors’ help-seeking as influenced by the COVID-19 pandemic. Qualitative codes representing the theoretical constructs of each model and its adaptation were identified and set a priori, and to maintain a deductive coding approach, no new codes were added throughout data analysis. Manual coding of the transcripts was done by the first author. Once all transcripts were coded, code frequency and code co-occurrence analyses were performed to determine how well the different models mapped onto IPV survivors’ experiences.

Results: Codes from the BMHSU adaptation were applied most often, and codes from the 3DM adaptation were applied least often. The 3DM captured IPV survivors’ barriers to initially accessing care; however, it did not allow for a nuanced understanding of how the care system affected help-seeking. The BMHSU adaptation provided the richest understanding of IPV survivors’ barriers and facilitators to help-seeking with its expanded inclusion of psychosocial factors.

Conclusion: These findings highlight the strengths and limitations of two theoretical models and their adaptations, allowing for a better framework for understanding barriers and facilitators of IPV survivors’ help-seeking. Future research is needed to integrate these models into one comprehensive model for capturing factors contributing to IPV survivors’ help-seeking.