# A Delphi Study to prioritize implementation strategies to increase the adoption of screening and referral for brain injury among survivors of intimate partner violence and sexual assault within community-based organizations

## TL;DR

This study identifies key strategies to help community organizations better screen for brain injuries in survivors of domestic violence and sexual assault.

## Contribution

A Delphi method was used to co-develop tailored implementation strategies for BI screening in IPV-serving CBOs.

## Key findings

- 21 strategies were identified as relevant for CBOs, including education, technical assistance, and workflow changes.
- Seven strategies were prioritized as most feasible and relevant for adoption across CBOs.
- Tailoring strategies to CBO contexts was emphasized as critical for successful implementation.

## Abstract

Women who experience intimate partner violence (IPV) are at a high risk for injuries to the head, neck, and face that can result in a traumatic brain injury (BI). Despite increasing evidence of the high risk for BI in this vulnerable population, BI screenings remain critically under-implemented in community-based organizations (CBOs) serving IPV survivors. The aim of this community-engaged dissemination and implementation project was to co-identify implementation strategies to increase the adoption of brain injury (BI) screening and referral within intimate partner violence (IPV)-serving CBOs.

We used a modified Delphi method to prioritize 47 CBO relevant strategies from the Expert Recommendations for Implementation Change compendium to increase the adoption of BI screening and referral among IPV-serving CBOs. In Round-1, 14 Community-campus advisory board (CAB) members, including representatives from 10 CBOs prioritized relevant strategies in a virtual meeting. In Round-2, 62 CBOs staff members responded to a survey to refine a subset of prioritized strategies to 6–8 primary strategies that could be tested across the CBOs.

CAB participants identified 21 strategies as particularly relevant to CBOs including 4 educational, 2 technical assistance, 5 staff and leadership, 4 management and evaluation, and 6 organizational workflow strategies. Survey responses indicated rated 7 of the 21 strategies were most consistently rated as relevant and feasible. The final list of 7 strategies included training opportunities, ongoing consultation, developing implementation plans, establishing local screening and referral protocols, soliciting survivor feedback, promoting adaptability, and tailoring strategies to CBOs contexts.

This study highlights the importance of creating tailored implementation strategies within IPV-serving CBOs to enhance the adoption of brain injury screening and referral protocols. The identified strategies offer valuable insights into optimizing support for IPV survivors and advancing public health interventions.