18 - Cash Assistance for Survivors of Intimate Partner Violence

Publication Number: 4017.18

Dhatri Abeyaratne, Yale School of Medicine, New Haven, CT, United States; Erin Latham, Yale New Haven Hospital, North Haven, CT, United States; Elaine Couvertier, yale, New Haven, CT, United States; Cristina Del valle, Yale-New Haven Children's Hospital, Shelton, CT, United States; Brianna Oakley, Yale University, Orange, CT, United States; Noah Brazer, Yale School of Medicine, New Haven, CT, United States; Paula Schaeffer, Yale School of Medicine, New Haven, CT, United States; James Dodington, Yale School of Medicine, Guilford, CT, United States; Gunjan Tiyyagura, Yale School of Medicine, Cheshire, CT, United States

Background: Intimate Partner Violence (IPV) impacts an estimated 1 in 3 women in the United States, with economically disadvantaged individuals at disproportionate risk. Subsequently, 1 in 4 children are exposed to caregiver IPV, with significant physical and behavioral health consequences. Evidence from low- and middle-income countries suggests that financial support in the form of cash assistance (CA) may reduce rates of IPV, but mechanisms remain poorly understood and unstudied in high-income settings.

Objective: To explore the experiences of survivors who disclosed IPV during a pediatric or general emergency department (ED) visit and received unconditional CA ($250-1000) through one Hospital Violence Intervention Program (HVIP).

Design/Methods: We conducted this qualitative study using a constructivist paradigm and an intersectionality framework. Bicultural and bilingual investigators conducted semi-structured interviews with English and Spanish-speaking survivors who received CA within the past six months, as well as with HVIP staff and program funders. Interview guides were developed in collaboration with a Family Violence Community Advisory Board (CAB), composed of IPV service providers, child protective services staff, ED and child abuse pediatricians and IPV survivors. Six researchers independently coded interview transcripts, then met regularly to review and iteratively refine the coding structure and interview guides over an 8-month period. Finally, we checked our interpretation of the data through a collaborative reflexive exercise with the CAB.

Results: Of 23 survivors approached, 13 participated in interviews. All identified as cisgender women; 62% were mothers, 38% Spanish-preferring immigrants, 46% uninsured, and 23% had experienced homelessness. Three HVIP staff and two funders also participated. We identified five themes (Table 1): 1) Poverty and IPV mutually reinforce one another, especially for mothers of young children and those with marginalized identities 2) survivors used CA for basic and safety-related needs 3) CA provided emotional relief and empowerment 4) unconditional CA preserved dignity and accessibility, while strengthening trust and engagement with HVIP staff 5) CA was limited in amount and scope.

Conclusion(s): Findings suggest that unconditional CA may help survivors address urgent needs, enhance safety for themselves and their children, and foster empowerment and engagement with advocacy services. These insights can guide the selection of patient-informed outcomes for future clinical trials and help inform the design of survivor-centered CA models within healthcare settings.

Table 1
PAS Cash Aid Abstract Table 1.pdfSample quotations from each theme.