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Program Profile: Lethality Assessment Program (Oklahoma)

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on October 24, 2016

Program Summary

This is a crisis-response program in which police connect female victims of intimate partner violence with a social service provider, via telephone, at the scene of a domestic violence dispute. The program is rated Promising. When compared with the control group, program participants reported experiencing less violence at follow up. Participants were also more likely to receive an order of protection, and to contact domestic violence services.

Program Description

Program Goals/ Target Population
The Lethality Assessment Program is a field intervention for police who encounter a female victim of intimate partner violence (IPV). The goals of this crisis-response program are to 1) reduce subsequent violent encounters among female IPV victims, and 2) increase violence prevention and help-seeking behaviors among female IPV victims. Women are the target population for this program, given the frequency with which they experience IPV incidents and their susceptibility to physical and mental health problems as a result of these incidents.
Program Activities  
There are two main components of the Lethality Assessment Program. The first is a police-administered, 11-item Lethality Screen, which is used to assess if the victim is at high risk of homicide (considered the most serious form of IPV). The Lethality Screen is an abbreviated version of Campbell’s Danger Assessment (2003). Administering the Lethality Screen is done at the discretion of the police officer, who decides if the victim is at risk for domestic violence.
For those who screen positively, the second component (called the Protocol Referral) includes immediate phone contact with a social service provider at the scene of the IPV incident. The social service provider advises the victim on safety precautions and encourages her to come into the social service office to receive more information and services. Women who screen positively on the Lethality Screen choose whether they wish to speak to the social service provider. The police officer can express concern for the woman’s safety and encourage her to speak with the social service provider; however, if she declines, then the officer must honor her choice. If she agrees to speak with the social service provider, the conversation is approximately 10 minutes long and specifically tailored to a listener who did not personally initiate such a call and, therefore, may be less informed about available services or less educated about the risks of domestic violence.
Program Theory
This program is based on the belief that criminal justice and social services should work in collaboration to provide IPV victims with the best possible intervention. This intervention is a collaborative effort between police, who are most frequently contacted following an IPV incident, and social service providers, whose services have proven to be more effective than police at preventing subsequent incidents of IPV (Messing et al. 2014). In this program model, the criminal justice system holds the offenders accountable, while the victims are provided safety options by social services (working with the criminal justice system).

Evaluation Outcomes

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Study 1
Repeat Victimization/Violence
Messing and colleagues (2014) found that women in the Lethality Assessment Program (LAP) intervention group reported experiencing significantly less violence. On average, the intervention group scored 14.71 fewer points than the control group on measures of violence at the 7-month follow up. 
Applied for Order of Protection
Women in the LAP intervention group were significantly more likely to apply for an order of protection at the follow up. LAP participants had a 40.8 percent chance of applying for an order of protection, while the comparison group had a 32.3 percent chance of applying for an order of protection. 
Received Services Related to Domestic Violence
At the 7-month follow up, women in the LAP intervention group were significantly more likely to receive services related to domestic violence. LAP participants had a 31.2 percent chance of seeking domestic violence services, while those in the comparison group had a 20.4 percent chance of seeking services.
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Evaluation Methodology

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Study 1
Using a quasi-experimental design, Messing and colleagues (2014) evaluated the Lethality Assessment Program. A total of 414 women were included in the study (202 women were in the intervention group and 212 women were in the comparison group). The study was conducted in seven jurisdictions in Oklahoma. Police officers were responsible for participant recruitment and recruited women they suspected to be potential victims of partner abuse. All individuals who consented to participate had a 45-minute baseline interview and received the Lethality Screen. For those who could be contacted, a second interview was conducted 7 months later. Women in the intervention group who scored positive on the Lethality Screen, indicating a high homicide risk, were put into direct contact with a social service provider via telephone. Those women in the control group who scored positive for being at high homicide risk were not. 
Women in the study ranged in age from 18–79 years. The race/ethnicity of the study participants was white (42.8 percent), African American (29.4 percent), Native American (10.0 percent), Latina (7.9 percent), multiracial (7.5 percent), and other (2.2. percent). The intervention and control groups were not significantly different on baseline measures, except for marital status and immigration status. Half of the sample (51.8 percent) completed high school or had a GED equivalent, and less than half (40.6 percent) had full-time or part-time employment. The overwhelming majority reported being victims of domestic violence by their intimate partners, and many reported being victims of severe violence. 
The outcomes of interest were the frequency and severity of repeat intimate partner violence (IPV), and the rates of emergency safety planning and help seeking among women who experienced IPV and called the police in the participating jurisdictions during the time of the study. The first outcome was measured using the Conflict Tactics Scale (CTS-2), which measures severity and frequency of violence over time on a linear, 168-unit scale. Data was collected via self-report. Researchers followed up with participants through email or telephone. Scores from baseline were subtracted from scores at follow up. The second outcome was measured using a 16-item version of a safety-promoting behavior checklist, developed by McFarlane and colleagues (2004). These “yes” or “no” items were asked of women at baseline and then again at follow up.  

Logistic and linear regression models controlled for differences between groups at baseline based on marital status, immigration status, Danger Assessment category or severe violence, and time between baseline and follow-up observations. Attrition is a notable limitation of the study, given that 40 percent of participants dropped out between baseline and follow-up observations.
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There is no cost information available for this program.
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Implementation Information

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A copy of the Lethality Screening instrument is available on page 99 of the Messing and colleagues (2014) study, accessible via this link:
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Messing, Jill T., Jacquelyn Campbell, Janet Sullivan Wilson, Sheryll Brown, Beverly Patchell, and Christine Shall. 2014. Police Departments’ Use of the Lethality Assessment Program: A Quasi-Experimental Evaluation. Washington, D.C.: U.S Department of Justice.

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Additional References

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These sources were used in the development of the program profile:

McFarlane, J., A. Malecha, J. Gist, K. Watson, E. Batten, I. Hall, and S. Smith. 2004. “Increasing the Safety-Promoting Behaviors of Abused Women.” American Journal of Nursing 104(3):40–50.

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Program Snapshot

Age: 18 - 79

Gender: Both

Race/Ethnicity: Black, American Indians/Alaska Native, Hispanic, White, Other

Setting (Delivery): Home, Other Community Setting

Program Type: Crisis Intervention/Response, Victim Programs, Violence Prevention

Targeted Population: Females, Victims of Crime

Current Program Status: Active