Date of Award

January 2026

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Gunjan Tiyyagura

Abstract

CASH ASSISTANCE FOR SURVIVORS OF INTIMATE PARTNER VIOLENCE: A QUALITATIVE STUDY Dhatri Abeyaratne, Elaine Couvertier, Erin Latham, Cristina Del valle, Brianna Oakley, Noah Brazer, Paula Schaeffer, James Dodington, Gunjan Tiyyagura. Section of Pediatric Emergency Medicine, Department of Pediatrics, Yale University, School of Medicine, New Haven, CT.

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. While evidence from low- and middle-income countries suggests that financial support in the form of cash assistance (CA) may reduce rates of IPV, mechanisms remain poorly understood and unstudied in high-income settings. Research Aims: To explore the experiences of survivors who disclosed IPV during an emergency department (ED) visit or hospital encounter and received unconditional CA ($250-1000) through one Hospital Violence Intervention Program (HVIP). Hypothesis or Question: We anticipate that qualitative findings may shed light on potential mechanisms through which CA influences survivor safety and well-being, generating hypotheses and guiding the selection of patient-informed outcomes for future studies. 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 seven themes: 1) Poverty and IPV mutually reinforce one another, particularly for survivors with marginalized identities 2) survivors face systemic gaps when seeking help for IPV 3) survivors used CA for basic and safety-related needs 4) CA provides emotional relief and empowerment 5) CA strengthened trust and engagement with HVIP staff 6) giving CA unconditionally may preserve dignity and improve accessibility 7) CA was limited in amount sand scope. Statement of Scientific Impact: 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.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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