Exploring the Use of the WAST-Short Domestic Abuse Screening Tool in Primary Care: A Cross-Sectional Study in Northwest London

Domestic abuse (DA) is often overlooked in primary care, despite primary care’s pivotal role. While screening improves early detection, it is not standard in primary care. This cross-sectional study aimed to assess the potential integration of a brief DA screening tool into primary care and explore the association between abuse history and WAST-Short score, controlling for demographics in Northwest London. An e-Survey with 29 items, translated into 18 languages, was sent to eligible NHS patients (aged 18 years and older) identified by general practices between 3 March and 7 October 2022 via SMS. It included questions about DA experiences, with the WAST-Short screening questionnaire used to assess tension in relationships and difficulty resolving arguments. Regression analysis examined the relationship between WAST-Short score and abuse history. Seventeen general practices participated, with 6,967 patients clicking the survey link and 4,253 (61%) completing it. Nearly half reported DA experiences, while 6.1% declined disclosure. After adjusting for age, gender and ethnicity, the multivariable logistic regression models revealed that higher WAST-Short score were associated with higher odds of disclosing history of abuse and higher odds of refraining from disclosing abuse history. This study underscores the potential of DA screening in primary care, particularly for those hesitant to disclose abuse. The WAST-Short tool offers a non-intrusive means of early identification. However, successful implementation requires adequate training and resources for primary care practitioners.