Partner Dynamics Extended (eHITS)đź”—

Name

Partner Dynamics Extended – Hurt, Insult, Threaten, Scream (eHITS)

Table Namesed_bm_ehits
Construct

Intimate Partner Violence

Study Visits

V01

TypeIn-person Questionnaire (Parent on Self; 2 min)
Quality Control

Monitor data dashboard for variable missingness, possible coding errors, scoring verification, and data consistency.

Instrument Detailsđź”—

The eHITS is a self-administered 5 question Likert scale screener for experiences of psychological aggression, physical assault, sexual coercion, and injury. Originally created for quick administration in a health care setting or emergency department, the eHITS asks individuals to indicate whether their partner has done any of the following over the past 12 months: "physically hurt you", "insulted you", "threatened to harm you", "screamed or cursed at you", or "forced you to have sexual activities."

Wording Changes

Various research groups made minor word changes. Sherin and colleagues developed the original instrument, HITS, published in 1998. Chan and colleagues expanded HITS to include a question regarding forced sexual activity (Chan et al. 2010). To acknowledge these changes in future publications, we recommend including the exact verbiage of the HBCD-version of the item in the methods section of any reports, presentations, and manuscripts.

Instruction/Assessment Item Modifications

See this supplemental table comparing the differences in the wording and content of items across prior versions of eHITS and the HBCD version.

Response option changes

Compared with previous versions (Sherin et al., 1998; Chan et al., 2010), HBCD:

  • Renumbered the response scale from 1–5 to 0–4.
  • Changed "Sometimes" to "Seldom."
  • Changed "Fairly often" to "Very often."
  • Added the response options Don't know, Decline to answer, and NA.
  • Retained Never, Rarely, and Frequently.

Scoring and Clinical Alert Criteria

The eHITS summary score is calculated as the sum of all item responses. Published versions of the instrument use different score ranges and screening thresholds for intimate partner violence (IPV):

  • Sherin et al. (1998)
    • Score range: 4–20
    • Published IPV cutoff: >10.5
  • Chan et al. (2010)
    • Score range: 5–25
    • Published IPV cutoff: >8.5
  • HBCD (2024)
    • Score range: 0–20
    • Published IPV cutoff: >3.5

HBCD Clinical Alert

Within HBCD, a clinical alert for IPV is generated when the participant's summary score is greater than 7, or when either of the following items receives a response greater than 0: "...physically hurt you?" and/or "...forced you to engage in sexual activity?". _If one or more items are answered _Don't know, a clinical alert may not be generated even if the participant's true responses would otherwise meet the alert criteria.

Chan, C. C., Chan, Y. C., Au, A., & Cheung, G. O. C. (2010). Reliability and validity of the “Extended - Hurt, Insult, Threaten, Scream” (E-hits) screening tool in detecting intimate partner violence in hospital emergency departments in Hong Kong. Hong Kong Journal of Emergency Medicine, 17(2), 109–117. https://doi.org/10.1177/102490791001700202

Portnoy, G. A., Haskell, S. G., King, M. W., Maskin, R., Gerber, M. R., & Iverson, K. M. (2018). Accuracy and acceptability of a screening tool for identifying intimate partner violence perpetration among women veterans: A pre-implementation evaluation. Women’s Health Issues: Official Publication of the Jacobs Institute of Women’s Health. https://doi.org/10.1016/j.whi.2018.04.003

Sherin, K. M., Sinacore, J. M., Li, X. Q., Zitter, R. E., & Shakil, A. (1998). HITS: a short domestic violence screening tool for use in a family practice setting. Family Medicine, 30(7), 508–512. https://www.ncbi.nlm.nih.gov/pubmed/9669164