Psychometric Properties of HITS Screening Tool (Hurt, Insult, Threaten, Scream) in Detecting Intimate Partner Violence in Iranian Women

Absence of a screening tool for domestic violence seriously influences clinical practice and research in Iran.

In this study, a four-item Hurt-Insult-Threaten-Scream (HITS) screening tool was translated into Persian and evaluated in the Iranian women.

The HITS was translated into Persian, evaluated, and finalized by a panel of experts, with acceptable face and content validity. Married women who referred to Psychiatry Clinic and family practice offices of Tabriz and Kermanshah Universities of Medical Sciences first answered Farsi HITS and then underwent a psychiatric interview. The results of these two evaluations were compared. The participants were invited to answer HITS four weeks later again to evaluate the reliability.

A total of 269 participants (Azeri, Kurdish and Fars ethnicity) were included with a mean age ± standard deviation of 34.96 ± 9.83 years. Based on reports of the psychiatric interview, 58 women (21.5%) were victimized by domestic violence. The ROC curve analysis, reported the best cut-off point for the Persian version of HITS to be 9, giving a sensitivity of 91.4% and a specificity of 94.3%. About 75% showed up for the second time, and Cronbach’s alpha coefficients for testing the consistency of answers for all questions of Farsi HITS showed acceptable reliability.

The Persian version of HITS is now available as a valid tool for screening domestic violence in Iranian women with acceptable validity and reliability.