Health system preparedness to respond to domestic and sexualized violence: A cross-sectional survey in Nova Scotia, Canada

<b>Objective:</b> Violence against women (VAW) has detrimental health consequences, making the health system an important intervention point. There are no large-scale Canadian studies on health system preparedness or practices related to VAW using data collected in the last 20 years. We investigated health professionals' knowledge and practices around VAW in Nova Scotia, which has the highest self-reported prevalence of intimate partner violence against women of all Canadian provinces. <b>Methods:</b> We surveyed 1649 participants working in health services and policy in Nova Scotia in partnership with knowledge users across the VAW and health sectors. We descriptively analyzed quantitative data on knowledge and practices related to domestic and sexualized violence (the most common forms of VAW). <b>Results:</b> Over 90 % of participants worked in areas of high priority to addressing VAW (e.g., mental health and addictions), yet only 35 % reported that addressing domestic or sexualized violence was part of their team's goals. Nearly half the sample (43 %) reported seeing at least one new case of abuse in their work in the last six months, two-thirds of whom had not received training on domestic or sexualized violence since March 2020. Participants reported significant deficits in VAW-related knowledge and systems-level supports, including inadequate referral resources, time, and space to respond to violence among patients. <b>Conclusions:</b> We found significant gaps in current health system capacity to respond to VAW in one of Canada's most impacted provinces, despite increased awareness and programming around VAW since March 2020. Given the health inequities faced by survivors, health sectors must be better equipped to respond to VAW.