After the trial: how a programme to improve the health care response to domestic violence and abuse fares in the real-world NHS

 

 

 

By Dr Natalia Lewis, Research Fellow, Centre for Academic Primary Care, University of Bristol

A new paper by researchers from the University of Bristol and NIHR CLAHRC North Thames highlights the post-trial journey of an evidence-based domestic violence and abuse (DVA) intervention to the NHS front-line, and the human and contextual factors that influence how its effect is sustained over time.

IRIS (Identification and Referral to Improve Safety) is a general-practice-based DVA training, support and referral programme. The programme develops DVA awareness and skills among general practice staff and provides a referral pathway to a named DVA advocate (IRIS advocate educator) based in a third sector agency. IRIS advocate educators provide IRIS training and ongoing support, consultancy to practice staff, and advocacy to referred patients.

Following a successful randomised controlled trial, IRIS has been implemented in over 30 local authorities in the UK. The trial … Read more

Domestic violence and abuse: ‘If we all work together, it will make a difference’

Guest blog by Medina Johnson (left), Chief Executive
and Lucy Downes (right), National Implementation Manager
IRIS Interventions

 

 

As we gear up for events and conversations to mark the 16 Days of Activism against Gender-based Violence, it’s timely to reflect on the importance of the healthcare response to gender-based violence. IRISi’s vision is a world in which gender-based violence is consistently recognised and addressed as a health issue.

Violence against women is a global health problem of epidemic proportions. Dr Margaret Chan, World Health Organization Director-General

The IRIS programme is our flagship intervention working with primary care to change and improve clinical practice and to provide patients affected by domestic abuse with access to specialist advice and support. It provides training and support to GPs, practice nurses and other primary care clinicians to help them identify and refer women with experience of domestic violence and abuse (DVA) to … Read more

Finding a better way to identify children experiencing domestic violence

by Dr Natalia Lewis
Research Fellow
Centre for Academic Primary Care
@DV_Bristol

 

Around one in five children in the UK have been exposed to domestic violence or abuse between their parents or caregivers. When adults are involved in an abusive relationship, their children bear the consequences.

The effects of domestic violence on a child can range from emotional and behavioural problems to physical injury and death when children are caught up in the violence between adults.

Even when not directly involved, children’s exposure continues through witnessing and being aware of the violence – and through its health, social and financial consequences.

Health and social care workers are often the first professionals to have contact with a child experiencing these situations. This could be when the abused parent seeks help, or when children undergo health checks. It can happen during assessments for emotional or behavioural problems, or when social services, … Read more

How important are informal supporters of women experiencing domestic violence?

by Dr Alison Gregory
Research Fellow (Traumatised and Vulnerable Populations)
Centre for Academic Primary Care
@DV_Bristol

 

“How important are informal supporters of women experiencing domestic violence?”: Very” – a simple answer to a complicated question. The bottom line, in terms of statistics, is that if survivors disclose their situation to anyone, it will most likely be to informal supporters (friends, relatives, neighbours and colleagues) rather than professionals.1 And this is true across the world, with research indicating that sometimes a disclosure to an informal supporter happens alongside a disclosure to a professional, but frequently this is not the case.2-5 In addition, it is not unusual for informal supporters to witness abusive behaviours, but commonly they are uncertain about what exactly it is that they are seeing, in particular, what it means, and what their role in the situation should be.6 ,7

Why are informal

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How we learned to love doing workshops

by Jessica Roy
Research Associate
Centre for Academic Primary Care
@DV_Bristol

The prospect of running a three-hour conference workshop can provoke anxiety even for the most seasoned conference-goer. Last month, I was a member of the IRIS+ research team, led by Dr Eszter Szilassy, that attended and presented a workshop at the Second European Conference of Domestic Violence in Porto, Portugal.

The conference brings together researchers, practitioners and policy makers from all corners of the globe to discuss, debate and exchange knowledge regarding domestic violence and abuse (DVA).

For context, the IRIS+ project is a training and intervention programme to support clinicians (GPs and nurses) to identify, document and refer female and male victims and perpetrators of DVA, as well as their children, to our dedicated specialist support service.

Before presenting, we had concerns that our workshop might not attract an audience, partly because we thought our topic … Read more

Worried about asking people to take part in research? Don’t be!

by Dr Alison Gregory
Research Fellow (Traumatised and Vulnerable Populations), Senior Research Associate
Centre for Academic Primary Care
@AlisonGregory73

When I first became a health researcher, I felt that people would see taking part in research as a bother, a pain, or a waste of their time and that, by association, they would see me as akin to a nuisance caller, intent on coercing them into some unwanted activity. Thankfully, after 10 years doing research, it’s become apparent to me that this is far from the truth.

For a start, the tentativeness with which most of the researchers I know proceed as they recruit participants is anything but a hard-sell. In fact, due to necessarily stringent ethics and governance processes and practices, strict eligibility criteria, and a healthy dose of ‘only wanting to do what’s best for people’, we are possibly more in danger of being talked out of taking … Read more

Why gender can’t be ignored when dealing with domestic violence

by Gene Feder and Lucy Potter
Centre for Academic Primary Care

First published in The Conversation

Domestic violence is a violation of human rights with damaging social, economic and health consequences. It is any incident of controlling, coercive, threatening behaviour, violence or abuse. That abuse can be psychological, emotional, physical, sexual and financial.

The “domestic” element refers to abuse between people aged 16 or over who are, or have been, intimate partners or family members, regardless of gender or sexuality. Men, women or transgender people in straight, gay or lesbian relationships can perpetrate or experience it. So does this mean domestic violence is gender neutral? Is gender irrelevant to prevention efforts and to responding to survivors’ needs? We do not think so.

Globally, direct experience of being subjected to domestic violence is greater among women then among men. In the UK, 27% of women and 13% of men … Read more

Listening to the child’s voice in research on domestic violence and abuse

LisaArai071015By Lisa Arai
Senior Research Associate
Centre for Academic Primary Care

Anybody who has worked on a systematic review will know you spend a lot of time thinking about the type of research papers to include in your review and those you will exclude. Tightly defined inclusion criteria, as well as critical appraisal, an explicit synthesis stage and measures to reduce reviewer bias (such as inter-rater checks), are what distinguish systematic from traditional reviews (a point usefully made by Mark Petticrew more than a decade ago, when he sought – among other things – to debunk the notion that systematic reviews are simply larger versions of traditional reviews).

Over many years teaching research methods, I’ve noticed students often regard this early stage of the review process as troublesome. It’s often approached with an uncertainty that, if not properly resolved, can render the review unwieldy. Or its significance might be underestimated; … Read more

Why GPs need training about domestic violence and children

Eszter Szilassy2by Eszter Szilassy
Senior Research Associate
Centre for Academic Primary Care

While violence against men continues to fall in the UK, women affected by violence and domestic abuse are bearing the brunt of a hidden rise in violent crime. This rise coincides with the austerity-led cutting of domestic violence services.

Domestic violence and abuse (DVA) damages physical and mental health resulting in increased use of health services by survivors of abuse. The prevalence of DVA among women attending general practice is higher than in the wider population. Women experiencing DVA are more likely to be in contact with GPs than with any other professionals. Reduced investment in specialist domestic violence services further increases the demand for direct general practice responses to DVA. Although victims tend not to disclose spontaneously to their GP, they have an expectation, often unfulfilled, that doctors can be trusted with disclosure, and can offer them … Read more