‘It felt like there was always someone there for us’: Supporting children affected by domestic violence and abuse who are identified by general practice

Exposure to domestic violence and abuse and consultations for emergency contraception: nested case-control study in a UK primary care dataset

British Journal of General Practice ◽

10.3399/bjgp18x700277 ◽

2018 ◽

Vol 69 (680) ◽

pp. e199-e207 ◽

Cited By ~ 1

Author(s):

Joni Jackson ◽

Natalia V Lewis ◽

Gene S Feder ◽

Penny Whiting ◽

Timothy Jones ◽

...

Keyword(s):

Primary Care ◽

Domestic Violence ◽

General Practice ◽

Emergency Contraception ◽

Case Control Study ◽

Case Control ◽

Exposure To Domestic Violence ◽

Nested Case Control ◽

Domestic Violence And Abuse ◽

Control Study

BackgroundEvidence of an association between exposure to domestic violence and abuse (DVA) and use of emergency contraception (EC) is lacking in the UK.AimTo quantify the association between exposure to DVA and consultations for EC in general practice.Design and settingNested case-control study in UK general practice.MethodUsing the Clinical Practice Research Datalink, the authors identified all women all women aged 15–49 years registered with a GP between 1 January 2011 and 31 December 2016. Cases with consultations for EC (n = 43 570) were each matched on age and GP against four controls with no consultations for EC (n = 174 280). The authors calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the association between exposure to DVA in the previous year and consultations for EC. Covariates included age, ethnicity, socioeconomic status, pregnancy, children, alcohol misuse, and depression.ResultsWomen exposed to DVA were 2.06 times more likely to have a consultation for EC than unexposed women (95% CI = 1.64 to 2.61). Women aged 25–39 years with exposure to DVA were 2.8 times more likely to have a consultation for EC, compared with unexposed women (95% CI = 2.08 to 3.75). The authors found some evidence of an independent effect of exposure to DVA on the number of consultations for EC (OR 1.48, 95% CI = 0.99 to 2.21).ConclusionA request for EC in general practice can indicate possible exposure to DVA. Primary care consultation for EC is a relevant context for identifying and responding to DVA as recommended by the World Health Organization and National Institute for Health and Care Excellence guidelines. DVA training for providers of EC should include this new evidence.

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Is it coercive controlling violence? A cross-sectional domestic violence and abuse survey of men attending general practice in England.

Psychology of Violence ◽

10.1037/vio0000107 ◽

2017 ◽

Vol 7 (3) ◽

pp. 417-427 ◽

Cited By ~ 12

Author(s):

Marianne Hester ◽

Cassandra Jones ◽

Emma Williamson ◽

Eldin Fahmy ◽

Gene Feder

Keyword(s):

Domestic Violence ◽

General Practice ◽

Cross Sectional ◽

Domestic Violence And Abuse

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Health professionals responding to men for safety (HERMES): feasibility of a general practice training intervention to improve the response to male patients who have experienced or perpetrated domestic violence and abuse

Primary Health Care Research & Development ◽

10.1017/s1463423614000358 ◽

2014 ◽

Vol 16 (03) ◽

pp. 281-288 ◽

Cited By ~ 20

Author(s):

Emma Williamson ◽

Sue K. Jones ◽

Giulia Ferrari ◽

Thangam Debbonaire ◽

Gene Feder ◽

...

Keyword(s):

Primary Care ◽

Domestic Violence ◽

General Practice ◽

Medical Records ◽

Training Intervention ◽

Structured Interviews ◽

Post Intervention ◽

Male Patients ◽

Primary Care Clinicians ◽

Domestic Violence And Abuse

AimTo evaluate a training intervention for general practice-based doctors and nurses in terms of the identification, documentation, and referral of male patients experiencing or perpetrating domestic violence and abuse (DVA) in four general practices in the south west of England.BackgroundResearch suggests that male victims and perpetrators of DVA present to primary care clinicians to seek support for their experiences. We know that the response of primary care clinicians to women patients experiencing DVA improves from training and the establishment of referral pathways to specialist DVA services.MethodThe intervention consisted of a 2-h practice-based training. Outcome measures included: a pre-post, self-reported survey of staff practice; disclosures of DVA as documented in medical records pre-post (six months) intervention; semi-structured interviews with clinicians; and practice-level contact data collected by DVA specialist agencies.ResultsResults show a significant increase in clinicians’ self-reported preparedness to meet the needs of male patients experiencing or perpetrating DVA. There was a small increase in male patients identified within the medical records (6 pre- to 17 post-intervention) but only five of those patients made contact with a specialist DVA agency identified within the referral pathway. The training increased clinicians’ confidence in responding to male patients affected by DVA. The increase in recorded identification of DVA male patients experiencing or perpetrating DVA was small and contact of those patients with a specialist DVA support service was negligible. We need to better understand male help seeking in relation to DVA, further develop interventions to increase identification of male patients experiencing or perpetrating DVA behaviours, and facilitate access to support services.

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General practice clinicians’ perspectives on involving and supporting children and adult perpetrators in families experiencing domestic violence and abuse

Family Practice ◽

10.1093/fampra/cmv070 ◽

2015 ◽

pp. cmv070 ◽

Cited By ~ 1

Author(s):

Cath Larkins ◽

Jessica Drinkwater ◽

Marianne Hester ◽

Nicky Stanley ◽

Eszter Szilassy ◽

...

Keyword(s):

Domestic Violence ◽

General Practice ◽

Domestic Violence And Abuse

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Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial

Journal of Interpersonal Violence ◽

10.1177/08862605211004177 ◽

2021 ◽

pp. 088626052110041

Author(s):

Roos Ruijne ◽

Cornelis Mulder ◽

Milan Zarchev ◽

Kylee Trevillion ◽

Roel van Est ◽

...

Keyword(s):

Mental Health ◽

Domestic Violence ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Referral Rates ◽

Randomized Controlled ◽

Cluster Randomized ◽

And Control ◽

Domestic Violence And Abuse

Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. To estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams. We also aimed to determine whether improvements in knowledge, skills and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. We conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills and attitude during that follow-up period were greater in intervention teams than in control teams: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. A low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended.

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Testimonial Smothering and Domestic Violence Disclosure in Clinical Contexts

Episteme ◽

10.1017/epi.2021.3 ◽

2021 ◽

pp. 1-18

Author(s):

Jack Warman

Keyword(s):

Public Health ◽

Domestic Violence ◽

Recent Work ◽

Social Epistemology ◽

Empirical Work ◽

Health Sciences ◽

Epistemic Injustice ◽

Global Public Health ◽

Personal Histories ◽

Domestic Violence And Abuse

Abstract Domestic violence and abuse (DVA) are at last coming to be recognised as serious global public health problems. Nevertheless, many women with personal histories of DVA decline to disclose them to healthcare practitioners. In the health sciences, recent empirical work has identified many factors that impede DVA disclosure, known as barriers to disclosure. Drawing on recent work in social epistemology on testimonial silencing, we might wonder why so many people withhold their testimony and whether there is some kind of epistemic injustice afoot here. In this paper, I offer some philosophical reflections on DVA disclosure in clinical contexts and the associated barriers to disclosure. I argue that women with personal histories of DVA are vulnerable to a certain form of testimonial injustice in clinical contexts, namely, testimonial smothering, and that this may help to explain why they withhold that testimony. It is my contention that this can help explain the low rates of DVA disclosure by patients to healthcare practitioners.

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Domestic violence and abuse related emergency room visits in Ontario, Canada

BMC Public Health ◽

10.1186/s12889-021-10501-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sonica Singhal ◽

Sarah Orr ◽

Harkirat Singh ◽

Menaka Shanmuganantha ◽

Heather Manson

Keyword(s):

Domestic Violence ◽

Emergency Room Visits ◽

Emergency Rooms ◽

Relative Index ◽

Efficient Management ◽

Dissemination Area ◽

Icd 10 ◽

Index Of Inequality ◽

Policies And Programs ◽

Domestic Violence And Abuse

Abstract Background Hospitals’ emergency rooms (ERs) are generally the first point of contact of domestic violence and abuse (DVA) victims to the health care system. For efficient management and resource allocation for ERs to manage DVA-related emergencies in Canada, it is important to quantify and assess the pattern of these visits. Methods Aggregate DVA-related ER visits data, using relevant ICD-10-CA codes, from 2012 to 2016 were retrieved from IntelliHealth Ontario. The 2011 ON-Marg (Ontario Marginalization) indices were linked at the Dissemination Area level to ER data. Descriptive analyses including total number and rate of visits per 100,000 people were calculated, stratified by age and sex. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were also assessed. Results From 2012 to 2016, 10,935 (81.2% by females and 18.8% by males) DVA-related visits were made to ERs in Ontario. An annual average of 25.5 visits per 100,000 females and 6.1 visits per 100,000 males was observed. Residential instability and deprivation were significant predictors of DVA-related ER visits. No particular site of injury was indicated in 38.5% of visits, 24.7% presented with cranio-maxillofacial (CMF) trauma in isolation, 28.9% presented with non-CMF injuries, and 7.9% visits presented with both CMF and non-CMF injuries. Conclusion This study identified that the burden of DVA-related ER visits is large enough to warrant timely public health interventions, and observed that certain populations in Ontario experience more DVA and/or are more prone to its impact. Our findings have important implications for various stakeholders involved in planning and implementing relevant policies and programs.

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Professionals’ views on working in the field of domestic violence and abuse during the first wave of COVID-19: a qualitative study in the Netherlands

BMC Health Services Research ◽

10.1186/s12913-021-06674-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nicole E. van Gelder ◽

Ditte L. van Haalen ◽

Kyra Ekker ◽

Suzanne A. Ligthart ◽

Sabine Oertelt-Prigione

Keyword(s):

Domestic Violence ◽

The Netherlands ◽

Working Conditions ◽

Critical Evaluation ◽

Physical Contact ◽

Structured Interviews ◽

Online Tools ◽

The Impact ◽

Domestic Violence And Abuse

Abstract Background The COVID-19 pandemic and lockdown evoked great worries among professionals in the field of domestic violence and abuse (DVA) as they expected a rise of the phenomenon. While many countries reported increased DVA, the Netherlands did not. To understand this discrepancy and the overall impact of the lockdown on DVA support services, we interviewed DVA professionals about their experiences with DVA during the rise of COVID-19, the impact of the lockdown on clients and working conditions, and views on eHealth and online tools. Methods Semi-structured interviews were conducted among 16 DVA professionals with various specializations. This data was analyzed using open thematic coding and content analysis. Results Most professionals did not see an increase in DVA reports but they did notice more severe violence. They experienced less opportunities to detect DVA and worried about their clients’ wellbeing and the quality of (online) care. Furthermore, their working conditions rapidly changed, with working from home and online, and they expressed frustration, insecurity and loneliness. Professionals feel eHealth and online tools are not always suitable but they do see them as an opportunity to increase reach and maintain services when physical contact is not possible. Conclusion This study suggests DVA was probably under-detected during the lockdown rather than not having increased. The Dutch system heavily relies on professionals to detect and report DVA, suggesting a need for critical evaluation of the accessibility of professional help. Professionals experienced significant challenges and should themselves be supported psychologically and in their changed work practices to maintain their ability to aid survivors.

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