Why do certain primary health care teams respond better to intimate partner violence than others? A multiple case study

Goicolea, Isabel; Marchal, Bruno; Hurtig, Anna-Karin; Vives‐Cases, Carmen; Briones-Vozmediano, Érica; Sebastián, Miguel San

doi:10.1016/j.gaceta.2017.10.005

Cited by 27 publications

(28 citation statements)

References 20 publications

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“…While the intervention was popular among all participating clinicians, there was a large variation in both the level of clinician engagement with IRIS+ and the rates of referrals across the four practices. This variation is in line with that shown in other studies [ 55 , 56 ], including recent findings from the IRIS implementation evaluation [ 57 ].…”

Section: Discussionsupporting

confidence: 93%

Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care

et al. 2021

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Background Primary care needs to respond effectively to patients experiencing or perpetrating domestic violence and abuse (DVA) and their children, but there is uncertainty about the value of integrated programmes. The aim of the study was to develop and test the feasibility of an integrated primary care system-level training and support intervention, called IRIS+ (Enhanced Identification and Referral to Improve Safety), for all patients affected by DVA. IRIS+ was an adaptation of the original IRIS (Identification and Referral to Improve Safety) model designed to reach female survivors of DVA. Methods Observation of training; pre/post intervention questionnaires with clinicians and patients; data extracted from medical records and DVA agency; semi-structured interviews with clinicians, service providers and referred adults and children. Data collection took place between May 2017 and April 2018. Mixed method analysis was undertaken to triangulate data from various sources to assess the feasibility and acceptability of the intervention. Results Clinicians and service providers believed that the IRIS+ intervention had filled a service gap and was a valuable resource in identifying and referring women, men and children affected by DVA. Despite increased levels of preparedness reported by clinicians after training in managing the complexity of DVA in their practice, the intervention proved to be insufficient to catalyse identification and specialist referral of men and direct identification and referral (without their non-abusive parents) of children and young people. The study also revealed that reports provided to general practice by other agencies are important sources of information about adult and children patients affected by DVA. However, in the absence of guidance about how to use this information in patient care, there are uncertainties and variation in practice. Conclusions The study demonstrates that the IRIS+ intervention is not feasible in the form and timeframe we evaluated. Further adaptation is required to achieve identification and referral of men and children in primary care: an enhanced focus on engagement with men, direct engagement with children, and improved guidance and training on responding to reports of DVA received from other agencies.

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Section: Discussionsupporting

confidence: 93%

Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care

et al. 2021

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“…The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool [20], a widely adopted, adapted, and used tool by various cadres in the health workforce [21][22][23][24], was applied to collect data after adjusting for nurses in the study setting. The tool was originally developed in English and translated into Swahili, the common language in Tanzania that most people are more comfortable with.…”

Section: Methodsmentioning

confidence: 99%

Knowledge, attitude, and preparedness toward IPV care provision among nurses and midwives in Tanzania

2020

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Background: With increasing recognition of intimate partner violence (IPV) as a public health challenge, nurses and midwives are recognized for their crucial role in providing front-line healthcare services for IPV. This study aimed to evaluate knowledge, attitude, and preparedness related to IPV care provision in health facilities among nurses and midwives in Tanzania. Methods: A self-administered anonymous questionnaire survey was conducted among nurses and midwives working in health facilities in the Mbeya region between December 2018 and January 2019. The questionnaire consisted of questions on their perceived and actual knowledge, attitudes, and preparedness to provide care in relation to IPV. Results: A total of 662 (50.1%) of 1321 nurses and midwives who worked in hospitals and/or health centers in the Mbeya region participated in this study, and 461 (69.6%) completed questionnaires were included in the analysis. The proportion of nurses and midwives with high scores in IPV perceived knowledge, actual knowledge, attitude, and preparedness to provide care was 59.9%, 53.1%, 54.2%, and 54.0%, respectively. Regardless of the type of facility, gender, educational level, and work experience, the use of IPV guidelines was significantly associated with high scores in IPV perceived knowledge (P < 0.001), actual knowledge (P = 0.004), and preparedness to provide care (P < 0.001), but not attitude, which was negatively associated (P = 0.048). Regardless of the type of facility, gender, educational level, and work experience, receiving preservice IPV training was associated with high scores in IPV perceived knowledge (P < 0.001), actual knowledge (P = 0.049), and preparedness to provide care (P = 0.002), but not attitude (P = 0.192). Regardless of the type of facility, gender, educational level, and work experience, inservice IPV training was associated with high scores in IPV perceived knowledge (P < 0.001), actual knowledge (P = 0.043), and preparedness to provide care (P = 0.001), but not attitude (P = 0.063). Conclusions: Although guidelines and training could improve nurses' and midwives' knowledge and preparedness to provide care regarding IPV, attitudes against IPV care are a challenge. To improve attitudes regarding IPV among front-line nurses and midwives, it is necessary to address concepts of IPV care and sympathy with potential and actual victims of IPV in pre-and in-service training in addition to providing recall-level knowledge.

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“…Adequately trained and motivated providers can facilitate integration of health interventions. 6,42,62 DV training is thus important to help clarify providers' values and the boundaries of their role within a comprehensive multi-sector response.…”

Section: Coordinationmentioning

confidence: 99%

Are We Asking Too Much of the Health Sector? Exploring the Readiness of Brazilian Primary Healthcare to Respond to Domestic Violence Against Women

d’Oliveira

Pereira

Bacchus

et al. 2020

Int J Health Policy Manag

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Background: There is growing recognition of the health sector’s potential role in addressing domestic violence (DV) against women. Although Brazil has a comprehensive policy framework on violence against women (VAW), implementation has been slow and incomplete in primary healthcare (PHC), and little is known about the implementation challenges. This paper aims to assess the readiness of two PHC clinics in urban Brazil to integrate an intervention to strengthen their DV response. Methods: We conducted 20 semi-structured interviews with health managers and health providers; a document analysis of VAW and DV policies from São Paulo and Brazil; and 2 structured facility observations. Data were analysed using thematic analysis. Results: Findings from our readiness assessment revealed gaps in both current policy and practice needing to be addressed, particularly with regards to governance and leadership, health service organisation and health workforce. DV received less political recognition, being perceived as a lower priority compared to other health issues. Lack of clear guidance from the central and municipal levels emerged as a crucial factor that weakened DV policy implementation both by providers and managers. Furthermore, responses to DV lost visibility, as they were diluted within generic violence responses. The organizational structure of the PHC system in São Paulo, which prioritised the number of consultations and household visits as the main performance indicators, was an additional difficulty in legitimising healthcare providers’ time to address DV. Individual-level challenges reported by providers included lack of time and knowledge of how to respond, as well as fears of dealing with DV. Conclusion: Assessing readiness is critical because it helps to evaluate what services and infrastructure are already in place, also identifying obstacles that may hinder adaptation and integration of an intervention to strengthen the response to DV before implementation.

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Why do certain primary health care teams respond better to intimate partner violence than others? A multiple case study

Cited by 27 publications

References 20 publications

Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care

Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care

Knowledge, attitude, and preparedness toward IPV care provision among nurses and midwives in Tanzania

Are We Asking Too Much of the Health Sector? Exploring the Readiness of Brazilian Primary Healthcare to Respond to Domestic Violence Against Women

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