Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention?

Warren‐Gash, Charlotte; Bartley, Angela; Bayly, Jude; Dutey-Magni, Peter; Edwards, S. R.; Madge, Sara; Miller, Charlotte E.; Nicholas, Rachel; Radhakrishnan, Sheila; Sathia, Leena; Swarbrick, Helen A.; Blaikie, Dee; Rodger, Alison

doi:10.1136/bmjopen-2015-009069

Cited by 26 publications

(42 citation statements)

References 11 publications

(9 reference statements)

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“…Since IDVAs could refer to other services and departments within the hospital, support was holistic and multi-disciplinary, and the service stopped survivors being lost along the referral pathway. As with previous research [22], healthcare professionals and IDVAs felt that the IDVA reached survivors with complex needs and multiple disadvantages, as well as other 'hidden' survivors-older people, those from higher-income households, and men. Reaching men was important because as earlier research has shown, healthcare professionals do not always realise the extent of male victimhood [14].…”

Section: Discussionsupporting

confidence: 57%

“…Interviewees in the current study highlighted that hospital-wide strategies could help increase healthcare professionals' awareness of, and referrals to, the IDVA service. Warren-Gash et al [22] highlighted the importance of such strategies at the local level and spent time introducing the IDVA at meetings, distributing business cards, and adding information about the service to the staff intranet. Commissioners and hospital managers could use existing structures such as safeguarding training as an opportunity to make healthcare professionals aware of the IDVA service and to deliver domestic violence and abuse training.…”

Section: Discussionmentioning

confidence: 99%

“…(Hospital IDVA) Survivors with 'complex needs', or who face multiple disadvantages-i.e. substance/alcohol use disorder, homelessness, and/or mental ill health-can face numerous barriers to accessing support, such as a lack of suitable services [22]. Healthcare professionals felt that hidden survivors might become visible in a hospital because they see it as "a place of safety and confidentiality" (Emergency Department doctor).…”

Section: Idvas Support Hidden and Disadvantaged Survivorsmentioning

confidence: 99%

“…Three studies have evaluated the co-located IDVA model. One such intervention was based in a hospital's gynaecology, HIV medicine, and genitourinary medicine clinics [22]. The IDVA here also dealt with sexual violence and was available during business hours to see referred patients and to advise, train, and support staff.…”

Section: Introductionmentioning

confidence: 99%

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“From taboo to routine”: a qualitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse

Dheensa

Halliwell

Daw³

et al. 2020

BMC Health Serv Res

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Background: Health services are often the first point of professional contact for people who have experienced domestic violence and abuse. We report on the evaluation of a multi-site, hospital-based advocacy intervention for survivors of domestic violence and abuse. Independent Domestic Violence Advisors (IDVAs), who provide survivors with support around safety, criminal justice, and health and wellbeing, were located in five hospitals in England between 2012 and 2015 in emergency departments and maternity services. We present views about IDVAs' approaches to tackling domestic violence and abuse, how the IDVA service worked in practice, and factors that hindered and facilitated engagement with survivors. Methods: We adopted a convenience sampling approach and invited participation from all who offered to take part within the study timeframe. Sixty-four healthcare professionals, IDVAs, IDVA service managers, and commissioners at all sites were interviewed. Interviews were analysed using a thematic approach: familiarising ourselves with the data through repeated readings and noting initial ideas; generating initial codes through double coding notable features of the data across the dataset; collating codes into potential themes; and reviewing themes to ensure they captured the essence of the data. Results: Two key themes emerged. The first was Hospital-based IDVAs fulfil several crucial roles. This theme highlighted that healthcare professionals thought the hospital-based IDVA service was valuable because it enhanced their skills, knowledge, and confidence in asking about domestic violence and abuse. It enabled them to immediately refer and provide support to patients who might have otherwise been lost along a referral pathway. It also reached survivors who might otherwise have remained hidden. The second theme was Success hinges on a range of structural factors. This theme illustrated the importance of ongoing domestic violence and abuse training for staff, the IDVA having private and dedicated space, and the service being embedded in hospital infrastructure (e.g. featuring it in hospital-wide policies and enabling IDVAs access to medical records). Conclusion: Hospital-based IDVAs offer a unique and valued way to respond to domestic violence and abuse in a healthcare setting. Further work must now be done to explore how to implement the service sustainably.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Idvas Support Hidden and Disadvantaged Survivorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

“From taboo to routine”: a qualitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse

Dheensa

Halliwell

Daw³

et al. 2020

BMC Health Serv Res

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“…Compared with other specialities in our hospital undertaking screening, IPV was more commonly reported in the HIV clinic; for example, IPV was reported by 5.7% of patients in genitourinary medicine (GUM) services [5]. This may be because those with HIV infection are a more vulnerable group.…”

mentioning

confidence: 85%

Screening for intimate partner violence in a London HIV clinic: characteristics of those screening positive

et al. 2016

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Intimate partner violence (IPV) is widespread and more prevalent in the HIV-positive population than in the general population [1]. However, there is little published work concerning IPV in this population in the UK [2]. Dhairyawan et al. [3] found a 52% lifetime prevalence of IPV in HIV-positive women in a London clinic, with 14% reporting IPV in the last year. Health care workers have been identified as professionals to whom patients might choose to disclose IPV [4].Screening for IPV is recommended in selected health care settings, and at our hospital there is a new post for an independent domestic and sexual violence advisor (IDSVA). We established screening in an out-patient HIV clinic and compared those screened with those not screened, and summarized the characteristics of those reporting current or previous IPV.Multidisciplinary staff were trained to ask the following standardized question: "Have you ever been emotionally or physically hurt by your partner, ex-partner or family member?" Those who answered positively were assessed for current or past IPV by asking, "Are you still in contact with this person and are they still causing you and your family issues?" Screening took place while the patient was alone in a private place. Patients were referred to safeguarding services if necessary and to the IDSVA. If referral to the IDVSA was declined or there was no current risk, leaflets and contact information were given.We report on the demographics of 348 screened patients. Data were collected over 5 months and recorded on a standardized sheet and linked to the HIV database by hospital number and then anonomysed. Groups were compared using the v 2 test or Fisher's exact test for categorical variables, and using the MannÀWhitney U test for continuous variables as they were not normally distributed. No formal adjustment for multiple testing was made.Ten per cent (348 of 3383) of the current clinic population were screened. Those screened had similar demographics and HIV markers to those not screened. Almost a third of participants (103 of 348; 30%) had ever experienced IPV, and were more likely to be female (P = 0.01) with a trend towards heterosexual risk group (P = 0.085) and a detectable viral load (P = 0.088). A total of 68 of 348 patients (20%) had experienced IPV in the past and 35 of 348 (10%) of those screened were experiencing current IPV or were given contact information for future self referral. Fourteen of 348 patients (4%) agreed to be referred to the IVDSA. Ten were women and seven of 14 were of black ethnicity. Other variables were similar to those of the whole population, except that seven of those referred had detectable viraemia (50% vs. 15% in the whole population). Although numbers are small, perhaps this may suggest a relationship between adherence and access to medication, which could be further explored. Among the 103 who screened positive as a group there was also a trend towards detectable viraemia (P = 0.088).There was evidence of differences also when comparing men who screened posit...

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Application of the Consolidated Framework for Implementation Research to Facilitate Violence Screening in HIV Care Settings: a Review of the Literature

2021

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Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention?

Cited by 26 publications

References 11 publications

“From taboo to routine”: a qualitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse

“From taboo to routine”: a qualitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse

Screening for intimate partner violence in a London HIV clinic: characteristics of those screening positive

Application of the Consolidated Framework for Implementation Research to Facilitate Violence Screening in HIV Care Settings: a Review of the Literature

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