The promotion of well-being among children exposed to intimate partner violence: A systematic review of interventions

Harmonising outcome measurement for child focused domestic abuse interventions. Reflections on the development and implementation of a core outcome set

There is appetite in the UK to better measure the impact of domestic violence and abuse (DVA) interventions on children. The spread of outcomes-based commissioning means outcome measurement is no longer just the territory of academic researchers but is now firmly within the purview of practitioners and policy makers. However, outcomes measured in trials only partially represent the views of those delivering and using services with respect to how success should be defined and captured. Even within trials there is huge inconsistency in the definition and measurement of important endpoints. This yields a body of evidence that is difficult to make sense of, defeating the ends for which it was produced - to improve the response to children and families who have experienced abuse. Development of Core Outcome Sets (COS) is seen as a solution to this problem, by establishing consensus across key stakeholder groups regarding a minimum standard for outcome measurement in trials, and increasingly in service delivery contexts. To date COS development has addressed outcomes relating to health conditions or interventions, with limited application to public health challenges. We reflect on our efforts to develop a COS to evaluate psychosocial interventions for children and families experiencing DVA. We highlight the value of COS development as a mechanism for improving evidence quality and the response to families experiencing abuse. Finally, we make recommendations to researchers and COS guideline developers to support this broader application of COS methodology.

A Systematic Review of Children's Perspectives of Fathers who Perpetrate Intimate Partner Violence

Exposure to intimate partner violence (IPV) between parents or caregivers can result in lifelong mental, physical, and relational challenges for children. Although the impacts of IPV on children are well documented, the aim of this systematic review was to be the first to synthesize the literature on children's perspectives of fathers who have perpetrated IPV. Five electronic databases were searched using a string of search terms relating to the variables of interest. In total, 11,40 records were obtained from the database search. Screening based on a strict inclusion and exclusion criteria yielded 24 qualitative articles addressing the perceptions of children concerning fathers who perpetrate IPV. Research capturing the views of children regarding fathers who perpetrate IPV is scant. The current review highlights that children experience a range of feelings about their perpetrating fathers, including fear, anger, hatred, as well as ambivalence and love toward their father and children often have difficulty integrating contradictory experiences of their fathers' behaviors. Father-child relationships are severely affected by IPV, including their fathers' use of coercive control, even after the parents have separated. Finally, children's experiences of their fathers' attempts at behavior change varied. More research is needed to understand the views of children in this area, with consideration given to children's developmental stage and the type of IPV experienced. Recommendations for research and interventions for children and families are emphasized further within this review.

Child and family-focused interventions for child maltreatment and domestic abuse: development of core outcome sets

BACKGROUND

The current evidence for child maltreatment (CM) and domestic violence and abuse (DVA) interventions is limited by the diversity of outcomes evaluated and the variety of measures used. The result is studies that are difficult to compare and lack focus on outcomes reflecting service user or provider priorities.

OBJECTIVE

To develop core outcome sets (COSs) for evaluations of child and family-focused interventions for: (1) CM and (2) DVA.

DESIGN

We conducted a two-stage consensus process. Stage 1: a long list of candidate outcomes across CM and DVA was developed through rapid systematic reviews of intervention studies, qualitative and grey literature; stakeholder workshops; survivor interviews. Stage 2: three-panel, three-round e-Delphi surveys for CM and DVA with consensus meetings to agree with the final COSs.

PARTICIPANTS

287 stakeholders participated in at least one stage of the process (ie, either CM or DVA COS development): workshops (n=76), two e-Delphi surveys (n=170) and consensus meetings (n=43). Stakeholders included CM and DVA survivors, practitioners, commissioners, policymakers and researchers.

RESULTS

Stage 1 identified 335 outcomes categorised into 9 areas and 39 domains. Following stage 2, the final five outcomes included in the CM-COS were: child emotional health and well-being; child's trusted relationships; feelings of safety; child abuse and neglect; service harms. The final five outcomes in the DVA-COS were: child emotional health and well-being; caregiver emotional health and well-being; family relationships; freedom to go about daily life; feelings of safety.

CONCLUSIONS

We developed two COSs for CM and DVA with two common outcomes (child emotional health and well-being; feelings of safety). The COSs reflect shared priorities among service users, providers and researchers. Use of these COSs across trials and service evaluations for children and families affected by CM and DVA will make outcome selection more consistent and help harmonise research and practice.

Gender Perspective in Research on Interventions in Children with Experiences of Parental Gender-Based Violence: Application of GPIHR Criteria

The aim of this study was to analyse the inclusion of a gender perspective (GP) in scientific production on interventions for a reduction in psychological distress in children who have experienced parental gender-based violence (CEXPGBV). To achieve this, a review of publications was carried out in the Web of Science, EBSCOhost, ProQuest and Cochrane Library databases. A total of 3418 records were found, and 44 items of research selected. For GP analysis, the questionnaire "Gender perspective in health research" (GPIHR) was applied and relationships with the terminology of violence were analysed, as well as the definition of term used, references to violence by men or received by women and the instruments used to assess these. Generally, the assessed studies do not contain a GP, since 70% of the GPIHR items were answered negatively. Likewise, 89% of research used general terms to refer to violence without referring to gender. These results show the importance of considering instruments such as GPIHR in both the planning and development of future research in order to avoid possible gender bias.

Protocol for developing core outcome sets for evaluation of psychosocial interventions for children and families with experience or at risk of child maltreatment or domestic abuse

INTRODUCTION

Recognition that child maltreatment (CM) and domestic violence and abuse (DVA) are common and have serious and long-term adverse health consequences has resulted in policies and programmes to ensure that services respond to and safeguard children and their families. However, high-quality evidence about how services can effectively intervene is scant. The value of the current evidence base is limited partly because of the variety of outcomes and measures used in evaluative studies. One way of addressing this limitation is to develop a core outcome set (COS) which is measured and reported as a minimum standard in the context of trials and other types of evaluative research. The study described in this protocol aims to develop two discrete COSs for use in future evaluation of psychosocial interventions aimed at improving outcomes for children and families at risk or with experience of (1) CM or (2) DVA.

METHODS AND ANALYSIS

A two-phase mixed methods design: (1) rapid reviews of evidence, stakeholder workshops and semistructured interviews with adult survivors of CM/DVA and parents of children who have experienced CM/DVA and (2) a three panel adapted E-Delphi Study and consensus meeting. This study protocol adheres to reporting guidance for COS protocols and has been registered on the Core Outcome Measures for Effectiveness Trials (COMET) database.

ETHICS AND DISSEMINATION

We will disseminate our findings through peer-reviewed and open access publications, the COMET website and presentations at international conferences. We will engage with research networks, journal editors and funding agencies to promote awareness of the CM-COS and DVA-COS. We will work with advisory and survivor and public involvement groups to coproduce a range of survivor, policy and practice facing outputs.Approval for this study has been granted by the Research Ethics Committee at University College London.

Gender Differences in Witnessing and the Prevalence of Intimate Partner Violence from the Perspective of Children in Finland

Background-Intimate partner violence (IPV) has both direct and longer-term effects on children's well-being. Much of the research thus far has relied on caregiver reports of IPV and clinical samples of children. By contrast, minimal research has examined violence between parents from the perspective of children using nationwide samples. Objective-This study explored the frequency of IPV witnessed by children and gender variations regarding the victims, perpetrators, and witnesses. Methods-The data were derived from a sample of 11,364 children from the Finnish Child Victim Survey 2013. The children were between 11 and 17 years old and were enrolled in the Finnish school system. The main methods of analysis included crosstabulation and the chi-square test. Results-The results indicate that children witnessed more IPV against their mother (4.9%) than their father (3.5%). Girls reported having witnessed more violence against both their mother (7.0%) and father (5.1%) than boys did (mothers 2.7%, fathers 1.8%). Girls' reports of IPV against both parents were twice or more than twice as common as boys' reports. Conclusions-The above differences might result from gendered expectations and boys' and girls' different relationships to violence, as well as differences in the recognition and interpretation of violent incidents. Therefore, practitioners should adopt a gender-sensitive approach as a precondition and practice for working with children in social and health care.