Strategies to promote uptake and use of intimate partner violence and child maltreatment knowledge: an integrative review

Effectiveness of a community-based participatory health promotion intervention to address knowledge, attitudes and practices related to intimate partner violence: a quasi-experimental study

BACKGROUND

Intimate partner violence is the most common form of violence experienced by women. It has detrimental consequences. A range of determinants cause intimate partner violence and to reduce it, effective interventions are required to address the determinants. Health promotion interventions have been recommended as effective to enable people to control over the determinants and to improve health. Hence, a community based participatory health promotion intervention was developed and tested in a selected study setting. The objective was to evaluate the effectiveness of a health promotion intervention in terms of addressing knowledge, attitudes and practices related to intimate partner violence.

METHODS

A quasi-experimental study was conducted by recruiting ninety women aged 15 to 49 years separately from two health administrative areas identified as the intervention area and the control area from the Kandy district of Sri Lanka. A pretested interviewer-administered questionnaire was used in both pre- and post-assessments. Selected groups of women from the intervention area were facilitated with a health promotion intervention to improve knowledge, attitudes and practices related to intimate partner violence. To evaluate the effectiveness of the intervention descriptive summaries and bivariate analysis were used.

RESULTS

The response rate was 90.9% (N = 90) during the pre-assessment and 87.9% (n = 87) and 82.8% (n = 82) from the intervention and control areas, respectively, during the post-assessment. Statistically significant improvement was reported in the total mean score comprising knowledge, attitudes, practices and identification of determinants from 59.6 to 80.8 in the intervention area [Pre-assessment: Mean = 59.6 (standard deviation-SD) = 17.5; Post-assessment: Mean = 80.8, SD = 19.0; p < 0.001) compared to the improvement in the control area from 62.2 to 63.0 (Pre-assessment: Mean = 62.2, SD = 17.3; Post-assessment: Mean = 63.0, SD = 18.9; p = 0.654).

CONCLUSIONS

The intervention was effective to improve knowledge, attitudes and practices related to intimate partner violence. Hence, the present approach can be used in similar contexts to address the knowledge, attitudes and certain practices related to intimate partner violence.

Prevalence and associated factors of intimate partner violence against pregnant women in urban areas of Japan: a cross-sectional study

BACKGROUND

Intimate partner violence (IPV) against pregnant women is associated with many negative maternal and fetal outcomes and is a common public health problem all over the world. However, the issue has not been fully explored in Japan. This study aimed to explore the prevalence and risk factors of IPV against pregnant women in urban areas of Japan.

METHODS

This study was a secondary data analysis of a cross-sectional survey that was conducted on women beyond 34 weeks' gestation in five perinatal facilities in urban areas of Japan, from July to October 2015. The sample size was calculated to be 1230. The Violence Against Women Screen was used for IPV screening. Multiple logistic regression analysis was used to calculate the adjusted odds ratio (AOR) with 95% confidence interval (CI) for risks of IPV while adjusting for confounding factors.

RESULTS

Of the 1346 women who participated in this study, 180 (13.4%) were identified as experiencing IPV. Compared to those who did not experience IPV (n = 1166 (86.6%)), women experiencing IPV had higher odds of being single mothers (AOR = 4.8; 95%CI: 2.0, 11.2), having lower household income (< 3 million yen, AOR = 2.6; 95%CI: 1.4, 4.6; ≥ 3 million yen and < 6 million yen, AOR = 1.9; 95%CI: 1.2, 2.9), having junior high school education background (AOR = 2.3; 95%CI: 1.0, 5.3) and being multipara (AOR = 1.6; 95%CI: 1.1, 2.4).

CONCLUSIONS

13.4%, or about one in seven women, experienced IPV while pregnant. This high proportion indicates the need for policy to address the issue of violence against pregnant women. There is an urgent need to build a system for the early detection of victims that offers appropriate support to prevent the recurrence of violence while encouraging victim recovery.

Ethically Driven and Methodologically Tailored: Setting the Agenda for Systematic Reviews in Domestic Violence and Abuse

Purpose

Systematic reviews have an important, and growing, role to play in the global evidence eco-system of domestic violence and abuse. Alongside substantive contributions to knowledge, such reviews stimulate debates about ethical reviewing practices and the importance of tailoring methods to the nuances of the field. This paper aims to pinpoint a set of ethical and methodological priorities to guide and enhance review practices specifically in the field of domestic abuse.

Method

The five Pillars of the Research Integrity Framework (ethical guidelines for domestic abuse research) are used to interrogate the systematic review process. To do so, the Framework is retrospectively applied to a recently completed systematic review in domestic abuse. The review included a rapid systematic map and in-depth analysis of interventions aimed at creating or enhancing informal support and social networks for victim-survivors of abuse.

Results

Ethical and methodological priorities for systematic reviews in domestic abuse include (1) Safety and wellbeing: maintaining the wellbeing of researchers and stakeholders, and appraising the ethics of included studies, (2) Transparency/ accountability: transparent reporting of research funding, aims and methods together with explicit consideration of authorship of outputs, (3) Equality, human rights and social justice: developing diverse review teams/ Advisory groups, and review methods that aim to search for, and report, diverse perspectives. Considering researcher positionality/ reflexivity in the review, (4) Engagement: collaboration with non-academic stakeholders and individuals with lived experience throughout the review process, (5) Research Ethics: independent ethical scrutiny of systematic review proposals with input from researchers with expertise in systematic reviews and domestic abuse.

Conclusion

Additional research is required to comprehensively examine the ethics of each stage of the review process. In the meantime, attention should be given to the underpinning ethical framework for our systematic review practices and the wider research infrastructure that governs reviews.

Effects of e-learning on the support of midwives and nurses to perinatal women suffering from intimate partner violence: A randomized controlled trial

AIMS

To examine the effects of e-learning on intimate partner violence (IPV) knowledge, preparatory/reinforcing behaviors for supporting IPV victims, and IPV screening of midwives and nurses.

METHODS

Participants were randomly assigned to the intervention group (IG: e-learning) and control group (CG: no e-learning). The primary outcome was the mean change in knowledge score. The secondary outcomes were the mean number of types of practiced preparatory/reinforcing behaviors and the proportions of participants who practice screening. Unpaired t tests were performed in intention-to-treat analysis.

RESULTS

Of the 88 participants, 45 were randomly assigned to the IG and 43 to the CG. For the post-1-test, the IG had a mean change in the knowledge score of 8.5 points with a significant difference from the 1.4 points in the CG (mean difference [MD] 7.1, 95% CI [4.1, 10.1]). The mean change between the pre-test and the post-2-test was significantly larger in the IG (7.9 points) than in the CG (1.3 points) (MD 6.6, 95% CI [3.3, 9.9]). The mean number of types of practiced behaviors at the post-1-test and post-2-test was significantly higher in the IG than in the CG (MD 1.4, 95% CI [0.1, 2.8]). There was no significant difference in the proportions of participants who practice screening between the two groups postintervention.

CONCLUSIONS

The e-learning effectively improved knowledge and promoted preparatory/reinforcing behaviors.

Integrated knowledge translation to strengthen public policy research: a case study from experimental research on income assistance receipt among people who use drugs

BACKGROUND

Solutions to complex public health issues should be informed by scientific evidence, yet there are important differences between policy and research processes that make this relationship challenging. Integrated knowledge translation (IKT) is a strategy of sustained stakeholder engagement that intends to address barriers to evidence use. We highlight an example of an IKT project alongside a randomized controlled trial of a public policy intervention that tested different disbursement patterns of income assistance among people who use drugs in Vancouver, British Columbia.

METHODS

A case study design was used where an IKT strategy led by a knowledge broker embedded within the research team acts as the case. This case study evaluates the process and effectiveness of the integrated knowledge translation project by measuring intermediate outcomes within a Theory of Change created to map pathways to impact. Content analysis was performed using an evaluation template through document review, post-event evaluations, and detailed tracking of media, knowledge translation activities and requests for information.

RESULTS

A host of knowledge translation products synthesized existing research about the harms of synchronized income assistance disbursement and supported stakeholder engagement, facilitating conversation, relationship building and trust with stakeholders. Engagement improved knowledge of the contextual feasibility for system change, and contributed experiential knowledge to study findings. A combination of access to information and stakeholder and media engagement led to increased acknowledgement of the issue by policy makers directly involved in the income assistance system.

CONCLUSIONS

This project shows how a multipronged approach to IKT addressed barriers to evidence-informed public policy and successfully contributed to increased public discourse around income assistance policy reform. Additionally, sustained engagement with diverse stakeholders led to improved contextual knowledge and understanding of potential community level impacts that, along with scientific results, improved the evidence available to inform system change. This case study provides insight into the role IKT can play alongside research aimed at public policy improvements.

TRIAL REGISTRATION

This IKT project was embedded within the study titled: The impact of Alternative Social Assistance Disbursement on Drug-Related Harm (TASA), known as Cheque Day Study, registered on ClinicalTrials.gov ( NCT02457949 ) May 29, 2015.

Exploring the knowledge translation of domestic violence research: A literature review

There is growing recognition of the links between knowledge translation, policy and practice, particularly in the domestic violence research area. A literature review applying a systematic approach with a realist lens was the preferred methodology. The review answered the following question: What are the mechanisms of change in research networks which 'work' to support knowledge translation? A search of eight electronic databases for articles published between 1960 and 2018 was completed, with 2,999 records retrieved, 2,869 records excluded and 130 full-text articles screened for final inclusion in the review. The inclusion criteria were purposefully broad, including any study design or data source (including grey literature) with a focus on domestic violence knowledge translation. The analysis of included studies using a realist lens identified the mechanisms of change to support knowledge translation. A disaggregation of the included studies identified five theories focused on the following outcomes: (1) develop key messages, (2) flexible evidence use, (3) strengthen partnerships, (4) capacity building and (5) research utilisation. This review adds to our understanding of knowledge translation of domestic violence research. The mechanisms of change identified may support knowledge translation of research networks. Further research will focus on exploring the potential application of these program theories with a research network.

The Role of Integrated Knowledge Translation in Intervention Research

There is widespread recognition across the full range of applied research disciplines, including health and social services, about the challenges of integrating scientifically derived research evidence into policy and/or practice decisions. These "disconnects" or "knowledge-practice gaps" between research production and use have spawned a new research field, most commonly known as either "implementation science" or "knowledge translation." The present paper will review key concepts in this area, with a particular focus on "integrated knowledge translation" (IKT)-which focuses on researcher-knowledge user partnership-in the area of mental health and prevention of violence against women and children using case examples from completed and ongoing work. A key distinction is made between the practice of KT (disseminating, communicating, etc.), and the science of KT, i.e., research regarding effective KT approaches. We conclude with a discussion of the relevance of IKT for mental health intervention research with children and adolescents.

Knowledge Dissemination of Intimate Partner Violence Intervention Studies Measured Using Alternative Metrics: Results From a Scoping Review

Alternative metrics measure the number of online mentions that an academic paper receives, including mentions in social media and online news outlets. It is important to monitor and measure dispersion of intimate partner violence (IPV) victim intervention research so that we can improve our knowledge translation and exchange (KTE) processes improving utilization of study findings. The objective of this study is to describe the dissemination of published IPV victim intervention studies and to explore which study characteristics are associated with a greater number of alternative metric mentions and conventional citations. As part of a larger scoping review, we conducted a literature search to identify IPV intervention studies. Outcomes included znumber of alternative metric mentions and conventional citations. Fifty-nine studies were included in this study. The median number of alternative metric mentions was six, and the median number of conventional citations was two. Forty-one percent of the studies (24/59) had no alternative metric mentions, and 27% (16/59) had no conventional citations. Longer time since publication was significantly associated with a greater number of mentions and citations, as were systematic reviews and randomized controlled trial designs. The majority of IPV studies receive little to no online attention or citations in academic journals, indicating a need for the field to focus on implementing strong knowledge dissemination plans. The papers receiving the most alternative metric mentions and conventional citations were also the more rigorous study designs, indicating a need to focus on study quality. We recommend using alternative metrics in conjunction with conventional metrics to evaluate the full dissemination of IPV research.

Translating behavioral medicine evidence to public policy

Behavioral medicine has made significant contributions to our understanding of how to prevent disease and improve health. However, social and environmental factors continue to have a major influence on health in ways that will be difficult to combat on a population level without concerted efforts to scale interventions and translate the evidence into public health policies. Now is also the right time to increase our efforts to produce policy relevant research and partnerships that will maximize the chances that our evidence is taken to scale in ways that can influence population health broadly, and perhaps contribute to the reduction of the recalcitrant health disparities that plague virtually every area of behavioral medicine focus. As a field we must take an active role in policy translation, learning from the public policy and political science disciplines, and our own pioneers in policy translation. This article discusses importance of accelerating evidence translation to policy, and suggests several factors that could enhance our translation efforts, including embracing policy translation as a key goal in behavioral medicine, increasing our understanding in variability of evidence-based policy adoption across and within states, improving our understanding of how to most effectively communicate our findings to policy makers, conducting research that is responsive to policy makers' needs, and considering the important role of local policy partnerships.

Do evidence summaries increase health policy-makers' use of evidence from systematic reviews? A systematic review

This review summarizes the evidence from six randomized controlled trials that judged the effectiveness of systematic review summaries on policymakers' decision making, or the most effective ways to present evidence summaries to increase policymakers' use of the evidence. This review included six randomized controlled studies. A randomized controlled study is one in which the participants are divided randomly (by chance) into separate groups to compare different treatments or other interventions. This method of dividing people into groups means that the groups will be similar and that the effects of the treatments they receive will be compared more fairly. At the time the study is done, it is not known which treatment is the better one. The researchers who did these studies invited people from Europe, North America, South America, Africa, and Asia to take part in them. Two studies looked at "policy briefs," one study looked at an "evidence summary," two looked at a "summary of findings table," and one compared a "summary of findings table" to an evidence summary. None of these studies looked at how policymakers directly used evidence from systematic reviews in their decision making, but two studies found that there was little to no difference in how they used the summaries. The studies relied on reports from decision makers. These studies included questions such as, "Is this summary easy to understand?" Some of the studies looked at users' knowledge, understanding, beliefs, or how credible (trustworthy) they believed the summaries to be. There was little to no difference in the studies that looked at these outcomes. Study participants rated the graded entry format higher for usability than the full systematic review. The graded entry format allows the reader to select how much information they want to read. The study participants felt that all evidence summary formats were easier to understand than full systematic reviews.

Plain language summary

Policy briefs make systematic reviews easier to understand but little evidence of impact on use of study findings: It is likely that evidence summaries are easier to understand than complete systematic reviews. Whether these summaries increase the use of evidence from systematic reviews in policymaking is not clear.What is this review about?: Systematic reviews are long and technical documents that may be hard for policymakers to use when making decisions. Evidence summaries are short documents that describe research findings in systematic reviews. These summaries may simplify the use of systematic reviews.Other names for evidence reviews are policy briefs, evidence briefs, summaries of findings, or plain language summaries. The goal of this review was to learn whether evidence summaries help policymakers use evidence from systematic reviews. This review also aimed to identify the best ways to present the evidence summary to increase the use of evidence.What are the main findings of this review?: This review included six randomized controlled studies. A randomized controlled study is one in which the participants are divided randomly (by chance) into separate groups to compare different treatments or other interventions. This method of dividing people into groups means that the groups will be similar and that the effects of the treatments they receive will be compared more fairly. At the time the study is done, it is not known which treatment is the better one.The researchers who did these studies invited people from Europe, North America, South America, Africa, and Asia to take part in them. Two studies looked at "policy briefs," one study looked at an "evidence summary," two looked at a "summary of findings table," and one compared a "summary of findings table" to an evidence summary.None of these studies looked at how policymakers directly used evidence from systematic reviews in their decision making, but two studies found that there was little to no difference in how they used the summaries. The studies relied on reports from decision makers. These studies included questions such as, "Is this summary easy to understand?"Some of the studies looked at users' knowledge, understanding, beliefs, or how credible (trustworthy) they believed the summaries to be. There was little to no difference in the studies that looked at these outcomes. Study participants rated the graded entry format higher for usability than the full systematic review. The graded entry format allows the reader to select how much information they want to read.. The study participants felt that all evidence summary formats were easier to understand than full systematic reviews.What do the findings of this review mean?: Our review suggests that evidence summaries help policymakers to better understand the findings presented in systematic reviews. In short, evidence summaries should be developed to make it easier for policymakers to understand the evidence presented in systematic reviews. However, right now there is very little evidence on the best way to present systematic review evidence to policymakers.How up to date is this review?: The authors of this review searched for studies through June 2016.

Executive summary/Abstract

Background: Systematic reviews are important for decision makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. Strategies to promote the use of evidence to decision makers are required, and evidence summaries have been suggested as a facilitator. Evidence summaries include policy briefs, briefing papers, briefing notes, evidence briefs, abstracts, summary of findings tables, and plain language summaries. There are many organizations developing and disseminating systematic review evidence summaries for different populations or subsets of decision makers. However, evidence on the usefulness and effectiveness of systematic review summaries is lacking. We present an overview of the available evidence on systematic review evidence summaries.Objectives: This systematic review aimed to 1) assess the effectiveness of evidence summaries on policy-makers' use of the evidence and 2) identify the most effective summary components for increasing policy-makers' use of the evidence.Search methods: We searched several online databases (Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Global Health Library, Popline, Africa-wide, Public Affairs Information Services, Worldwide Political Science Abstracts, Web of Science, and DfiD), websites of research groups and organizations which produce evidence summaries, and reference lists of included summaries and related systematic reviews. These databases were searched in March-April, 2016.Selection criteria: Eligible studies included randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA) studies, and interrupted time series (ITS) studies. We included studies of policymakers at all levels as well as health system managers. We included studies examining any type of "evidence summary", "policy brief", or other product derived from systematic reviews that presented evidence in a summarized form. These interventions could be compared to active comparators (e.g. other summary formats) or no intervention.The primary outcomes were: 1) use of systematic review summaries decision-making (e.g. self-reported use of the evidence in policy-making, decision-making) and 2) policymaker understanding, knowledge, and/or beliefs (e.g. changes in knowledge scores about the topic included in the summary). We also assessed perceived relevance, credibility, usefulness, understandability, and desirability (e.g. format) of the summaries.Results: Our database search combined with our grey literature search yielded 10,113 references after removal of duplicates. From these, 54 were reviewed in full text and we included 6 studies (reported in 7 papers, 1661 participants) as well as protocols from 2 ongoing studies. Two studies assessed the use of evidence summaries in decision-making and found little to no difference in effect. There was also little to no difference in effect for knowledge, understanding or beliefs (4 studies) and perceived usefulness or usability (3 studies). Summary of Findings tables and graded entry summaries were perceived as slightly easier to understand compared to complete systematic reviews. Two studies assessed formatting changes and found that for Summary of Findings tables, certain elements, such as reporting study event rates and absolute differences were preferred as well as avoiding the use of footnotes. No studies assessed adverse effects. The risks of bias in these studies were mainly assessed as unclear or low however, two studies were assessed as high risk of bias for incomplete outcome data due to very high rates of attrition.Authors' conclusions: Evidence summaries may be easier to understand than complete systematic reviews. However, their ability to increase the use of systematic review evidence in policymaking is unclear.

The Effect of Education on the Attitude and Child Abuse Behaviors of Mothers with 3-6 Year Old Children: A Randomized Controlled Trial Study

BACKGROUND

Child abuse is a kind of domestic violence of children under the age of 18 which potentially or actually damages all aspects of their health. This study was conducted to determine the effect of education based on growth and development with home-visiting follow up on the mothers' attitude and child abuse with 3-6-year-old children.

METHODS

This controlled trial study was carried out in two rural community health centers in Khorasan Razavi province in Iran, during April 2016 to Jun 2017 on 64 abusive mothers of 3-6-year-old children. The data collection tools included the 32-item adult adolescent parenting inventory (AAPI) and the questionnaire of child abuse. By using multi-stage random sampling, the mothers referring to two health centers were assigned to the experimental (N=32) and control groups (N=32). The intervention group received parenting educational interventions based on child growth and development and after being followed up for eight weeks through home-visits. The data were analyzed in SPSS-16, using descriptive statistics, analytical tests including the Chi-square, independent t-test, and Mc Nemars test.

RESULTS

After the intervention, the overall score of parenting attitudes was found to be significantly increased (P<0.001), and the prevalence of most abusive behaviors towards children was significantly reduced (P<0.05) in the intervention group compared to the control group.

CONCLUSION

According to the results, this educational program was found to be significantly more effective in improving parenting attitudes and preventing child abuse compared to routine childcare programs in health centers. Trial Registration Number: IRCT2016052628094N1.

Effectively engaging stakeholders and the public in developing violence prevention messages

Background

Preventing family violence requires that stakeholders and the broader public be involved in developing evidence-based violence prevention strategies. However, gaps exist in between what we know (knowledge), what we do (action), and the structures supporting practice (policy).

Discussion

We discuss the broad challenge of mobilizing knowledge-for-action in family violence, with a primary focus on the issue of how stakeholders and the public can be effectively engaged when developing and communicating evidence-based violence prevention messages. We suggest that a comprehensive approach to stakeholder and public engagement in developing violence prevention messages includes: 1) clear and consistent messaging; 2) identifying and using, as appropriate, lessons from campaigns that show evidence of reducing specific types of violence; and 3) evidence-informed approaches for communicating to specific groups. Components of a comprehensive approach must take into account the available research evidence, implementation feasibility, and the context-specific nature of family violence.

Summary

While strategies exist for engaging stakeholders and the public in messaging about family violence prevention, knowledge mobilization must be informed by evidence, dialogue with stakeholders, and proactive media strategies. This paper will be of interest to public health practitioners or others involved in planning and implementing violence prevention programs because it highlights what is known about the issue, potential solutions, and implementation considerations.

Using theory to design, implement and evaluate sustained nurse domestic violence screening and supportive care

Domestic violence is prevalent and harmful for abused women and children and damages women’s capacity to maintain wellbeing and parent effectively. As women’s health is likely to be poor, greater identification and support by nurses for abused women is needed. The aim of this study is to highlight the importance of theory in nursing intervention research on domestic violence and how the application of implementation theory can be used to promote programme sustainability. In particular, we discuss the use of Normalization Process Theory (NPT) in the MOVE (improving maternal and child health care for vulnerable mothers) study, a randomised controlled trial which aimed to increase nurse inquiry, safety planning and referral of abused women. NPT was used in the participatory action research and design stage of the trial, in the implementation and process evaluation phases. In conclusion, the use of implementation theory in nursing research can enhance the uptake of complex interventions, address the knowledge–practice gap and potentially improve outcomes for women experiencing domestic violence.

Moving knowledge about family violence into public health policy and practice: a mixed method study of a deliberative dialogue

BACKGROUND

There is a need to understand scientific evidence in light of the context within which it will be used. Deliberative dialogues are a promising strategy that can be used to meet this evidence interpretation challenge.

METHODS

We evaluated a deliberative dialogue held by a transnational violence prevention network. The deliberative dialogue included researchers and knowledge user partners of the Preventing Violence Across the Lifespan (PreVAiL) Research Network and was incorporated into a biennial full-team meeting. The dialogue included pre- and post-meeting activities, as well as deliberations embedded within the meeting agenda. The deliberations included a preparatory plenary session, small group sessions and a synthesizing plenary. The challenge addressed through the process was how to mobilize research to orient health and social service systems to prevent family violence and its consequences. The deliberations focused on the challenge, potential solutions for addressing it and implementation factors. Using a mixed-methods approach, data were collected via questionnaires, meeting minutes, dialogue documents and follow-up telephone interviews.

RESULTS

Forty-four individuals (all known to each other and from diverse professional roles, settings and countries) participated in the deliberative dialogue. Ten of the 12 features of the deliberative dialogue were rated favourably by all respondents. The mean behavioural intention score was 5.7 on a scale from 1 (strongly disagree) to 7 (strongly agree), suggesting that many participants intended to use what they learned in their future decision-making. Interviews provided further insight into what might be done to facilitate the use of research in the violence prevention arena.

CONCLUSION

Findings suggest that participants will use dialogue learnings to influence practice and policy change. Deliberative dialogues may be a viable strategy for collaborative sensemaking of research related to family violence prevention, and other public health topics.

Domestic Violence in the Canadian Workplace: Are Coworkers Aware?

Background

Domestic violence (DV) is associated with serious consequences for victims, children, and families, and even national economies. An emerging literature demonstrates that DV also has a negative impact on workers and workplaces. Less is known about the extent to which people are aware of coworkers' experiences of DV.

Methods

Using data from a pan-Canadian sample of 8,429 men and women, we examine: (1) awareness of coworker DV victimization and perpetration; (2) the warning signs of DV victimization and perpetration recognized by workers; (3) whether DV victims are more likely than nonvictims to recognize DV and its warning signs in the workplace; and (4) the impacts of DV that workers perceive on victims'/perpetrators' ability to work.

Results

Nearly 40% of participants believed they had recognized a DV victim and/or perpetrator in the workplace and many reported recognizing more than one warning sign. DV victims were significantly more likely to report recognizing victims and perpetrators in the workplace, and recognized more DV warning signs. Among participants who believed they knew a coworker who had experienced DV, 49.5% thought the DV had affected their coworker's ability to work. For those who knew a coworker perpetrating DV, 37.9% thought their coworker's ability to work was affected by the abusive behavior.

Conclusion

Our findings have implications for a coordinated workplace response to DV. Further research is urgently needed to examine how best to address DV in the workplace and improve outcomes for victims, perpetrators, and their coworkers.

Where is the Child in Family Therapy Service After Family Violence? A Study from the Norwegian Family Protection Service

Extensive documentation on consequences of family violence laid the ground for a politically decided mandate for the Norwegian Family Protection Service (FPS) to prioritize families with children and violence. This study explores the practice of one of the country’s larger FPS offices following this mandate and its kick-off start. Data from all cases in 1 year with families with children and violence were gathered (106) as to what were cases referred, services provided, main cross-points, dilemmas, and challenges. Descriptive statistical analyses were utilized and qualitative analysis conducted. The study shows success in supplying a direct, much used route both for private persons and main collaborative agencies, although all abusers need others as promoters for change. The service succeeds to pioneer brief treatment combined with taking a stand against violence. However, while services are provided fairly quickly when violence is reported, several changes are called for: A more violence-sensitive intake procedure, stronger cooperation with specialty mental health service and primary health service, extended use of assessment tools and outcome measures. Given the nature of violence, particularly follow up measures are required. However, first and foremost, the study calls for a better inclusion of the child. Despite mandated priority, a major neglect of children takes place. In line with the UN Convention on the Rights of the Child, the Norwegian Family Protection Services in a country complying with this Convention is obliged to take the child more successfully into account in its own right. Future efforts are required to safeguard child-focused services.