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Williams JR, Gonzalez-Guarda RM, Halstead V, Martinez J, Joseph L. Disclosing Gender-Based Violence During Health Care Visits: A Patient-Centered Approach. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:5552-5573. [PMID: 29294854 PMCID: PMC9527868 DOI: 10.1177/0886260517720733] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The purpose of this study was to better understand victims' perspectives regarding decisions to disclose gender-based violence, namely, intimate partner violence (IPV) and human trafficking, to health care providers and what outcomes matter to them when discussing these issues with their provider. Twenty-five participants from racially/ethnically diverse backgrounds were recruited from a family justice center located in the southeastern United States. Two fifths had experienced human trafficking, and the remaining had experienced IPV. Upon obtaining informed consent, semistructured, in-depth interviews were conducted. Interviews were audio recorded and transcribed verbatim. Qualitative content analysis was used to examine interview data. Five primary themes emerged. Three themes focused on factors that may facilitate or impede disclosure: patient-provider connectedness, children, and social support. The fourth theme was related to ambiguity in the role of the health care system in addressing gender-based violence. The final theme focused on outcomes participants hope to achieve when discussing their experiences with health care providers. Similar themes emerged from both IPV and human trafficking victims; however, victims of human trafficking were more fearful of judgment and had a stronger desire to keep experiences private. Cultural factors also played an important role in decisions around disclosure and may interact with the general disparities racial/ethnic minority groups face within the health care system. Recognizing factors that influence patient engagement with the health care system as it relates to gender-based violence is critical. The health care system can respond to gender-based violence and its associated comorbidities in numerous ways and interventions must be driven by the patient's goals and desired outcomes of disclosure. These interventions may be better served by taking patient-centered factors into account and viewing the effectiveness of intervention programs through a behavioral, patient-centered lens.
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Cameron J, Humphreys C, Kothari A, Hegarty K. Exploring the knowledge translation of domestic violence research: A literature review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1898-1914. [PMID: 32614128 DOI: 10.1111/hsc.13070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 05/21/2020] [Accepted: 05/28/2020] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
- Jacqui Cameron
- Department of Social Work, The University of Melbourne, Melbourne, Vic, Australia
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Cathy Humphreys
- Department of Social Work, The University of Melbourne, Melbourne, Vic, Australia
| | - Anita Kothari
- School of Health Studies, University of Western Ontario, London, Canada
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Vic, Australia
- Royal Women's Hospital, Melbourne, Vic, Australia
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Daoud N, Kraun L, Sergienko R, Batat N, Shoham-Vardi I, Davidovitch N, Cohen A. Patterns of healthcare services utilization associated with intimate partner violence (IPV): Effects of IPV screening and receiving information on support services in a cohort of perinatal women. PLoS One 2020; 15:e0228088. [PMID: 32004325 PMCID: PMC6994004 DOI: 10.1371/journal.pone.0228088] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 01/07/2020] [Indexed: 11/19/2022] Open
Abstract
Background While women experiencing intimate partner violence (IPV) face significant health consequences, their patterns of healthcare services (HCS) utilization are unclear, as are the effects of IPV screening and receiving information on these patterns. Objectives 1. Compare utilization patterns of five HCS (visits to family physician, gynecologist, specialist and emergency room, and hospitalization) in a cohort of perinatal women who reported experiencing versus not experiencing any IPV and IPV types (physical and/or sexual; emotional and/or verbal; social and economic); 2. Examine whether IPV screening, receiving information on support services, or both, affect patterns; and 3. Compare these associations between ethnic groups (Arab and Jewish women). Methods We conducted a prospective study using registry data on HCS utilization obtained from Israel’s largest Health Fund (Clalit) in the year following a 2014–2015 survey of a cohort of 868 perinatal women in Israel (327 Arab minority, 542 Jewish) on their reports of experiencing IPV, IPV screening, and receiving information. Using multivariate analysis, we calculated adjusted odds ratios (AOR) and 95% confidence intervals (CI) for the five HCS utilizations in association with reports of any IPV and IPV types. We adjusted for IPV screening, receiving information about services, and both, in the total sample, and separately among ethnic groups. Results Any IPV and IPV types had significant associations with some HCS utilization variables, with different directions and patterns for the ethnic groups. Experiencing IPV was associated with higher HCS utilization among Arab women, lower utilization in Jewish women. Arab women experiencing IPV were twice as likely to visit a gynecologist than women not experiencing IPV (AOR (95% CI) was 2.00, 1.14–3.51 for any IPV; 2.17, 1.23–3.81 for emotional and/or verbal IPV, and 1.83, 1.04–3.22, for social and economic IPV). Among Jewish women, experiencing any IPV was associated with lower likelihood of emergency-room visits (0.62, 0.41–0.93); and experiencing physical and/or sexual IPV was associated with lower likelihood of family physician visits (OR = 0.20, 0.05–0.82). Both IPV screening and receiving information were associated with lower HCS utilization among Arab women only. Conclusions Different HCS utilization patterns among women who reported experiencing versus not experiencing IPV in different ethnic groups suggest complex relationships that hinge on how HCS address women’s needs, starting with IPV screening and providing information. This might inform tailored programs to tackle IPV at the HCS, particularly for minority women.
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Affiliation(s)
- Nihaya Daoud
- Department of Public Health, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- * E-mail:
| | - Lotan Kraun
- Department of Public Health, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences & Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ruslan Sergienko
- Department of Public Health, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | | | - Ilana Shoham-Vardi
- Department of Public Health, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Nadav Davidovitch
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences & Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Arnon Cohen
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences & Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Fawole OI, Balogun BO, Adejimi AA, Akinsola OJ, Van Wyk JM. Training medical students: victim's perceptions of selectively screening women for intimate partner violence in health care settings. BMC MEDICAL EDUCATION 2019; 19:196. [PMID: 31185978 PMCID: PMC6558861 DOI: 10.1186/s12909-019-1627-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 05/22/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Routine IPV screening is a controversial topic and there is no evidence to suggest that it improves the health outcomes of women. Consequently, understanding the socio-cultural dimensions, becomes essential to ensure that victims receive appropriate and local support. This study was conducted to gather the perceptions of victims of IPV on the relevance of raising the topic at health care facilities and to determine specific categories of women to target for screening by medical personnel. It also explored how the information gathered could support victims and whether medical students should be trained on issues relating to IPV. METHODS Thirty-three key informant interviews were conducted among women attending clinics from three teaching hospitals in the Lagos, Oyo and Osun States of South West Nigeria. The hospitals offer antenatal, emergency, primary care and community outreach clinics which are well-attended by women. A six-item questionnaire assessed eligibility for participation in the study and participants were then purposively sampled. Interviews were conducted using a semi-structured guide. Ethical approval and gatekeepers' permissions were obtained, and each participant signed informed consent. Data was collected between June and November 2017. The data was entered into Excel and analysed deductively to answer each objective. RESULTS Most (n = 24) participants stated that medical practitioners should ask all women who present to health care facilities, about their experiences of IPV. Physically, medically and socially vulnerable women, including those in relationships with men in risky occupations, were identified as needing special attention and possible follow-up. They supported the use of the information within and outside of the health care facility, depending on the need of the woman. The majority (n = 24) indicated a need to train medical students about IPV and 19 participants suggested for the topic to be curriculated. Most victims favoured the inclusion of a multidisciplinary team in teaching medical students about IPV. CONCLUSIONS Victims of IPV were in support of initiatives to discuss the topic among some groups of female patients in health care settings. They thought it would enhance the quality of care (medical, psychological, legal and social) to victims. They identified an inter-professional team of stakeholders to include when training medical students about IPV.
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Affiliation(s)
- Olufunmilayo I. Fawole
- Department of Epidemiolgy and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Busola O. Balogun
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adebola A. Adejimi
- Department of Community Medicine, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Nigeria
| | - O. J. Akinsola
- Department of Community Medicine and Primary Health Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Jacqueline M. Van Wyk
- Department of Clinical and Professional Practice, Nelson R. Mandela School of Medicine, University of Kwa-Zulu Natal, Durban, South Africa
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Wathen CN, MacMillan HL. The Role of Integrated Knowledge Translation in Intervention Research. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:319-327. [PMID: 25969410 DOI: 10.1007/s11121-015-0564-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
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.
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Affiliation(s)
- C Nadine Wathen
- Faculty of Information & Media Studies, The University of Western Ontario, London, Ontario, Canada.
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Daoud N, Berger-Polsky A, Sergienko R, O’Campo P, Leff R, Shoham-Vardi I. Screening and receiving information for intimate partner violence in healthcare settings: a cross-sectional study of Arab and Jewish women of childbearing age in Israel. BMJ Open 2019; 9:e022996. [PMID: 30796117 PMCID: PMC6398676 DOI: 10.1136/bmjopen-2018-022996] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We studied the proportion of women who have ever been screened (ES) for intimate partner violence (IPV) in a healthcare setting, received information (RI) about relevant services, or both, and explored disparities in screening and information provision by ethnicity and other characteristics. DESIGN In 2014-2015, we undertook a cross-sectional study, conducting interviews using a structured questionnaire among a stratified sample of 1401 Arab and Jewish women in Israel. SETTING A sample of 63 maternal and child health clinics (MCH) clinics in four geographical districts. PARTICIPANTS Women aged 16-48 years, pregnant or up to 6 months after childbirth. PRIMARY AND SECONDARY OUTCOME MEASURES We used multivariable generalised estimating equation analysis to determine characteristics of women who were ES (Has anyone at the healthcare services (HCS) ever asked you whether you have experienced IPV?); RI (Have you ever received information about what to do if you experience IPV?); and both (ES&RI). RESULTS Less than half of participants (48.8%) reported ES; 50.5% RI; and 30% were both ES&RI. Having experienced any IPV was not associated with ES or ES&RI, but was associated with RI in an unexpected direction. Women at higher risk for IPV (Arab minority women, lower education, unmarried) were less likely to report being ES, RI or both. The OR and 95% CI for not ER&RI were: 1.58 (1.00 to 2.49) among Arab compared with Jewish women; 1.95 (1.42 to 2.66) among low education versus academic education women; 1.34 (1.03 to 1.73) among not working versus working. ES, RI and both differ across districts. CONCLUSIONS While Israel mandates screening and providing information regarding IPV for women visiting the HCS, we found inequalities, suggesting inconsistencies in policy implementation and missed opportunities to detect IPV. To increase IPV screening and information provision, the ministry of health should circulate clarification and provide support to healthcare providers to conduct these activities.
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Affiliation(s)
- Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer -Sheva, Israel
| | - Alexandra Berger-Polsky
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer -Sheva, Israel
| | - Ruslan Sergienko
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer -Sheva, Israel
| | - Patricia O’Campo
- Centre for Urban Health Solutions, St.Michael’s Hospital, Toronto, Ontario, Canada
| | - Rebecca Leff
- School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer -Sheva, Israel
| | - Ilana Shoham-Vardi
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer -Sheva, Israel
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Kothari A, Wathen CN. Integrated knowledge translation: digging deeper, moving forward. J Epidemiol Community Health 2017; 71:619-623. [PMID: 28298415 DOI: 10.1136/jech-2016-208490] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 02/06/2017] [Accepted: 02/19/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Integrated knowledge translation has risen in popularity as a solution to the underuse of research in policy and practice settings. It engages knowledge users-policymakers, practitioners, patients/consumers or their advocates, and members of the wider public-in mutually beneficial research that can involve the joint development of research questions, data collection, analysis and dissemination of findings. Knowledge that is co-produced has a better chance of being implemented. DISCUSSION The purpose of this paper is to update developments in the field of integrated knowledge translation through a deeper analysis of the approach in practice-oriented and policy-oriented health research. We present collaborative models that fall outside the scope of integrated knowledge translation, but then explore consensus-based approaches and networks as alternate sites of knowledge co-production. We discuss the need to advance the field through the development, or use, of data collection and interpretation tools that creatively engage knowledge users in the research process. Most importantly, conceptually relevant outcomes need to be identified, including ones that focus on team transformation through the co-production of knowledge. CONCLUSIONS We explore some of these challenges and benefits in detail to help researchers understand what integrated knowledge translation means, and whether the approach's potential added value is worth the investment of time, energy and other resources.
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Affiliation(s)
- Anita Kothari
- School of Health Studies, The University of Western Ontario, London, Ontario, Canada
| | - C Nadine Wathen
- Faculty of Information & Media Studies, Centre for Research & Education on Violence Against Women & Children, The University of Western Ontario, London, Ontario, Canada
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McPherson C, Ploeg J, Edwards N, Ciliska D, Sword W. A catalyst for system change: a case study of child health network formation, evolution and sustainability in Canada. BMC Health Serv Res 2017; 17:100. [PMID: 28143621 PMCID: PMC5286844 DOI: 10.1186/s12913-017-2018-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 01/16/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine key processes and supportive and inhibiting factors involved in the development, evolution, and sustainability of a child health network in rural Canada. This study contributes to a relatively new research agenda aimed at understanding inter-organizational and cross-sectoral health networks. These networks encourage collaboration focusing on complex issues impacting health - issues that individual agencies cannot effectively address alone. This paper presents an overview of the study findings. METHODS An explanatory qualitative case study approach examined the Network's 13-year lifespan. Data sources were documents and Network members, including regional and 71 provincial senior managers from 11 child and youth service sectors. Data were collected through 34 individual interviews and a review of 127 documents. Interview data were analyzed using framework analysis methods; Prior's approach guided document analysis. RESULTS Three themes related to network development, evolution and sustainability were identified: (a) Network relationships as system triggers, (b) Network-mediated system responsiveness, and (c) Network practice as political. CONCLUSIONS Study findings have important implications for network organizational development, collaborative practice, interprofessional education, public policy, and public system responsiveness research. Findings suggest it is important to explicitly focus on relationships and multi-level socio-political contexts, such as supportive policy environments, in understanding health networks. The dynamic interplay among the Network members; central supportive and inhibiting factors; and micro-, meso-, and macro-organizational contexts was identified.
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Affiliation(s)
- Charmaine McPherson
- School of Nursing, Faculty of Science, St. Francis Xavier University, Box 5000, Antigonish, Nova Scotia B2G 2W5 Canada
| | - Jenny Ploeg
- School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5 Canada
| | - Nancy Edwards
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario KlH 8M5 Canada
| | - Donna Ciliska
- School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5 Canada
| | - Wendy Sword
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario KlH 8M5 Canada
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Rodríguez DC, Shearer J, Mariano ARE, Juma PA, Dalglish SL, Bennett S. Evidence-informed policymaking in practice: country-level examples of use of evidence for iCCM policy. Health Policy Plan 2017; 30 Suppl 2:ii36-ii45. [PMID: 26516149 PMCID: PMC4625759 DOI: 10.1093/heapol/czv033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Integrated Community Case Management of Childhood Illness (iCCM) is a policy for providing treatment for malaria, diarrhoea and pneumonia for children below 5 years at the community level, which is generating increasing evidence and support at the global level. As countries move to adopt iCCM, it becomes important to understand how this growing evidence base is viewed and used by national stakeholders. This article explores whether, how and why evidence influenced policy formulation for iCCM in Niger, Kenya and Mozambique, and uses Carol Weiss’ models of research utilization to further explain the use of evidence in these contexts. A documentary review and in-depth stakeholder interviews were conducted as part of retrospective case studies in each study country. Findings indicate that all three countries used national monitoring data to identify the issue of children dying in the community prior to reaching health facilities, whereas international research evidence was used to identify policy options. Nevertheless, policymakers greatly valued local evidence and pilot projects proved critical in advancing iCCM. World Health Organization and United Nations Children's Fund (UNICEF) functioned as knowledge brokers, bringing research evidence and experiences from other countries to the attention of local policymakers as well as sponsoring site visits and meetings. In terms of country-specific findings, Niger demonstrated both Interactive and Political models of research utilization by using iCCM to capitalize on the existing health infrastructure. Both Mozambique and Kenya exhibit Problem-Solving research utilization with different outcomes. Furthermore, the persistent quest for additional evidence suggests a Tactical use of research in Kenya. Results presented here indicate that while evidence from research studies and other contexts can be critical to policy development, local evidence is often needed to answer key policymaker questions. In the end, evidence may not be enough to overcome resistance if the policy is viewed as incompatible with national goals.
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Affiliation(s)
- Daniela C Rodríguez
- Johns Hopkins Bloomberg School of Public Health, Dept. of International Health, 615 N Wolfe Street, Baltimore, MD 21205, USA,
| | - Jessica Shearer
- Johns Hopkins Bloomberg School of Public Health, Dept. of International Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - Alda R E Mariano
- Universidade Eduardo Mondlane, Community Health Department, Maputo, Mozambique and
| | - Pamela A Juma
- African Population and Health Research Center, Nairobi, Kenya
| | - Sarah L Dalglish
- Johns Hopkins Bloomberg School of Public Health, Dept. of International Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - Sara Bennett
- Johns Hopkins Bloomberg School of Public Health, Dept. of International Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
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O'Doherty L, Taket A, Valpied J, Hegarty K. Receiving care for intimate partner violence in primary care: Barriers and enablers for women participating in the weave randomised controlled trial. Soc Sci Med 2016; 160:35-42. [PMID: 27208669 DOI: 10.1016/j.socscimed.2016.05.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 04/21/2016] [Accepted: 05/09/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Interventions in health settings for intimate partner violence (IPV) are being increasingly recognised as part of a response to addressing this global public health problem. However, interventions targeting this sensitive social phenomenon are complex and highly susceptible to context. This study aimed to elucidate factors involved in women's uptake of a counselling intervention delivered by family doctors in the weave primary care trial (Victoria, Australia). METHODS We analysed associations between women's and doctors' baseline characteristics and uptake of the intervention. We interviewed a random selection of 20 women from an intervention group women to explore cognitions relating to intervention uptake. Interviews were audio-recorded, transcribed, coded in NVivo 10 and analysed using the theory of planned behaviour (TPB). RESULTS Abuse severity and socio-demographic characteristics (apart from current relationship status) were unrelated to uptake of counselling (67/137 attended sessions). Favourable doctor communication was strongly associated with attendance. Eight themes emerged, including four sets of beliefs that influenced attitudes to uptake: (i) awareness of the abuse and readiness for help; (ii) weave as an avenue to help; (iii) doctor's communication; and (iv) role in providing care for IPV; and four sets of beliefs regarding women's control over uptake: (v) emotional health, (vi) doctors' time, (vii) managing the disclosure process and (viii) viewing primary care as a safe option. CONCLUSIONS This study has identified factors that can promote the implementation and evaluation of primary care-based IPV interventions, which are relevant across health research settings, for example, ensuring fit between implementation strategies and characteristics of the target group (such as range in readiness for intervention). On practice implications, providers' communication remains a key issue for engaging women. A key message arising from this work concerns the critical role of primary care and health services more broadly in reaching victims of domestic violence, and providing immediate and ongoing support (depending on the healthcare context).
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Affiliation(s)
- Lorna O'Doherty
- Centre for Research in Psychology, Behaviour and Achievement, Coventry University, Priory Street, Coventry CV1 5FB, UK; General Practice and Primary Care Academic Centre, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria, Australia.
| | - Ann Taket
- School of Health and Social Development, Deakin University, Victoria, Australia.
| | - Jodie Valpied
- General Practice and Primary Care Academic Centre, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria, Australia.
| | - Kelsey Hegarty
- General Practice and Primary Care Academic Centre, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria, Australia.
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Boyko JA, Kothari A, Wathen CN. Moving knowledge about family violence into public health policy and practice: a mixed method study of a deliberative dialogue. Health Res Policy Syst 2016; 14:31. [PMID: 27098267 PMCID: PMC4839163 DOI: 10.1186/s12961-016-0100-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 03/30/2016] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Jennifer A Boyko
- School of Health Studies, Faculty of Health Sciences & Faculty of Information & Media Studies, Western University, Health Sciences Building, Room 403, London, ON, N6A 5B9, Canada.
| | - Anita Kothari
- School of Health Studies, Faculty of Health Sciences, Western University, Health Sciences Building, Room 222, London, ON, N6A 5B9, Canada
| | - C Nadine Wathen
- Health Information Science, Faculty of Information & Media Studies, Western University, London, ON, N6A 5B7, Canada
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Boyko JA, Carter N, Bryant-Lukosius D. Assessing the Spread and Uptake of a Framework for Introducing and Evaluating Advanced Practice Nursing Roles. Worldviews Evid Based Nurs 2016; 13:277-84. [DOI: 10.1111/wvn.12160] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Jennifer A. Boyko
- Postdoctoral Fellow, Faculty of Health Sciences and Faculty of Information & Media Studies; Western University; London ON Canada
| | - Nancy Carter
- Assistant Professor, School of Nursing, Affiliate, Canadian Centre for Advanced Practice Nursing Research; McMaster University; Hamilton ON Canada
| | - Denise Bryant-Lukosius
- Associate Professor, School of Nursing and Department of Oncology, Co-Director, Canadian Centre for Advanced Practice Nursing Research; McMaster University Hamilton; ON Canada
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Sibbald SL, MacGregor JCD, Surmacz M, Wathen CN. Into the gray: a modified approach to citation analysis to better understand research impact. J Med Libr Assoc 2015; 103:49-54. [PMID: 25552946 DOI: 10.3163/1536-5050.103.1.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Shannon L Sibbald
- Shannon L. Sibbald, PhD (corresponding author), , Faculty of Health Sciences and Schulich Interfaculty Program in Public Health; Jennifer C. D. MacGregor, PhD, , Faculty of Health Sciences and Faculty of Information & Media Studies; Marisa Surmacz, MLIS, , Western Libraries; C. Nadine Wathen, PhD, , Faculty of Information & Media Studies; Western University, 1151 Richmond Street, London, ON Canada
| | - Jennifer C D MacGregor
- Shannon L. Sibbald, PhD (corresponding author), , Faculty of Health Sciences and Schulich Interfaculty Program in Public Health; Jennifer C. D. MacGregor, PhD, , Faculty of Health Sciences and Faculty of Information & Media Studies; Marisa Surmacz, MLIS, , Western Libraries; C. Nadine Wathen, PhD, , Faculty of Information & Media Studies; Western University, 1151 Richmond Street, London, ON Canada
| | - Marisa Surmacz
- Shannon L. Sibbald, PhD (corresponding author), , Faculty of Health Sciences and Schulich Interfaculty Program in Public Health; Jennifer C. D. MacGregor, PhD, , Faculty of Health Sciences and Faculty of Information & Media Studies; Marisa Surmacz, MLIS, , Western Libraries; C. Nadine Wathen, PhD, , Faculty of Information & Media Studies; Western University, 1151 Richmond Street, London, ON Canada
| | - C Nadine Wathen
- Shannon L. Sibbald, PhD (corresponding author), , Faculty of Health Sciences and Schulich Interfaculty Program in Public Health; Jennifer C. D. MacGregor, PhD, , Faculty of Health Sciences and Faculty of Information & Media Studies; Marisa Surmacz, MLIS, , Western Libraries; C. Nadine Wathen, PhD, , Faculty of Information & Media Studies; Western University, 1151 Richmond Street, London, ON Canada
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Taft AJ, Hooker L, Humphreys C, Hegarty K, Walter R, Adams C, Agius P, Small R. Maternal and child health nurse screening and care for mothers experiencing domestic violence (MOVE): a cluster randomised trial. BMC Med 2015; 13:150. [PMID: 26111528 PMCID: PMC4480893 DOI: 10.1186/s12916-015-0375-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 05/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mothers are at risk of domestic violence (DV) and its harmful consequences postpartum. There is no evidence to date for sustainability of DV screening in primary care settings. We aimed to test whether a theory-informed, maternal and child health (MCH) nurse-designed model increased and sustained DV screening, disclosure, safety planning and referrals compared with usual care. METHODS Cluster randomised controlled trial of 12 month MCH DV screening and care intervention with 24 month follow-up. The study was set in community-based MCH nurse teams (91 centres, 163 nurses) in north-west Melbourne, Australia. Eight eligible teams were recruited. Team randomisation occurred at a public meeting using opaque envelopes. Teams were unable to be blinded. The intervention was informed by Normalisation Process Theory, the nurse-designed good practice model incorporated nurse mentors, strengthened relationships with DV services, nurse safety, a self-completion maternal health screening checklist at three or four month consultations and DV clinical guidelines. Usual care involved government mandated face-to-face DV screening at four weeks postpartum and follow-up as required. Primary outcomes were MCH team screening, disclosure, safety planning and referral rates from routine government data and a postal survey sent to 10,472 women with babies ≤ 12 months in study areas. Secondary outcomes included DV prevalence (Composite Abuse Scale, CAS) and harm measures (postal survey). RESULTS No significant differences were found in routine screening at four months (IG 2,330/6,381 consultations (36.5 %) versus CG 1,792/7,638 consultations (23.5 %), RR = 1.56 CI 0.96-2.52) but data from maternal health checklists (n = 2,771) at three month IG consultations showed average screening rates of 63.1 %. Two years post-intervention, IG safety planning rates had increased from three (RR 2.95, CI 1.11-7.82) to four times those of CG (RR 4.22 CI 1.64-10.9). Referrals remained low in both intervention groups (IGs) and comparison groups (CGs) (<1 %). 2,621/10,472 mothers (25 %) returned surveys. No difference was found between arms in preference or comfort with being asked about DV or feelings about self. CONCLUSION A nurse-designed screening and care model did not increase routine screening or referrals, but achieved significantly increased safety planning over 36 months among postpartum women. Self-completion DV screening was welcomed by nurses and women and contributed to sustainability. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry, ACTRN12609000424202, 10/03/2009.
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Affiliation(s)
- Angela J Taft
- Judith Lumley Centre, La Trobe University, Melbourne, Australia.
| | - Leesa Hooker
- Judith Lumley Centre, La Trobe University, Melbourne, Australia.
| | - Cathy Humphreys
- School of Social Work, University of Melbourne, Melbourne, Australia.
| | - Kelsey Hegarty
- Primary Care Research Unit, Department of General Practice, University of Melbourne, Melbourne, Australia.
| | - Ruby Walter
- College of Health and Biomedicine, Victoria University, Melbourne, Australia.
| | - Catina Adams
- Judith Lumley Centre, La Trobe University, Melbourne, Australia.
| | - Paul Agius
- Centre for Population Health, Burnet Institute, Melbourne, Australia.
| | - Rhonda Small
- Judith Lumley Centre, La Trobe University, Melbourne, Australia.
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Hoelle RM, Elie MC, Weeks E, Hardt N, Hou W, Yan H, Carden D. Evaluation of healthcare use trends of high-risk female intimate partner violence victims. West J Emerg Med 2015; 16:107-13. [PMID: 25671018 PMCID: PMC4307692 DOI: 10.5811/westjem.2014.12.22866] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 11/18/2014] [Accepted: 12/10/2014] [Indexed: 11/28/2022] Open
Abstract
Introduction Practitioners need more information about intimate partner violence (IPV) victims’ healthcare use trends. We used a novel data-linkage method and complaint categorization allowing us to evaluate IPV victims healthcare use trends compared to the date of their victimization. Methods This was a retrospective case series using data-linking techniques cross-referencing databases of Medicaid-eligible women between the ages of 16 and 55 years, an IPV Case Database for 2007 and the Florida State Agency for Healthcare Administration, which tracks hospital inpatient, ambulatory and emergency department (ED) use within the State of Florida. We analyzed resulting healthcare visits 1.5 years before and 1.5 years after the women’s reported IPV offense. Using all available claims data a ‘complaint category’ representing categories of presenting chief complaints was assigned to each healthcare visit. Analysis included descriptive statistics, correlation coefficients between time of offense and visits, and a logistic regression analysis. Results The 695 victims were linked with 4,344 healthcare visits in the four-year study period. The victims were young (46% in the 16–25 age group and 79% were younger than 35). Healthcare visits were in the ED (83%) rather than other healthcare sites. In the ED, IPV victims mostly had complaint categories of obstetrics and gynaecology-related visits (28.7%), infection-related visits (18.9%), and trauma-related visits (16.3%). ED use escalated approaching the victim’s date of offense (r=0.59, p<0.0001) compared to use of non-ED sites of healthcare use (r=0.07, p=0.5817). ED use deescalated significantly after date of reported offense for ED visits (r=0.50, p<0.0001) versus non-ED use (r=0.00, p=0.9958). The victims’ age group more likely to use the ED than any other age group was the 36–45 age group (OR 4.67, CI [3.26–6.68]). Conclusion IPV victims use the ED increasingly approaching their date of offense. Presenting complaints were varied and did not reveal unique identifiers of IPV victims. This novel method of database matching between claims data and government records has been shown to be a valid way to evaluate healthcare utilization of at-risk populations.
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Affiliation(s)
- Robyn M Hoelle
- University of Florida, Department of Emergency Medicine, Gainesville, Florida
| | - Marie-Carmelle Elie
- University of Florida, Department of Emergency Medicine, Gainesville, Florida
| | - Emily Weeks
- University of Florida, Department of Emergency Medicine, Gainesville, Florida
| | - Nancy Hardt
- University of Florida, Family Data Center, Gainesville, Florida
| | - Wei Hou
- Stony Brook University Medical Center, Department of Preventative Medicine, Stony Brook, New York
| | - Hui Yan
- University of Florida, Department of Biostatistics, Gainesville, Florida
| | - Donna Carden
- University of Florida, Department of Emergency Medicine, Gainesville, Florida
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MacGregor JCD, Wathen N, Kothari A, Hundal PK, Naimi A. Strategies to promote uptake and use of intimate partner violence and child maltreatment knowledge: an integrative review. BMC Public Health 2014; 14:862. [PMID: 25146253 PMCID: PMC4152574 DOI: 10.1186/1471-2458-14-862] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/24/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) and child maltreatment (CM) are major social and public health problems. Knowledge translation (KT) of best available research evidence has been suggested as a strategy to improve the care of those exposed to violence, however research on how best to promote the uptake and use of IPV and CM evidence for policy and practice is limited. Our research asked: 1) What is the extent of IPV/CM-specific KT research? 2) What KT strategies effectively translate IPV/CM knowledge? and 3) What are the barriers and facilitators relevant to translating IPV/CM-specific knowledge? METHODS We conducted an integrative review to summarize and synthesize the available evidence regarding IPV/CM-specific KT research. We employed multiple search methods, including database searches of Embase, CINAHL, ERIC, PsycInfo, Sociological Abstracts, and Medline (through April, 2013). Eligibility and quality assessments for each article were conducted by at least two team members. Included articles were analyzed quantitatively using descriptive statistics and qualitatively using descriptive content analysis. RESULTS Of 1230 identified articles, 62 were included in the review, including 5 review articles. KT strategies were generally successful at improving various knowledge/attitude and behavioural/behavioural intention outcomes, but the heterogeneity among KT strategies, recipients, study designs and measured outcomes made it difficult to draw specific conclusions. Four key themes were identified: existing measurement tools and promising/effective KT strategies are underused, KT efforts are rarely linked to health-related outcomes for those exposed to violence, there is a lack of evidence regarding the long-term effectiveness of KT interventions, and authors' inferences about barriers, facilitators, and effective/ineffective KT strategies are often not supported by data. The emotional and sometimes contested nature of the knowledge appears to be an important barrier unique to IPV/CM KT. CONCLUSIONS To direct future KT in this area, we present a guiding framework that highlights the need for implementers to use/adapt promising KT strategies that carefully consider contextual factors, including the fact that content in IPV/CM may be more difficult to engage with than other health topics. The framework also provides guidance regarding use of measurement tools and designs to more effectively evaluate and report on KT efforts.
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Affiliation(s)
- Jennifer CD MacGregor
- />Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St., London, ON N6A 5B7 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Nadine Wathen
- />Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St., London, ON N6A 5B7 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Anita Kothari
- />Faculty of Health Sciences, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 222, 1151 Richmond St., London, ON N6A 5B9 Canada
- />Schulich Interfaculty Program in Public Health, The University of Western Ontario, The Western Centre for Public Health and Family Medicine, 1465 Richmond St., 4th Floor, London, ON N6G 2M1 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Prabhpreet K Hundal
- />Faculty of Health Sciences, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 222, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Anthony Naimi
- />Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St., London, ON N6A 5B7 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
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Evaluation of partnerships in a transnational family violence prevention network using an integrated knowledge translation and exchange model: a mixed methods study. Health Res Policy Syst 2014; 12:25. [PMID: 24886489 PMCID: PMC4035665 DOI: 10.1186/1478-4505-12-25] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 05/14/2014] [Indexed: 11/10/2022] Open
Abstract
Background Family violence is a significant and complex public health problem that demands collaboration between researchers, practitioners, and policymakers for systemic, sustainable solutions. An integrated knowledge translation network was developed to support joint research production and application in the area. The purpose of this study was to determine the extent to which the international Preventing Violence Across the Lifespan (PreVAiL) Research Network built effective partnerships among its members, with a focus on the knowledge user partner perspective. Methods This mixed-methods study employed a combination of questionnaire and semi-structured interviews to understand partnerships two years after PreVAiL’s inception. The questionnaire examined communication, collaborative research, dissemination of research, research findings, negotiation, partnership enhancement, information needs, rapport, and commitment. The interviews elicited feedback about partners’ experiences with being part of the network. Results Five main findings were highlighted: i) knowledge user partner involvement varied across activities, ranging from 11% to 79% participation rates; ii) partners and researchers generally converged on their assessment of communication indicators; iii) partners valued the network at both an individual level and to fulfill their organizations’ mandates; iv) being part of PreVAiL allowed partners to readily contact researchers, and partners felt comfortable acting as an intermediary between PreVAiL and the rest of their own organization; v) application of research was just emerging; partners needed more actionable insights to determine ways to move forward given the research at that point in time. Conclusions Our results demonstrate the importance of developing and nurturing strong partnerships for integrated knowledge translation. Our findings are applicable to other network-oriented partnerships where a diversity of stakeholders work to address complex, multi-faceted public health problems.
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O'Doherty LJ, Taft A, Hegarty K, Ramsay J, Davidson LL, Feder G. Screening women for intimate partner violence in healthcare settings: abridged Cochrane systematic review and meta-analysis. BMJ 2014; 348:g2913. [PMID: 24821132 PMCID: PMC4018471 DOI: 10.1136/bmj.g2913] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the effectiveness of screening for intimate partner violence conducted within healthcare settings to determine whether or not screening increases identification and referral to support agencies, improves women's wellbeing, decreases further violence, or causes harm. DESIGN Systematic review and meta-analysis of trials assessing effectiveness of screening. Study assessment, data abstraction, and quality assessment were conducted independently by two of the authors. Standardised estimations of the risk ratios and 95% confidence intervals were calculated. DATA SOURCES Nine databases searched up to July 2012 (CENTRAL, Medline, Medline(R), Embase, DARE, CINAHL, PsycINFO, Sociological Abstracts, and ASSIA), and five trials registers searched up to 2010. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised or quasi-randomised trials of screening programmes for intimate partner violence involving all women aged ≥ 16 attending a healthcare setting. We included only studies in which clinicians in the intervention arm personally conducted the screening, or were informed of the screening result at the time of the consultation, compared with usual care (or no screening). Studies of screening programmes that were followed by structured interventions such as advocacy or therapeutic intervention were excluded. RESULTS 11 eligible trials (n=13,027) were identified. In six pooled studies (n=3564), screening increased the identification of intimate partner violence (risk ratio 2.33, 95% confidence interval 1.39 to 3.89), particularly in antenatal settings (4.26, 1.76 to 10.31). Based on three studies (n=1400), we detected no evidence that screening increases referrals to domestic violence support services (2.67, 0.99 to 7.20). Only two studies measured women's experience of violence after screening (three to 18 months after screening) and found no reduction in intimate partner violence. One study reported that screening does not cause harm. CONCLUSIONS Though screening is likely to increase identification of intimate partner violence in healthcare settings, rates of identification from screening interventions were low relative to best estimates of prevalence of such violence. It is uncertain whether screening increases effective referral to supportive agencies. Screening does not seem to cause harm in the short term, but harm was measured in only one study. As the primary studies did not detect improved outcomes for women screened for intimate partner violence, there is insufficient evidence for screening in healthcare settings. Studies comparing screening versus case finding, or screening in combination with therapeutic intervention for women's long term wellbeing, are needed to inform the implementation of identification policies in healthcare settings.
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Affiliation(s)
- Lorna J O'Doherty
- Department of General Practice, University of Melbourne, Carlton, Vic 3010, Australia
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