Improved identification and referral of women experiencing domestic violence

January 01, 0001

Improved identification and referral of women experiencing domestic violence

Most clinicians have no training about domestic violence, fail to identify patients experiencing abuse, and are uncertain about management after disclosure. The researchers from the UK tested the effectiveness of a programme of training and support in primary health-care practices to increase identification of women experiencing domestic violence and their referral to specialist advocacy services. In this cluster randomised controlled trial, they selected general practices in two urban primary care trusts, Hackney (London) and Bristol, UK. They randomised 51 (61%) of 84 eligible general practices in Hackney and Bristol. Of these, 24 received a training and support programme, 24 did not receive the programme, and three dropped out before the trial started.

1 year after the second training session, the 24 intervention practices recorded 223 referrals of patients to advocacy and the 24 control practices recorded 12 referrals (adjusted intervention rate ratio 22.1). Intervention practices recorded 641 disclosures of domestic violence and control practices recorded 236 (adjusted intervention rate ratio 3.1). No adverse events were recorded.

The researchers concluded: "A training and support programme targeted at primary care clinicians and administrative staff improved referral to specialist domestic violence agencies and recorded identification of women experiencing domestic violence. Our findings reduce the uncertainty about the benefit of training and support interventions in primary care settings for domestic violence and show that screening of women patients for domestic violence is not a necessary condition for improved identification and referral to advocacy services."

Sounds obvious. Referral, however, is a crude measurement of what is going on.

For the full abstract, click here.

The Lancet published online 13 October 2011 © 2011 Elsevier Inc
Identification and Referral to Improve Safety (IRIS) of women experiencing domestic violence with a primary care training and support programme: a cluster randomised controlled trial. Gene Feder, Roxane Agnew Davies and Kathleen Baird. Correspondence to Gene Feder: gene.feder@bristol.ac.uk

Category: Z. Social Problems. Keywords: identification, referral, safety, women, domestic violence, primary care, training, support, programme, cluster randomised controlled trial, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 28 October 2011

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