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BMC Primary Care
Published in: BMC Primary Care 1/2021

01-12-2021 | Care | Research article

Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care

Authors: Eszter Szilassy, Jessica Roy, Emma Williamson, Katherine Pitt, Mei-See Man, Gene Feder

Published in: BMC Primary Care | Issue 1/2021

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Abstract

Background

Primary care needs to respond effectively to patients experiencing or perpetrating domestic violence and abuse (DVA) and their children, but there is uncertainty about the value of integrated programmes. The aim of the study was to develop and test the feasibility of an integrated primary care system-level training and support intervention, called IRIS+ (Enhanced Identification and Referral to Improve Safety), for all patients affected by DVA. IRIS+ was an adaptation of the original IRIS (Identification and Referral to Improve Safety) model designed to reach female survivors of DVA.

Methods

Observation of training; pre/post intervention questionnaires with clinicians and patients; data extracted from medical records and DVA agency; semi-structured interviews with clinicians, service providers and referred adults and children. Data collection took place between May 2017 and April 2018. Mixed method analysis was undertaken to triangulate data from various sources to assess the feasibility and acceptability of the intervention.

Results

Clinicians and service providers believed that the IRIS+ intervention had filled a service gap and was a valuable resource in identifying and referring women, men and children affected by DVA. Despite increased levels of preparedness reported by clinicians after training in managing the complexity of DVA in their practice, the intervention proved to be insufficient to catalyse identification and specialist referral of men and direct identification and referral (without their non-abusive parents) of children and young people. The study also revealed that reports provided to general practice by other agencies are important sources of information about adult and children patients affected by DVA. However, in the absence of guidance about how to use this information in patient care, there are uncertainties and variation in practice.

Conclusions

The study demonstrates that the IRIS+ intervention is not feasible in the form and timeframe we evaluated. Further adaptation is required to achieve identification and referral of men and children in primary care: an enhanced focus on engagement with men, direct engagement with children, and improved guidance and training on responding to reports of DVA received from other agencies.
Appendix
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Metadata
Title
Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care
Authors
Eszter Szilassy
Jessica Roy
Emma Williamson
Katherine Pitt
Mei-See Man
Gene Feder
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Care
Published in
BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-020-01297-5

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