Longitudinal evaluation of a domestic violence training program for midwives

Abstract

Background: In Australia, 36% of women who experienced violence by a partner reported that this occurred when they were pregnant.1 Around seventeen percent of women experience domestic violence (DV) for the first time during pregnancy. Routine enquiry about domestic violence during pregnancy is now accepted best practice. Training is essential to improve knowledge and practice. Yet very few studies have undertaken a comprehensive evaluation of training impact over time. Aim: This presentation will provide an overview of an evaluation of the longitudinal impact of a domestic violence training and support program to promote midwives’ routine antenatal enquiry for domestic violence using a mixed methods design. Method: Data sources included (1) surveys of midwives at 6 months post-training, (2) interviews with key stakeholders at 12 months, (3) chart audit data of screening, risk, and disclosure rates (for 16 months). Measures included midwives’ knowledge and preparation for routine antenatal enquiry, and perceptions of organisational barriers to routine enquiry. Findings: Forty (out of 83) participant surveys could be matched and responses compared to baseline and post-training scores. Wilcoxon signed-rank test identified that all 6-month follow-up scores were significantly higher than those at baseline. Level of preparedness increased from 42.3 to 51.05 (Z = 4.88, p 90%) reported improved confidence to undertake routine inquiry. A chart audit of screening rates for 16 months post-training revealed of the 6671 women presenting for antenatal care, nearly 90% were screened. Disclosure of domestic violence was low (<2%) with most women at risk or experiencing violence declining referral. Contribution to policy & practice: Training, support processes, and referral pathways, contributed to midwives’ sustained preparedness and knowledge to conduct routine enquiry and support women disclosing domestic violence.