Abstract
BackgroundChildren’s exposure to domestic violence is a type of child maltreatment, yet many general practice clinicians remain uncertain of their child safeguarding responsibilities in the context of domestic violence. We developed an evidence-based pilot training on domestic violence and child safeguarding for general practice teams. The aim of this study was to test and evaluate its feasibility, acceptability and the direction of change in short-term outcome measures.MethodsWe used a mixed method design which included a pre-post questionnaire survey, qualitative analysis of free-text comments, training observations, and post-training interviews with trainers and participants. The questionnaire survey used a validated scale to measure participants’ knowledge, confidence/ self-efficacy, and beliefs/ attitudes towards domestic violence and child safeguarding in the context of domestic violence.ResultsEleven UK general practices were recruited (response rate 55%) and 88 clinicians attended the pilot training. Thirty-seven participants (42%) completed all pre-post questionnaires and nine were interviewed. All training sessions were observed. All six trainers were interviewed. General practice clinicians valued the training materials and teaching styles, opportunities for reflection and delivery by local trainers from both health and children’s social services. The training elicited positive changes in total outcome score and knowledge and confidence/ self-efficacy sub scores which remained at 3-month follow up. However, the mean sub score of beliefs and attitudes did not change and the qualitative results were mixed. Two interviewees described changes in their clinical practice. Participants’ suggestions for improving the training included incorporating more ethnic and class diversity in the material, using cases with multiple socio economic disadvantages, and addressing multi-agency collaboration in the context of changing and under-resourced services for children.ConclusionsThe pilot training for general practice on child safeguarding in the context of domestic violence was feasible and acceptable. It elicited positive changes in clinicians’ knowledge and confidence/ self-esteem. The extent to which clinical behaviour changed is unclear, but there are indications of changes in practice by some clinicians. The pilot training requires further refinement and evaluation before implementation.
Highlights
Children’s exposure to domestic violence is a type of child maltreatment, yet many general practice clinicians remain uncertain of their child safeguarding responsibilities in the context of domestic violence
Background the negative health impact of domestic violence and abuse (DVA) is well documented [1], training for health care professionals on how to identify and respond to patients experiencing DVA is virtually absent from undergraduate and postgraduate curricula [2, 3] and has a patchy presence within the continuing professional education [4,5,6]
We hypothesised that the RESPONDS training would: (i) be acceptable to general practice clinicians and feasible to deliver; (ii) increase clinicians’ knowledge on DVA and child safeguarding (CS) policy and procedures; (iii) increase clinicians’ confidence and self-efficacy in supporting families exposed to DVA; (iv) improve clinicians’ attitudes towards women and children exposed to DVA; (v) encourage reflection on clinicians’ own practice regarding DVA and CS
Summary
Children’s exposure to domestic violence is a type of child maltreatment, yet many general practice clinicians remain uncertain of their child safeguarding responsibilities in the context of domestic violence. We developed an evidence-based pilot training on domestic violence and child safeguarding for general practice teams. The negative health impact of domestic violence and abuse (DVA) is well documented [1], training for health care professionals on how to identify and respond to patients experiencing DVA is virtually absent from undergraduate and postgraduate curricula [2, 3] and has a patchy presence within the continuing professional education [4,5,6]. Training to identify and manage DVA and, where appropriate, refer children affected by DVA to children’s services is required [21]
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