Violence Training Research Articles

Empowering Salon Professionals: A Needs Assessment to Understand Training Preferences and Strategies for Addressing Sex Trafficking and Violence

ABSTRACT In some U.S. regions, laws mandate violence training for salon professionals, but Indiana has no current requirement. Our study surveyed 408 licensed salon professionals in Indiana to explore their experiences with violence and sex trafficking and their training preferences. Participants aged 18 to 70 came from all 92 counties, with most holding barber, cosmetologist, or massage therapist licenses. A significant majority (80.1%, n = 327) reported encounters with sex trafficking victims, and 88.0% (n = 359) noted interactions with intimate partner violence (IPV) victims. Barbers and instructors were more likely to encounter both IPV and sex trafficking victims compared to other professionals (χ2 = 7.45, p < .02; χ2 = 8.74, p < .01), while licensed estheticians and electrologists expressed significantly more uncertainty in responding to cases compared to non-licensed professionals (χ2 = 33.34, p < .001). Participants emphasized the need for mandatory violence prevention education covering intervention strategies, victim identification, resources, and safety plans. They also highlighted the importance of collaboration with state agencies, policymakers, and community partners. Longer-tenured professionals reported more frequent encounters with victims (F(2, 403) = 5.91, p < .01), reinforcing the need for ongoing, role-specific training to boost confidence in responding to suspected cases.

Strengthening person-centered care through quality improvement: a mixed-methods study examining implementation of the Person-Centered Care Assessment Tool in Zambian health facilities

Introduction Person-centered care (PCC) is considered a fundamental approach to address clients’ needs. There is a dearth of data on specific actions that HIV treatment providers identify as priorities to strengthen PCC. Objective This study team developed the Person-Centered Care Assessment Tool (PCC-AT), which measures PCC service delivery within HIV treatment settings. The PCC-AT, including subsequent group action planning, was implemented across 29 facilities in Zambia among 173 HIV treatment providers. Mixed-methods study objectives included: (1) identify types of PCC-strengthening activities prioritized based upon low and high PCC-AT scores; (2) identify common themes in PCC implementation challenges and action plan activities by low and high PCC-AT score; and (3) determine differences in priority actions by facility ART clinic volume or geographic type. Methods The study team conducted thematic analysis of action plan data and cross-tabulation queries to observe patterns across themes, PCC-AT scores, and key study variables. Results The qualitative analysis identified 39 themes across 29 action plans. A higher proportion of rural compared to urban facilities identified actions related to stigma and clients’ rights training; accessibility of educational materials and gender-based violence training. A higher proportion of urban and peri-urban compared to rural facilities identified actions related to community-led monitoring. Discussion Findings provide a basis to understand common PCC weaknesses and activities providers perceive as opportunities to strengthen experiences in care. Conclusion To effectively support clients across the care continuum, systematic assessment of PCC services, action planning, continuous quality improvement interventions and re-measurements may be an important approach.

Faith-Based Domestic Violence Training: Building Community Responses with an Islamic Perspective in Palestine

Domestic violence or intimate partner violence affects 1 in 3 women internationally,&amp;nbsp;but despite impacting women from all nations, it has somehow become a point of&amp;nbsp;contention between more secular factions in the western world and traditional Islamic&amp;nbsp;countries under Muslim majority rule. This perceived conflict of ideology has led to&amp;nbsp;a polarization serving to separate affected communities and slow progress on needed&amp;nbsp;resolutions. In Palestine, a long-awaited proposed Family Protection Act has been&amp;nbsp;paralyzed due to public outcry that it is not representative of the cultural and religious&amp;nbsp;context of the country. The following study introduced a training in domestic violence&amp;nbsp;for mental health and social service providers in Palestine that was created by the&amp;nbsp;Peaceful Families Project, a non-profit educational and advocacy organization. The&amp;nbsp;study aims to introduce the understanding that domestic violence is in fact a Muslim&amp;nbsp;issue with clear directives for prevention using a faith-based methodology. Despite&amp;nbsp;having professional experience working with domestic violence over years, participants&amp;nbsp;demonstrated significant changes in knowledge, attitude, and stated potential behaviors&amp;nbsp;after the training. Qualitative data enriched the discussion with participants stating&amp;nbsp;that such efforts could change the narrative and overcome the perceived western bias&amp;nbsp;of domestic violence awareness currently offered in Palestine. It also opens the door&amp;nbsp;for indigenous perspectives and creative, culturally generated solutions to this critical&amp;nbsp;issue. Using faith-based initiatives that correspond to the native culture of a community&amp;nbsp;can increase motivation, ownership, and the opportunity for unique programming and&amp;nbsp;innovative methodologies.

The Media's Influence on Uganda's Security Sector Reforms: An Analysis of a Few Broadcast and Print Media Stations in Kampala

The goal of this study was to investigate how the media and other external variables influenced Uganda's security sector reform. The study especially looked at the several ways that Uganda's media shaped the country's security sector reforms, noted the difficulties that the media in Uganda experienced in implementing these reforms, and determined the other elements that affected Uganda's security sector reform. The study population included Kampala city residents, security personnel, and media personnel. This study used a quantitative, descriptive, and correlative research approach to investigate how the media and other factors shaped the security sector changes. Conversely, a qualitative method was applied to evaluate the difficulties encountered by the media, involving the collection of data through in-depth interviews with journalists. According to the study's findings, the mass media—that is, radio, television, and print—accounted for 47.9% of the security sector's performance (adjusted R2 = 0.479). This indicates that other factors not taken into consideration by this model accounted for 52.1% of the contribution. Nonetheless, just two media outlets—radio (β = 0.568, p = 0.000 &lt; 0.05) and television broadcasting (β = 0.271, p = 0.004 &lt; 0.05)—had a positive and noteworthy impact on the security sector's performance in Uganda, whereas print media (β = -0.090, p = 0.312 &lt; 0.05) had a negative and negligible impact. The results of the journalist interviews also showed that, despite the media's beneficial influence on the performance of the security sector, the media in Uganda has certain obstacles to reforming the security sector. The primary obstacles identified by the interviewees were the absence of legal provisions or instruments that enable journalists to obtain information, coupled with the preservation of antiquated laws on statute books that restrict access, bureaucratic red tape in government, insufficient funding and institutional bureaucracy, political violence, and inadequate training. The results of the study showed that, as 45.2% of the data showed, there is a positive correlation between the other parameters and the performance of the security sector (p = 0.05). These other elements include company culture, resource availability, and leadership. This means that, despite a number of restrictions and laws put in place by governments to restrict media impact, the Ugandan media does its function. The study also comes to the conclusion that performance in the security industry is influenced by other factors. The report suggests that in order to enhance their effectiveness, the UPDF and UPF, which are the main security agencies, should rebrandtheir organizational culture, leadership, and structure. Keywords: Media, security sector, Uganda, Broadcast, Reform

What can veterinary professionals do? Measuring the effect of one domestic violence training pilot program on veterinary professionals' capacity to recognize, respond, and refer human victims of domestic violence.

Veterinary professionals have a key role in facilitating multi-agency collaboration to prevent and respond to domestic violence (DV) in situations where animals may be directly or indirectly involved. Yet despite their position as potential touchpoints for victim-survivors with animals, many veterinary professionals do not feel equipped to act on suspicions or disclosures of DV. In response to this identified need, one service operating in Melbourne, Australia, developed the Vet-3R's training program (Recognize-Respond-Refer) which was piloted on 65 veterinary professionals in Melbourne's Eastern Metropolitan Region. This is an exploratory study aimed at measuring the effect of the Vets 3-R's program on veterinary professionals' confidence and capacity to recognize, respond and refer victims of DV. Participants were invited to complete online surveys before and after the training to evaluate their understanding of DV and their capacity to support suspected victim-survivors with animals who present at their service. The pre-training self-evaluation scores indicated that while most veterinary professionals are aware of the link between animal abuse and DV, they lack the confidence to respond and refer individuals when confronted with suspicions or disclosures of abuse. However, upon completion of the Vets 3-R's program, participants reported marked improvements in their ability to recognize, respond, and refer victim-survivors. The most significant improvement could be seen in participants' self-reported ability to respond appropriately to suspicions of DV. While results are indicative only due to the small sample size, this study suggests that veterinary professionals may be an underutilized intervention point for DV victim-survivors with animals. The Vet-3R's training program can be a useful tool for increasing effectiveness of this intervention point to safely assist DV victim-survivors. More research on similar programs with a larger cohort of participants would be beneficial to measure the impact of such programs on a wider scale.

Evaluation of Gender-Related Digital Violence Training in Catalonia

This study examines the results of evaluating a Catalan training program for practitioners working with survivors of gender-related violence. Considering the lack of scientific evidence previously shown by studies on this topic, this article aimed to triangulate the participants’ self-perception with their assessment of knowledge and competencies in tackling digital gender-related violence before and after the training. To do so, a pre-test and post-test case-based design was employed to identify and measure the participants’ improvement in self-perceived knowledge and their effective gain in knowledge and skills to address this kind of violence. Considering the contributions of a feminist evaluation approach, we also included in our evaluation the analysis of classroom interactions and the participants’ responses. The results overall demonstrate that the incorporation of assessment criteria from the feminist evaluation methodology increased the reliability of evaluation criteria. In addition, it also enabled us to identify the need to continue developing training programs that empower participants and prevent women and LGBTQI+ people from disengaging from digital spaces.

Prevalence and factors associated with workplace violence in a tertiary healthcare facility in Nigeria.

Healthcare workers globally are at an increased risk of workplace violence. Adverse effects such as physical injury, reduced quality of care to patients and lower productivity with associated costs to employers occur. Non-reporting hinders the implementation of effective prevention. This study aimed to assess the prevalence, reasons for non-reporting of workplace violence, and knowledge of prevention prior to designing intervention strategies in the study location where there is a paucity of research on this issue. This cross-sectional study was conducted at a Teaching Hospital in Abakaliki, Ebonyi State, for 4 weeks in 2020 among 205 employees. The hospital was stratified into Clinical, Nursing Services, Pharmacy, Laboratory, and administrative divisions; proportionate allocation and random sampling were used to select the allocated samples. A structured questionnaire was used to collect data. Descriptive statistics determined the measures of central tendencies and dispersion, while bivariate analysis of the variables was done using Pearson's Chi-Square test. Statistical significance was set at p ≤ 0.05 with a confidence level of 95%. The mean age of the participants was 39.1 ± 7.8 years. The prevalence of workplace violence was 70%. The most common reason for non-reporting was complexities and time-consuming reporting procedures (26.5%) followed by fear of reprisal on career (22.4%). The proportion of respondents with good knowledge of workplace violence prevention strategies was high (69.8%). Gender (p = 0.03), work setting (p = 0.006), previous workplace violence training (p = 0.005) and knowledge of workplace violence preventive strategies (p = 0.04) had statistically significant associations with experience of workplace violence. The high prevalence of workplace violence suggests a need for a workplace violence prevention program which should include a simple process of reporting and training. The improved awareness from previous training may account for the significant association with workplace violence.

Feasibility of a reconfigured domestic violence and abuse training and support intervention responding to affected women, men, children and young people through primary care

BackgroundIdentification in UK general practice of women affected by domestic violence and abuse (DVA) is increasing, but men and children/young people (CYP) are rarely identified and referred for specialist support. To address this gap, we collaborated with IRISi (UK social enterprise) to strengthen elements of the IRIS + intervention which included the identification of men, direct engagement with CYP, and improved guidance on responding to information received from other agencies. IRIS + was an adaptation of the national IRIS (Identification and Referral to Improve Safety) model focused on the needs of women victim-survivors of DVA. Without diminishing the responses to women, IRIS + also responded to the needs of men experiencing or perpetrating DVA, and CYP living with DVA and/or experiencing it in their own relationships. Our study tested the feasibility of the adapted IRIS + intervention in England and Wales between 2019–21.MethodsWe used mixed method analysis to triangulate data from various sources (pre/post intervention questionnaires with primary care clinicians; data extracted from medical records and DVA agencies; semi-structured interviews with clinicians, service providers and referred adults and children) to assess the feasibility and acceptability of the IRIS + intervention.ResultsThe rate of referral for women doubled (21.6/year/practice) from the rate (9.29/year/practice) in the original IRIS trial. The intervention also enabled identification and direct referral of CYP (15% of total referrals) and men (mostly survivors, 10% of total referrals). Despite an increase in self-reported clinician preparedness to respond to all patient groups, the intervention generated a low number of men perpetrator referrals (2% of all referrals). GPs were the principal patient referrers. Over two-thirds of referred women and CYP and almost half of all referred men were directly supported by the service. Many CYP also received IRIS + support indirectly, via the referred parents. Men and CYP supported by IRIS + reported improved physical and mental health, wellbeing, and confidence.ConclusionsAlthough the study showed acceptability and feasibility, there remains uncertainty about the effectiveness, cost-effectiveness, and scalability of IRIS + . Building on the success of this feasibility study, the next step should be trialling the effectiveness of IRIS + implementation to inform service implementation decisions.

How much training is enough? Evaluating clinician self-reported family violence response skills following a 3-year transformational change project in a major trauma hospital.

Rates of family violence are high in many societies, with disproportionate impacts on women and children. Healthcare services have an important gateway role for victim-survivors requiring assistance. There is limited evidence regarding how much training is required for hospital clinicians to be adequately prepared to work effectively with clients experiencing family violence. This study aimed to investigate the impact of different levels of training in family violence, on the knowledge and confidence of hospital clinicians. A cross-sectional, online, survey of hospital clinicians in a major trauma hospital was conducted. The study evaluated the impact of level of family violence training (no training, some training, clinical champions) on staff self-reported family violence knowledge and confidence levels. The Assisting Patient/Clients Experiencing Family Violence: Royal Melbourne Hospital Clinician Survey tool was utilised, and open for clinicians to complete, anonymously over a 6-week period. In total, 526 clinical staff participated across a range of profession groups (Allied Health, 47%; Nursing 40%; Medical 13%). Staff with some training (mean training hours 3.25, SD 5.23) rated their knowledge and confidence levels at least two-thirds higher than those with no training. Those trained as clinical champions (mean training hours 14.60, SD 9.14) rated their knowledge and confidence at least 50% higher than staff with some training. An even more pronounced elevation across training levels was seen with specific family violence clinical skills - identifying the signs of family violence, knowing how to screen patients and providing an appropriate response to disclosures. Training in family violence clinical response significantly increased self-reported knowledge and confidence levels of hospital staff, with the extra time and resourcing required to train clinical champions, showing clear benefits. The provision of evidence-based and well-resourced family violence education for healthcare professionals is required to drive clinical practice improvements for victim-survivors.

Challenges and Opportunities for Workplace Violence Training for Healthcare Workers: A Qualitative Study of Staff Experiences

Challenges and Opportunities for Workplace Violence Training for Healthcare Workers: A Qualitative Study of Staff Experiences

Should we be concerned? A qualitative study of educators’ perceptions of medical student wellbeing in domestic violence training

Introduction Domestic violence (DV) is common in the Australian community so it is likely that there will be medical students who are affected personally by DV. Some of these students may find DV training confronting or even re-traumatising. A trauma-informed medical education (TIME) framework utilising trauma-informed care principles may minimise this risk to students. We aimed to explore educators’ perceptions of student well-being in Australian medical school DV training. Method This descriptive qualitative study interviewed 13 educators with experience teaching DV in Australian medical schools using an interpretivist methodology and a TIME framework. Interview data was thematically analysed to identify themes. Results Four key themes included (1) educators thrown in at the deep end; (2) keeping students emotionally safe; (3) a trauma-informed learning environment and; (4) challenges of student DV disclosures. Few of the participants had received training in DV. Educators used methods such as trigger warnings and ground rules to improve student’s emotional safety. Experienced educators dealt with disclosures of DV by students which led to role confusion. Discussion There is a need for increased training of medical educators that includes awareness and implementation of TIME principles when training medical students in DV as well as increased supports and resources for educators.

Understanding context of violence against healthcare through citizen science and evaluating the effectiveness of a co-designed code of conduct and of a tailored de-escalation of violence training in Eastern Democratic Republic of Congo and Iraq: a study protocol for a stepped wedge randomized controlled trial

BackgroundViolence against health care workers (HCWs) is a multifaceted issue entwined with broader social, cultural, and economic contexts. While it is a global phenomenon, in crisis settings, HCWs are exposed to exceptionally high rates of violence. We hypothesize that the implementation of a training on de-escalation of violence and of a code of conduct informed through participatory citizen science research would reduce the incidence and severity of episodes of violence in primary healthcare settings of rural Democratic Republic of Congo (DRC) and large hospitals in Baghdad, Iraq.MethodsIn an initial formative research phase, the study will use a transdisciplinary citizen science approach to inform the re-adaptation of a violence de-escalation training for HCWs and the content of a code of conduct for both HCWs and clients. Qualitative and citizen science methods will explore motivations, causes, and contributing factors that lead to violence against HCWs. Preliminary findings will inform participatory meetings aimed at co-developing local rules of conduct through in-depth discussion and input from various stakeholders, followed by a validation and legitimization process. The effectiveness of the two interventions will be evaluated through a stepped-wedge randomized-cluster trial (SW-RCT) design with 11 arms, measuring the frequency and severity of violence, as well as secondary outcomes such as post-traumatic stress disorder (PTSD), job burnout, empathy, or HCWs’ quality of life at various points in time, alongside a cost-effectiveness study comparing the two strategies.DiscussionViolence against HCWs is a global issue, and it can be particularly severe in humanitarian contexts. However, there is limited evidence on effective and affordable approaches to address this problem. Understanding the context of community distrust and motivation for violence against HCWs will be critical for developing effective, tailored, and culturally appropriate responses, including a training on violence de-escalation and a community behavioral change approach to increase public trust in HCWs. This study aims therefore to compare the effectiveness and cost-effectiveness of different interventions to reduce violence against HCWs in two post-crisis settings, providing valuable evidence for future efforts to address this issue.Trial registrationClinicalTrial.gov Identifier NCT05419687. Prospectively registered on June 15, 2022.

Evaluating the impact of an information-based education and training platform on the incidence, severity, and coping resources status of workplace violence among nurses: a quasi-experimental study

BackgroundWorkplace violence among nurses has emerged as a critical issue, posing a significant threat to their occupational safety. Education and training are the primary measures employed to prevent and respond to workplace violence. However, the current approaches have proven ineffective, possibly due to a lack of consideration for the specific needs of clinical nurses. Therefore, it is essential to explore the effectiveness of an informational education and training platform tailored to nurses' requirements. This study aimed to investigate the impact of such a platform on the incidence, severity, and coping resources of WPV in nurses.MethodsThis research was a quasi-experimental study. An information-based education and training platform focused on nurse workplace violence was developed through literature reviews, expert meetings, consultations with software development companies, and a trial run. A tertiary general hospital in Suzhou was selected, in which hospital district A was the intervention group and hospital district B was the control group. A total of 276 nurses were recruited, 140 in the intervention group and 136 in the control group. The nurses' incidence, severity, coping resources status, and evaluation of the application were measured before the intervention and at 1, 3, and 6 months after the intervention.ResultsThe overall incidence of workplace violence, verbal aggression, and verbal threat among nurses showed statistically significant differences (P < 0.05) for the time effect, while the incidence of physical aggression demonstrated statistically significant differences (P < 0.05) for the between-group effect and the time effect. The severity of physical violence among nurses exhibited statistically significant differences (P < 0.05) for the between-group effect and time effect, and the severity of psychological violence showed statistically significant differences (P < 0.05) for the time effect. Nurses' total coping resources score and dimensions also showed statistically significant differences in terms of group, time, and interaction effects (P < 0.001). The evaluation questionnaire for the mobile application indicated usefulness scores of 2 (1, 2); ease of learning scores of 2 (1, 2); ease of use scores of 2 (1, 2); trust scores of 2 (1, 2.75); acceptance score of 1 (1, 2); and satisfaction scores of 2 (1, 2).ConclusionsImplementing the nurse workplace violence information-based education and training platform proved beneficial in reducing the incidence and severity of workplace violence among nurses and enhancing their coping resources. This outcome suggested the platform's potential for further application and promotion in clinical settings.

Interprofessional Collaboration to Develop and Deliver Domestic Violence Curriculum to Dental Students

ABSTRACT Domestic violence (DV) is a serious social problem that impacts significantly on communities globally. While dentists are uniquely positioned to identify patients who experience DV, there is limited content specifically addressing the issue in their undergraduate training. James Cook University (JCU) dental students revealed this gap, and, in response, an interprofessional collaboration between JCU Social Work, JCU Dentistry and the Cairns Regional Domestic Violence Service was established to codesign and deliver the Dentists and Domestic Violence—Recognise, Respond and Refer program, evaluated through Participatory Action Research (PAR) cycles. The program is informed by critical and feminist social work theory with a gendered analysis of DV. The authors present the program’s evolution and examine the four elements identified as central to its success: interprofessional collaboration, critical and feminist theory and gendered analysis, scaffolded content, and skills-based activities. This article will provide a guide for others starting work in this space. IMPLICATIONS Designing and implementing an interprofessional domestic violence curriculum informed by critical theory and tailored for dental students’ can help meet their learning needs. Collaboratively educating dental students to recognise and respond to domestic violence cases will enable appropriate clinical interactions with patients who are victim-survivors of domestic violence and improve the quality of referrals and interactions with community support services. Undertaking evaluation research that guides effective domestic violence training for students across disciplines contributes to addressing domestic violence.

Multifaceted training and readiness to respond to family violence: A prospective cohort evaluation.

As frontline healthcare workers, there is a growing expectation that nurses should be able to respond to disclosures of family violence. However, the profession and hospital systems have been slow to respond with clear skills, knowledge and confidence deficits identified in existing research. There is limited research which has robustly evaluated the effectiveness of in-depth, multifaceted training on readiness to respond among nurses. To longitudinally evaluate the effectiveness of an in-depth family violence training intervention on confidence, knowledge and clinical skills of nurses working in a large tertiary adult hospital. Single-centre, longitudinal intervention study. Strengthening the Reporting of Observational studies in Epidemiology (STROBE) cross-sectional guidelines were used. One hundred and ten nursing clinicians participated in this study to complete a comprehensive evidence-based model of healthcare workers response for assisting patients experiencing family violence. A mixed methods survey was used to assess change in knowledge, confidence and clinical skills among participants. Outcome assessment was electronically undertaken at baseline, 6-9 months and 12-15 months following intervention. Statistically significant improvement was seen in self-reported knowledge, confidence and frequency of screening for family violence. Relative to baseline estimates, these improvements were identified 6-9 months and 12-15 months following intervention; albeit with consideration to the visually observed trend of skill reversion at follow-up. Quantitative findings were paralleled by qualitatively identified improvements in the recognition of the intersectional nature of violence, need for patient collaboration in screening and depth in considerations around how family violence is screened for. Findings provide tentative support for the utility of a multidimensional training approach to improving nurses' readiness to respond to disclosures of family violence. This study provides preliminary support for multidimensional, evidence-based training to effectively improve nurses' confidence, knowledge and clinical skills required for responding to family violence. The study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (SQUIRE) Statement: guidelines for reporting observational studies (see Table S1). Patients were involved in the initial design of the survey tool. This involvement came through the Allied Health Consumer panel and included input on the design and question wording of the survey items.

Assessment of Emergency Department Health Care Providers’ Readiness for Managing Intimate Partner Violence and Correlation With Perceived Cultural Competence

IntroductionIntimate partner violence is a public health problem, and emergency departments are often a victim’s only contact with health care providers. Despite this, recognition of intimate partner violence within emergency departments remains low owing, in part, to barriers experienced by providers. To better understand these barriers, this study examined relationships between readiness for managing intimate partner violence and cultural competence among emergency department health care providers. MethodsA cross-sectional, correlational study was conducted in 3 emergency departments. Eligible participants included registered nurses, physicians, physician assistants, nurse practitioners, and residents. Data were collected through an anonymous online self-report survey. Descriptive statistics and correlation analyses were conducted to answer study aims. ResultsOur sample included 67 respondents. More than one-third (38.8%) reported no previous intimate partner violence training. Those with previous training had higher readiness scores. Physicians were found to have higher intimate partner violence knowledge scores than registered nurses. Cultural competence scores were generally positive across domains. Aspects of intimate partner violence readiness were associated with culturally competent behaviors, communication, and practices. DiscussionOverall, participants were found to have low perceived readiness scores. Those with previous intimate partner violence training were found to have greater readiness in practice, suggesting that standardization of screening practices and intimate partner violence-related training should be the standard of care. Our data also suggest that perception of culturally competent behaviors and communication are learned skills that can increase screening rates within the emergency department.

Evaluating the impact of a family violence transformational change project in a major trauma hospital: A three-year follow-up comparison study of knowledge, confidence, and family violence response skills in clinical staff.

Family violence is a significant public health issue. Healthcare systems have an important role to play in recognising and responding to current family violence experiences in their patients. However, many healthcare workers and systems remain underprepared to fulfil this role. The current study evaluated the impact of a transformational change project in family violence clinical response at a major adult trauma hospital in Australia. Clinician self-rated knowledge, confidence, and family violence clinical skills were evaluated at three years post implementation of a family violence initiative at the Royal Melbourne Hospital, Melbourne. The three years post survey results (N = 526) were compared to baseline (N = 534) using Mann Whitney U and χ 2 analyses. Self-reported clinician family violence knowledge, confidence and patient screening were all significantly improved from baseline. Specific family violence skills, including knowledge of key indicators, enquiry with patients and disclosure response were also all significantly improved. The most common clinician identified barriers to working effectively in the area were similar to baseline and included the presence of a suspected perpetrator during the clinical interaction, clinicians perceiving patients would be reluctant to disclose, and time limitations. However, significantly fewer staff endorsed a lack of knowledge or supporting policies and procedures as a barrier. The findings indicate that investment in a transformational change project comprised of the establishment of response policies and clinical work-flow, broad-scale training, a clinical champions program, a secondary consultation service and links with partner organisations, was effective at improving clinician self-rated rated family violence skills, across the hospital. However, one quarter of clinicians still reported having not received any family violence training, and half endorsed having little or no confidence in their skills to identify and respond to patient family violence experiences. This indicates ongoing and sustained work is required to optimise clinician skills in responding to family violence.

Exploration of barriers to screening for domestic violence in the perinatal period using an ecological framework.

To explore Australian healthcare providers' perspectives on factors that influence disclosure and domestic violence screening through the lens of Heise's (1998) integrated ecological framework. This paper reports the findings that were part of a sequential mixed methods study with survey data informing interview questions. Participants for interviews were recruited after expressing an interest after completing surveys, as well as via snowball sampling. Semi-structured interviews were undertaken in 2017 with 12 practicing healthcare providers delivering care to women in the perinatal period in Greater Western Sydney, NSW, Australia. Data were analysed using Braun and Clarke's (2006) six-step thematic approach. The findings were framed within Heise's integrated ecological framework under four main themes. The main themes were 'Ontogenic: Factors preventing women from disclosing'; 'Microsystem: Factors preventing healthcare providers from asking'; 'Exosystem: Organizational structures not conducive to screening'; and 'Macrosystem: Cultural attitudes and socioeconomic influences affecting screening'. Organizational policies are needed for better systems of reminding healthcare providers to enquire for domestic and family violence and mandating this within their practices. Mandatory domestic and family violence education and training that is suitable for the time constraints and learning needs of the healthcare provider is recommended for all healthcare providers caring for perinatal women. Further research is needed in addressing culturally specific barriers for healthcare providers to enquire about domestic and family violence in a culturally appropriate way. No Patient or Public Contribution was embedded into the research reported in this paper as this research was specifically exploring healthcare providers' perspectives on domestic violence screening within their own practice experience.

Violence, Harassment, and Turnover Intention in Home and Community Care: The Role of Training.

Violence and harassment affect healthcare workers' well-being and career decisions in the home and community care sector. The objective of this study is to assess the role of training in alleviating the relationship between violence and harassment at work and turnover intention among personal support workers (PSWs). Cross-sectional survey data from 1401 PSWs in Ontario, Canada are analyzed with structural equation modeling. Utilizing a resource perspective, the associations between job demands (i.e., violence and harassment at work), personal resources (i.e., self-esteem), job resources (i.e., workplace violence training and challenging task training), stress, and intention to stay among personal support workers (PSWs) are examined. Challenging task training is positively associated with self-esteem and negatively associated with stress, whereas workplace violence training does not have a significant association with either variable. Stress has a negative relationship with intention to stay. Self-esteem is the mediator of both associations between violence and harassment at work and stress and between challenging task training and stress. The results point to varied degrees of training effectiveness that may be shaping turnover decisions of PSWs who experience violence and harassment in home and community care organizations. There seems to be a need to assess and redesign workplace violence training. Home and community care managers might be able to lower the impact of violence and harassment on PSWs' turnover by providing training that is not directly related to workplace violence and harassment.

Predicting intention of intimate partner violence screening among Thai nursing students: A cross-sectional study.

Using the theory of planned behaviour, the aim of this study was to examine predictors of intention to screen patients for intimate partner violence among Thai nursing students. We employed a cross-sectional, anonymous online survey study with convenience sampling of senior nursing students from across Thailand in April 2019. We administered the Intimate Partner Violence Screening Intention, Nursing Students, a 36-item tool, and analysed relationships between students' intentions and attitudes, subjective norms and perceived behavioural control towards intimate partner violence screening. PROCESS was used to test mediation analyses. Of N=639 respondents. Most (90%) reported intention to screen patients for intimate partner violence. Approximately 41% reported having no intimate partner violence training in their nursing school. Results of the multiple logistic analysis showed that attitudes (OR: 8.5; 95% CI 1.2-4.6) and subjective norms (OR: 4.4; 95% CI 1.4-4.6) significantly predicted intention, whereas perceived behavioural control (OR: 1.7; 95% CI 0.5-4.9) did not. Moreover, attitudes and subjective norm significantly mediated the association between providing a screening tool at clinical sites, and intention. Attitudes and subjective norms were significant predictors of intention of intimate partner violence screening. However, participants lacked adequate role models and training. Future research should improve the predictive power of the framework by integrating additional constructs such as the availability of screening tools, the presence of role models, to design and evaluate effective training and support for future nurses to address intimate partner violence in practice. It is time to seriously consider integrating intimate partner violence content and training into the Thai nursing curriculum, and address the policies, guidelines, and practice culture. The study was designed to examine predictors of intention to screen patients for intimate partner violence. Thai senior nursing students were contributed in the design and conduct of the study. However, the study did not include input from the public or the intended participants.