Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention

BMC Family Practice

Research Article

Eszter Szilassy¹  Natalia V. Lewis¹  Gene S. Feder¹  Jessica Drinkwater²  William Turner³  Nicky Stanley⁴  Cath Larkins⁴ 

[1] Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK;Leeds Institute of Health Sciences, Charles Thackrah Building, 101 Clarendon Road, LS2 9LJ, Leeds, UK;School for Policy Studies, University of Bristol, Social Science Complex, 8 Priory Road, BS8 1TZ, Bristol, UK;School of Social Work, Care and Community, University of Central Lancashire, Harrington Building, PR1 2HE, Preston, UK;

关键词: General practice;    Family practice;    Domestic violence;    Child safeguarding;    Child protection;    Pilot projects;    Evaluation report;    Pre-post-tests;    Qualitative evaluation;    Quantitative evaluation;   

DOI  :  10.1186/s12875-017-0603-7

 received in 2015-11-08, accepted in 2017-02-21,  发布年份 2017

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© The Author(s). 2017