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Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention
BACKGROUND: 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 s...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336644/ https://www.ncbi.nlm.nih.gov/pubmed/28259143 http://dx.doi.org/10.1186/s12875-017-0603-7 |
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author | Lewis, Natalia V. Larkins, Cath Stanley, Nicky Szilassy, Eszter Turner, William Drinkwater, Jessica Feder, Gene S. |
author_facet | Lewis, Natalia V. Larkins, Cath Stanley, Nicky Szilassy, Eszter Turner, William Drinkwater, Jessica Feder, Gene S. |
author_sort | Lewis, Natalia V. |
collection | PubMed |
description | BACKGROUND: 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 aim of this study was to test and evaluate its feasibility, acceptability and the direction of change in short-term outcome measures. METHODS: We 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. RESULTS: Eleven 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. CONCLUSIONS: The 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12875-017-0603-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5336644 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53366442017-03-07 Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention Lewis, Natalia V. Larkins, Cath Stanley, Nicky Szilassy, Eszter Turner, William Drinkwater, Jessica Feder, Gene S. BMC Fam Pract Research Article BACKGROUND: 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 aim of this study was to test and evaluate its feasibility, acceptability and the direction of change in short-term outcome measures. METHODS: We 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. RESULTS: Eleven 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. CONCLUSIONS: The 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12875-017-0603-7) contains supplementary material, which is available to authorized users. BioMed Central 2017-03-04 /pmc/articles/PMC5336644/ /pubmed/28259143 http://dx.doi.org/10.1186/s12875-017-0603-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Lewis, Natalia V. Larkins, Cath Stanley, Nicky Szilassy, Eszter Turner, William Drinkwater, Jessica Feder, Gene S. Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention |
title | Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention |
title_full | Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention |
title_fullStr | Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention |
title_full_unstemmed | Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention |
title_short | Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention |
title_sort | training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336644/ https://www.ncbi.nlm.nih.gov/pubmed/28259143 http://dx.doi.org/10.1186/s12875-017-0603-7 |
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