This annual report - Taranaki District Health Board

Other Systematic ReviewsNelson HD, et al. 2012. Screening women for intimate partner violence: a systematic review to update the U.S.Preventive Services Task Force recommendation. Annals of Internal Medicine, 156(11), 796-808.This review assessed the effectiveness of screening (one large cluster RCT) and interventions for women in health caresettings (6 RCTs) in reducing intimate partner violence (IPV) and related health outcomes, the diagnostic accuracy ofscreening instruments (15 studies evaluating 13 screening instruments), and adverse effects of screening andinterventions (reported in 3 trials, 11 descriptive studies and 2 systematic reviews). Data were synthesised narratively.Six of the screening instruments were found to be a highly accurate. One large cluster RCT assessing the effectivenessof screening versus usual care indicated reduced IPV and improved health outcomes for both groups, but no statisticallysignificant differences between the groups. Four trials of counselling reported reduced IPV and improved birth outcomesfor pregnant women, reduced IPV for new mothers, and reduced pregnancy coercion and unsafe relationships forwomen attending family-planning clinics. Minimal adverse effects were identified with screening, but some womenexperienced discomfort, loss of privacy, emotional distress, and concerns about further abuse. The authors conclude thatscreening instruments designed for health care settings can accurately identify women experiencing IPV, althoughfurther evaluation of computerised screening, which may be more acceptable to women, is required. Effectiveness trialswere limited by heterogeneity, lack of true control groups and use of self-reported measures but indicated that screeningcould reduce IPV and improve health outcomes, depending on the population screened and outcomes measured.O’Campo P, et al. 2011. Implementing successful intimate partner violence screening programs in health caresettings: Evidence generated from a realist-informed systematic review. Social Science & Medicine, 72(6), 855-66.This realist-informed systematic review (involving the assessment of contextual characteristics of programmes to helpexplain programme success or failure) aimed to determine why and how universal intimate partner violence (IPV)screening programmes in health care settings are effective. Twenty-three studies of varying methodologies, assessing17 programmes, were included. Programmes that took a comprehensive approach (incorporated multiple programmecomponents, including institutional support, training and immediate access to support services) were successful inincreasing IPV screening and disclosure/identification rates. The authors did not assess whether screening is effective inreducing IPV, arguing that it is not the best outcome to examine given the complexity of the screening process andnumerous mediating factors between screening and a change or reduction in violence. A conceptual framework for IPVscreening in health care settings is provided.Murphy CM & Ting L. 2010. The effects of treatment for substance use problems on intimate partner violence: Areview of empirical data. Aggression and Violent Behaviour, 15(5), 325-33.This review assessed whether, and to what extent, treatment for substance use problems is associated with a reductionin intimate partner violence (IPV). Seven uncontrolled studies (approximately 600 participants), that assessed abusivebehaviour before and after the intervention, and two small RCTs were included in the review. Overall, the prevalence ofIPV was higher before substance use treatment than after treatment, and the risk for IPV after treatment was higher forrelapsed versus remitted cases. Small to moderate effect sizes were observed for reductions in the frequency of IPVafter substance use treatment, and large effects observed for reductions in psychological aggression. Reduced alcoholconsumption and improved relationship functioning appeared to account for the observed reductions in partner abuse.Although generally supportive of substance use treatments, the findings are limited by the observational nature of mostof the studies.Feder G, et al. 2009. How far does screening women for domestic (partner) violence in different health-caresettings meet criteria for a screening programme? Systematic reviews of nine UK National Screening Committeecriteria. Health Technology Assessment, 13(16), 1-113.This extensive review assessed whether the evidence base fulfilled selected UK National Screening Committee (NSC)criteria to support the implementation of screening for partner violence in health-care settings. Evidence was reviewed forseven criteria: the lifetime prevalence was sufficient for partner violence to be a significant public health problem; a validscreening tool for use in healthcare settings was identified (the Hits, Insults, Threatens and Screams scale); most womenpatients considered screening acceptable (range 35 to 99%), although potential harms were identified; evidence foreffectiveness of advocacy is growing, and psychological interventions may be effective, although not necessarily forwomen identified through screening; no trials of screening programmes measured morbidity and mortality; acceptabilityscreening among health-care professionals ranged from 15% to 95%; there were no cost-effectiveness studies. Thereviewers found insufficient evidence to implement a screening programme for partner violence against women either inhealth services generally, or in specific clinical settings and recommendations for further research were made.Rabin RF, et al. 2009. Intimate Partner Violence Screening Tools: A Systematic Review. American Journal ofPreventive Medicine, 36(5), 439-45.e4.This review assessed the data on screening tools for intimate partner violence tested in healthcare settings. Thirty-threearticles, evaluating 21 intimate partner violence screening tools, were included. Sensitivities and specificities variedwidely within and between the screening tools and no single IPV screening tool had well-established psychometricproperties. The authors recommend that individual providers must determine the optimal balance between brevity andcomprehensiveness and identify a need for further testing and validation in diverse populations using a universallyaccepted comparison measure.Family Violence - 345