This annual report - Taranaki District Health Board

Stover CS, et al. 2009. Interventions for Intimate Partner Violence: Review and Implications for Evidence-BasedPractice. Professional Psychology - Research & Practice, 40(3), 223-33.This review assessed intimate partner violence (IPV) treatment studies that used randomised case assignment, and hadat least 20 participants per group. Studies were classified according to primary treatment focus: perpetrator (7 RCTs,6,390 participants), victim (5 RCTs, approximately 1,306 participants), couples (5 studies, approximately 887 couples), orchild-witness (3 RCTs, involving 75 pre-schoolers, 181 children aged 6 to 12 years, and 237 sexually abused children)interventions. There was limited evidence of the effectiveness of interventions on reducing repeat violence. Mostinterventions showed minimal benefit above arrest alone, and consistent recidivism rates of approximately 30% within sixmonths. Couples treatment approaches that simultaneously addressed problems with substance abuse and aggressionyielded the lowest recidivism rates (18% for Behavioural Couple Therapy versus 43% for individual substance misusetreatment at 12-month follow-up), supporting the benefit of integrating substance abuse treatments into interventions.The child witness to IPV intervention studies assessed reductions in symptoms of children exposed to violence. Severaltreatments showed promising effectiveness data, treatments involving the caregiver and child were the most effective.However, the generalisability of these findings is limited because continued residence with the perpetrator and maternalsubstance abuse were exclusion criteria.Robinson L & Spilsbury K. 2008. Systematic review of the perceptions and experiences of accessing healthservices by adult victims of domestic violence. Health and Social Care in the Community, 16(1), 16-30.This review qualitatively synthesised evidence on the perceptions and experiences of adult victims of domestic violencewhen accessing healthcare services. Ten qualitative studies were included. The data were thematically analysed toidentify recurrent themes and to answer four questions: what factors enabled and/or discouraged participants to discloseabuse to health professionals; what responses from healthcare professionals did participants define as particularlyhelpful and/or unhelpful in accessing services; what barriers deterred participants from accessing services in ahealthcare environment and what would help them gain access to health care; and in situations where abuse wasdisclosed, did participants feel that appropriate support and referral was provided. The studies identified that victims ofdomestic violence experienced difficulties when accessing healthcare services. Common themes included inappropriateresponses by healthcare professionals; discomfort in the healthcare environment; perceived barriers to disclosingdomestic violence, with many participants indicating they would like domestic violence to be proactively and routinelyraised by healthcare professional; and a lack of confidence in the outcomes of disclosure to a health professional. Theauthors make a number of recommendations regarding staff training and service provision.Whitaker DJ, et al. 2006. A critical review of interventions for the primary prevention of perpetration of partnerviolence. Aggression and Violent Behaviour, 11(2), 151-66.This review assessed primary prevention programmes targeting partner violence. Eleven studies, comprising of fivecluster RCTs, one randomised trial with no control group, three quasi-experimental and one pre-post test nonexperimentalstudy, were included. Interventions were mostly brief, universal, school-based programmes targeted middleor high-school aged students. Study quality was limited by short follow-up (only two studies collected data beyond sixmonths), high attrition rates (retention ranged from 37.8% to 84%) and a lack of behavioural measures. Two of the fourstudies that measured behaviour found a positive intervention impact. The two effective trials had the mostcomprehensive interventions, using both individual-level curricula and other community-based interventions, and themost rigorous designs. The authors conclude that while primary prevention programmes show promise, further researchis needed to assess their overall efficacy.Wathen C & MacMillan HL. 2003. Interventions for violence against women: Scientific review. JAMA: The Journal ofthe American Medical Association, 289(5), 589-600.This review assessed the effectiveness of interventions to detect and prevent violence against women from a primarycare perspective, including screening to detect abuse or risk of abuse, and intervention programmes for women or theirpartners which can be accessed from primary care. Sixteen studies (approximate overall n=5084), made up of onesystematic review, six RCTs, three quasi-randomised RCTs, one controlled clinical trial, four cohort studies and one nonequivalentcontrol group study, were identified. No studies examining the effectiveness of screening where the end pointwas improved outcomes for women, as opposed to identification of abuse status, were identified. No high-quality studiesassessing the effectiveness of a shelter stay in decreasing the incidence of violence were identified. One RCT identifiedthat for women who had spent at least one night in a shelter, those who received a specific programme of advocacycounselling reported a decreased rate of re-abuse and improved quality of life during the 2-year follow-up in comparisonwith those receiving normal care (76% versus 89%). Only one high-quality intervention programme RCT was identifiedwhich did not show significant benefits. Most of the studies did not assess potential harms.Other Relevant PublicationsKoziol-McLain J, et al. 2009. Hospital Responsiveness to Family Violence: 48 month follow-up evaluation report.Auckland: Auckland University of Technology. http://www.health.govt.nz/our-work/preventative-health-wellness/familyviolence/reports-family-violenceThe Ministry of Health’s Violence Intervention Programme (VIP) in DHBs seeks to reduce and prevent the health effectsof violence and abuse through early identification, assessment and referral of victims presenting to health services. Thisreport documents the development of DHB family violence systems responses based on four rounds of hospital auditsfrom 2004 to 2008. The evaluation found that Partner Abuse Intervention Programme scores and Child Abuse andNeglect Intervention Programme scores had increased substantially over time, suggesting programme maturation andinstitutional change. The authors found that improvement was strongly linked to support and resources provided by theMinistry of Health and DHBs.Family Violence - 346