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VISION hybrid seminar: An overview of systematic reviews on violence

This event is in the past.

Join us for a hybrid seminar at City St George’s on 10 September exploring two VISION systematic reviews: one on experiences of violence among people in insecure migration status and the other on the effectiveness of UK domestic and sexual violence and abuse support services and interventions.

The interdisciplinary UK Prevention Research Partnership (UKPRP) Violence, Health and Society (VISION) consortium brings together evidence on violence prevention from across health, social, crime and other sectors. A key method for producing comprehensive evidence syntheses is the systematic review.

In this seminar, we bring together two very different systematic reviews of evidence on violence:

The first presentation, by Alexandria Innes and Hannah Manzur, is global and examines the nature and prevalence of violence among people in different types of insecure migration status.
The second presentation, by Annie Bunce and Sophie Carlisle, focuses on the UK and summarises what we do and don’t know about the effectiveness of domestic and sexual violence support services and interventions.

For further information, please also see the VISION Policy Briefings stemming from the research:

Register in person or online here: Ticket Tailor – VISION Hybrid Seminar – 10 Sept 2025

In person: Rhind Building, St John Street, London, EC1R 0JD followed by an afternoon tea in the Violence & Society Centre.
Online: A Microsoft Teams link will be emailed the morning of the seminar

For further information, please contact VISION_Management_Team@citystgeorges.ac.uk

Insecure migration status increases risk of multiple forms of violence

Insecure migration status is defined as any person who does not have a long term secure immigration status and might fear removal from the country if they fail to comply with their visa restrictions, even if the failure to comply is unknown to them, if forced due to fear for their physical safety, or is coerced.

Research produced by Drs Alexandria Innes and Hannah Manzur of the VISION consortium and PhD student Jana Kriechbaum, Violence and Society Centre at City St George’s University of London, found that people in insecure migration status face or fear violence where violence prevention efforts and violence protection are either not extended to them, or are not made accessible to them.

Findings from their VISION Policy Briefing

The prevalence of violence against people in insecure migration status is a cause for concern. Prevalence of violence is not meaningfully different for people based on type of insecure status, such as those with undocumented status, asylum seekers and refugees, or employer-dependent visas.

Women on spousal visas connect experiences of domestic violence to insecurities associated with their immigration status. The power imbalance embedded in relationships that involve one citizen and one foreigner is exacerbated by attaching the relationship to dependent visa restrictions. Women on spousal visas associated their inability or unwillingness to leave a violent homelife with a fear of immigration removal, therefore prolonging their exposure to violence.

Recommendations

Decouple immigration enforcement from violence prosecution and victim support
Expand protections for survivors of domestic violence
Strengthen protections for victims of work-related exploitation and improve employer regulations
Address state violence in detention and border contexts
Align immigration policies with public health frameworks

To download the VISION Policy Briefing: Insecure Migration

To cite: Innes, Alexandria; Manzur, Hannah; Kriechbaum, Jana (2025). VISION Policy Briefing: Insecure Migration. City, University of London. Report. https://doi.org/10.25383/city.29860142.v1

For further information, please contact Andri at Alexandria.Innes@citystgeorges.ac.uk

Measuring the effectiveness of UK support services and interventions for domestic and sexual violence and abuse

Developing effective responses to domestic and sexual violence and abuse (DVSA) is critical. In the UK there are many support interventions and services, primarily provided by the third sector. Previous systematic reviews of the global evidence have found benefits of such interventions on a range of outcomes.

Despite this, there is limited understanding of which exact outcomes and outcome measures are currently being used both within and across DSVA support services and interventions in the UK specifically. Further, existing systematic reviews only focus on a single type of intervention or service, prohibiting comparisons across service types. Many also have only included evidence published in academic journals, potentially limiting and biasing findings.

For their VISION Policy Briefing, Drs Annie Bunce and Sophie Carlisle, carried out two evidence syntheses:

A scoping review to identify, group and explore outcome measures that have been used to assess the effectiveness of UK-based DSVA support interventions or services.
A systematic review to assess the effectiveness of these interventions or services in terms of the most commonly reported outcomes identified in the scoping review.

Findings include:

Outcome measures assessing the effectiveness of support interventions and services are varied and inconsistent.
Where consistent measures have been used, meta-analyses demonstrate potential benefits of UK-based advocacy and outreach services, psychological support interventions, and perpetrator programmes.
Studies and evaluations assessing the effectiveness of support interventions and services are often methodologically flawed.
Conflicting demands and lack of sufficient funding make robust testing and evaluation difficult in the third sector, reflecting a circular challenge.
There was a lack of evidence for certain types of services and interventions (e.g. specialist sexual violence services/Independent Sexual Violence Advisers [ISVAs] and by-and-for services).

Recommendations

Further high-quality research into the effectiveness of DVSA interventions of perpetrator programmes are required, including randomised controlled studies where appropriate and ethical, to improve certainty regarding the effect estimates generated from evidence syntheses. Published protocols, adherence to reporting guidelines such as CONSORT, STROBE and SQUIRE 2.0, and considering and accounting for confounding factors where randomisation is not feasible, will strengthen the research.

Developing a core outcome set via co-production with survivors and service users, practitioners and service providers, commissioners, policy makers and researchers will increase consistency in reported outcomes and create the cohesion.

To download the VISION Policy Briefing: Measuring the effectiveness of support services and interventions for domestic and sexual violence and abuse in the UK

To cite: Bunce, Annie; Carlisle, Sophie (2025). VISION Policy Briefing: Measuring the effectiveness of support services and interventions for domestic and sexual violence and abuse in the UK. City, University of London. Report. https://doi.org/10.25383/city.29852984.v1

For further information, please contact Annie at annie.bunce@citystgeorges.ac.uk

Carers’ increased risk of domestic violence and poor health outcomes

The poor health of unpaid carers is well-established, and evidence also shows they experience high levels of domestic violence. However, the links between domestic violence and carers’ poor health remains overlooked. The study, Health morbidities in carers with experience of domestic violence and abuse, led by Drs Juliana Onwumere and Emilie Wildman of King’s College London along with research team member Professor Sally McManus, VISION co-Deputy Director, and others, examined this relationship using the Adult Psychiatric Morbidity Survey (APMS), a representative sample of the adult population of England.

The results show that carers are more likely to be female, older, economically inactive, and in debt than non-carers, and that carers tend to have worse mental and physical health. One in three carers reported having had experience of domestic violence. With adjustment for confounders, carers were more likely than non-carers to be victims of physical, emotional and sexual forms of violence and abuse. People with experience of both caring responsibilities and domestic violence had particularly poor mental and physical health outcomes (compared to carers and non-carers without experience of domestic violence, as well as non-carers experiencing domestic violence).

NICE guidelines state that carers should be offered training to help them to provide care safely, including support around managing challenging behaviour from the person being cared for. However, professionals can struggle to identify and respond to carers’ experiences of domestic violence. Facilitating routine enquiry in carers is essential, particularly given that carers often delay seeking support for their own needs carers and may not readily and independently disclose their experiences of violence to professionals.

Recommendations

Efforts to incorporate inquiry into experiences of domestic violence into carers’ needs assessments, which unpaid carers are entitled to, may help facilitate identification and referral to appropriate support services.

Carers high risk of domestic violence goes largely unrecognised in UK policy and practice. This is a sensitive and hidden topic; these findings suggest that addressing carers’ poor health requires also identifying – and addressing – their experiences of domestic violence.

To download: Health morbidities in carers with experience of domestic violence and abuse

To cite: Wildman, E.K., Dickson, H., MacManus, D. McManus, S., Kuipers, E., Onwumere, J. Health morbidities in carers with experience of domestic violence and abuse. Soc Psychiatry Psychiatr Epidemiol (2025). Https://doi.org/10.1007/s00127-025-02959-4

For further information, please contact Juliana at juliana.1.onwumere@kcl.ac.uk

For further information about APMS, contact Sally at sally.mcmanus@citystgeorges.ac.uk

Photograph from Age Without Limits

Healthcare responding to violence and abuse in Brazil

Domestic violence against women (DVAW) is a public health issue and a breach of human rights, yet evidence on effective interventions remains limited, particularly in low-income and middle-income countries. In Brazil, around one third of women have reported current or previous experiences of DVAW, especially perpetrated by intimate partners. Brazil has a comprehensive policy framework on DVAW, however, their implementation has been piecemeal and low priority.

The research team, led by VISION co-Deputy Director Dr Estela Capelas Barbosa, aimed to evaluate changes in identification and referral to specialist support associated with system-level strategies implemented within Brazilian primary healthcare (PHC) to strengthen the response to DVAW as part of the Healthcare Responding to Violence and Abuse (HERA) programme.

The HERA Programme was an international collaboration, involving research partners in the UK, Brazil, Sri Lanka, Nepal and Palestine, which aimed to strengthen the healthcare system response to DVAW, in order to ultimately ensure better outcomes for women and children.

The researchers explored before and aftereffects using difference-in-difference techniques in a quasi-experimental design, using observational data. HERA intervention in Brazil was implemented in eight PHC clinics, while 33 served as controls. Data on DVAW identification and referral were obtained from the national Epidemiological Surveillance System.

Results indicated that the HERA implementation strategies were effective in increasing identification and referral of women who experienced violence and presented at primary care clinics. By prioritising the needs and experiences of women, under a gender and human rights perspective, the strategies may also have enhanced the quality of interactions between healthcare providers and patients.

To the research team’s knowledge, this is the first Brazilian study using a quasi-experimental design to evaluate a system-level set of implementation strategies to DVAW. It provides compelling evidence for the effectiveness of culturally tailored strategies aimed at improving the response of PHC settings to DVAW. The findings reveal significant improvements in both identification and referral rates. The evidence not only underscores the intervention’s potential but offers a valuable framework for policymakers and healthcare providers seeking to implement effective strategies in similar contexts, particularly in low- and middle-income settings.

To download: Healthcare responding to violence and abuse in Brazil: a quasi-experimental difference-in-differences analysis – ScienceDirect

To cite: Estela Capelas Barbosa, Stephanie Pereira, Loraine J. Bacchus, Manuela Colombini, Gene Feder, Lilia Blima Schraiber, Ana Flávia Pires Lucas d’Oliveira, Healthcare responding to violence and abuse in Brazil: a quasi-experimental difference-in-differences analysis, The Lancet Regional Health – Americas, Volume 47, 2025, 101114, ISSN 2667-193X, https://doi.org/10.1016/j.lana.2025.101114.

For further information, please contact Estela at e.capelasbarbosa@bristol.ac.uk

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Researching the impact of Black and Asian women leadership within East of England domestic abuse services

The East of England is a region with minimal presence of ‘by and for’ (BFR) domestic abuse (DA) specialist services despite being home to Black and Asian communities. A VISION-funded research project, ‘Nothing about us without us’: Investigating the impact of the leadership of ethnic minority women on domestic abuse service provision in East England’, is exploring the impact of the leadership of Black and Asian women within DA service provision in the region.

As part of the work, researchers Dr Mirna Guha (Anglia Ruskin University) and Dr Katherine Allen (University of Suffolk), hosted a leadership event on 3 April 2025 for racially and culturally diverse women. Held at a venue provided by the City of London police, the event was part of a leadership programme implemented through the HUM (‘Us) : A Place-based Emerging-Leaders Model designed and piloted by Mirna and Katherine to diversify leadership in domestic abuse and sexual violence services. Research aims include ensuring culturally responsive and representative support for minoritised victims-survivors in East England.

Prior to the April event, Mirna and Katherine researched the leadership needs of 19 overstretched frontline practitioners i.e. ‘emerging leaders’ from racialised communities working within White-majority and at times professionally isolating generalist services across Bedfordshire, Suffolk and Cambridgeshire. East England is home to scattered racialised and diasporic communities where women’s leadership in local politics and policymaking is low. Based on this, three events on trauma-informed, culturally responsive and diverse styles of leadership have been co-produced with national DASV experts. Participants were invited to also join a regionally pioneering Community of Practice (CoP).

At the April event in London, 15 emerging leaders from racialised backgrounds gained insights into the strategies, opportunities and challenges of practising culturally and racially representative leadership through an inspiring keynote by Superintendent Jasvinder Kaur, Domestic Abuse Lead at Suffolk Constabulary and co-founder of the National Women of Colour in Policing network. Furthermore, nine Black and racialised women speakers associated with statutory institutions viz. Cambridge City Council and the National Police Chief’s Council.

Voluntary organisations also spoke including Apna Haq in Rotherham, Asian Women’s Resource Centre in London, and Karim Foundation in Cambridge. Others also shared their experiences of navigating rural and predominantly White spaces, and their strategies for claiming space, giving voice to community members and creating opportunities for other culturally and racially diverse women leaders. One notable theme was the pathbreaking role each panellist had assumed during her career, opening (or at times creating) doors for herself and those who followed. Discussions across the day dwelled on temporality and the changing political landscapes as well as place-based challenges linked to rurality.

Overall, the leadership model, including this event and others and the growing leadership CoP, with a current membership of 25 emerging women leaders, aims to address these contextual and temporal challenges by bolstering and diversifying racialised women’s leadership in public services to ensure equity for minoritised victims-survivors.

By laying the groundwork for a regional advisory board through the CoP, the model challenges the epistemic erasure of racially and culturally minoritised women within the design of DASV, and broadly, public services which exacerbate the postcode lottery of services across England and Wales. Inspired by Pawson and Tilley’s (1997)[1] approach to realist evaluation (which seeks to understand what works for whom and in which circumstances) Mirna and Katherine aim to evaluate the impact of the leadership programme and CoP on how emerging leaders navigate specific challenges rooted in specific professional, relational and spatial contexts.

[1] Pawson, R. and Tilley, N., 1997. Realistic evaluation.

For further information, please contact Mirna at mirna.guha@aru.ac.uk

Photograph courtesy of Dr Mirna Guha and Dr Katherine Allen.

VISION/VASC Webinar Series: The intersection of a gendered economy and violence prevention

This event is in the past.

We are pleased to announce our next webinar for the VISION and Violence & Society Centre (VASC) Webinar Series on Tuesday, 17 June, 11.00 – 11.50.

Mary-Ann Stephenson is the Director of Women’s Budget Group (WBG), a feminist think tank that works in research, advocacy and training to realise a gender equal economy in the UK. As an influential link between academia, the community and voluntary sector, and through their activities of government building and exchanging evidence, data, knowledge, and capacity, WBG’s work often interlinks with violence-prevention research and policy.

Examples include their 2019 report, Benefits or barriers? Making social security work for survivors of violence and abuse across the UK’s four nations, written with Surviving Economic Abuse and End Violence Against Women Coalition. Findings highlighted that the social security systems across the UK failed survivors of violence and abuse when they needed help most.

In 2024, WBG published Funding for violence against women and girls services: Briefing for a new government. Recommendations included:

A commitment to long-term grant funding for specialist women’s services, including ringfenced funding for services led ‘by and for’ Black and minoritised women, Deaf and disabled women and LGBT+ survivors.
More specialist training for police dealing with VAWG cases.
Reform social security (including uprating benefits and scrapping the benefits cap and two-child limit) to ensure women’s economic independence and their ability to leave abusive relationships.

In this webinar, Mary-Ann will highlight WBG’s programme of work demonstrating that a gender equal economy and the embedding of gender equality policymaking are necessary in the reduction of violence against women.

Please join the VISION research consortium and the Violence and Society Centre at City St George’s University of London for what will be a fascinating exploration of economic inequality through a gendered lens.

To register for the event and receive the Teams link, please contact: VISION_Management_Team@city.ac.uk

The purpose of the VISION/VASC webinar series is to provide a platform for academia, government and the voluntary and community sector that work to reduce and prevent violence to present their work / research to a wider audience. This is a multidisciplinary platform and we welcome speakers from across a variety of fields such as health, crime, policing, ethnicity, migration, sociology, social work, primary care, front line services, etc. If interested in presenting at a future Series webinar, please contact: VISION_Management_Team@city.ac.uk

This webinar series is sponsored by the UK Prevention and Research Partnership consortium, Violence, Health and Society (VISION; MR-V049879) and the Violence and Society Centre at City St George’s, University of London.

A Scoping Review: Black and Minoritized Women’s Experiences of Specialist Domestic Violence Services in the UK

Domestic violence and abuse (DVA) harms individuals from all backgrounds, yet the experiences and needs of different communities vary significantly. The Crime Survey for England and Wales (CSEW) estimated that over 1.4 million women and 751,000 men experienced DVA in the year ending March 2023. Black and minoritized women may face heightened vulnerability to DVA due to factors such as socio-economic deprivation, racism, and exposure to specific forms of violence such as so-called honor-based abuse, female genital mutilation or forced marriage.

In addition, minoritized “survivor–victims” of DVA may face intersecting challenges within their socio-political and community context that impede their ability to disclose DVA and may experience social stigma and fears of racism from service providers for example.

This scoping review maps the existing available literature on Black and minoritized women’s experiences with specialist DVA services in the UK to summarize current understanding and identify knowledge gaps.

The research team, comprised of Penelope E. Lowe from University of Roehampton, VISION researchers Sally McManus, Ravi K. Thiara, Estela Capelas Barbosa and Ladan Hashemi, and Pardis Asadi Zeidabadi from City St George’s UoL, and Sumanta Roy of Imkaan and a VISION Advisory Board member, conducted a comprehensive search across multiple databases and gray literature sources.

Thematic analysis of the findings revealed three main themes: additional service needs, barriers to accessing support, and the pivotal role of “by and for” services. The team concluded that “by and for” services—provided by and for minoritized women—which adopt an intersectional approach are crucial in addressing the unique needs of Black and minoritized “survivor–victims”, particularly in terms of language support, practical assistance, and community-related support. There is a need for more peer-reviewed literature to recognize the role of “by and for” services, using diverse methodologies to support Black and minoritized communities better.

To download the article: Black and Minoritized Women’s Experiences of Specialist Domestic Violence Service in the United Kingdom (UK): A Scoping Review

To cite: Lowe, P. E., McManus, S., Asadi Zeidabadi, P., Thiara, R. K., Roy, S., Capelas Barbosa, E., & Hashemi, L. (2025). Black and Minoritized Women’s Experiences of Specialist Domestic Violence Services in the United Kingdom (UK): A Scoping Review. Trauma, Violence, & Abuse, 0(0). https://doi.org/10.1177/15248380251335038

For further information, please contact Penelope at penelope.lowe@rutgers.edu

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The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

Child maltreatment (CM) and parental domestic violence and abuse (pDVA) impose considerable lifelong adverse outcomes on those affected. Approximately 8.5 million adults in England and Wales are estimated to have been exposed to CM (physical, sexual or emotional abuse or emotional or physical neglect of a child by a parent or caregiver) before their 16th birthday. Despite sharing multiple family and environmental risk factors, the economic burden of child exposure where they co-occur has not previously been estimated in detail.

VISION researcher Professor Gene Feder estimated average lifetime societal costs resulting from CM or childhood exposure to pDVA, and incremental costs for scenarios where they co-occur with lead researcher Dr Kevin Gilbert at the University of Cambridge and others.

The findings showed that lifetime costs for childhood exposure to CM and/or pDVA, were £71,309 per child (non-fatal exposure), and £1,292,377 per CM fatality, with £27.8 billion projected costs (2013 UK birth cohort).

Total costs for exposure to pDVA alone was £1.0 billion (£16,639 per child exposed), rising to £2.0 billion (£71,037 per exposed child) for children reporting awareness of pDVA. Co-occurring CM and pDVA imposed greater costs than either alone, including costs from child perpetration of intimate partner violence.

As a result of the research the team concluded that CM and/or pDVA exposure incurs large personal and societal economic burdens. Costs from both pDVA exposure and intergenerational transmission of IPV perpetration highlight the importance for policies to address both CM and domestic violence and abuse in affected households.

Given the scale of burden accrued over the life course after CM and/or pDVA exposure, this model can provide a framework upon which policy makers can identify the best use of resources to maximise the societal benefits from the effective interventions needed to tackle a complex social issue.

To download the article: The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

To cite: Herbert K, Feder G, Gilbert R, Powell C, Howarth E, Morris S. The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK. Child Abuse Negl. 2025 Mar 31;163:107435. doi: 10.1016/j.chiabu.2025.107435. Epub ahead of print. PMID: 40168916.

For further information, please contact Kevin at kch28@medschl.cam.ac.uk

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Evaluation of a domestic violence training and support intervention in Palestinian primary care clinics in the west bank: a mixed method study

Domestic violence (DV) is a violation of human rights and a major public health problem that damages the health of women and their families. In the occupied Palestinian territories, 29% of women have a lifetime exposure to intimate partner violence, the most prevalent form of DV.

Despite the existence of national policies to prevent and respond to DV, implementation within the Palestinian primary health care system has been weak. The research team, including VISION researcher Professor Gene Feder, developed, piloted, and evaluated a system-level intervention, including training for health care providers and care pathways for women patients. The aim of the evaluation was to determine the feasibility and acceptability of the HEalthcare Responding to violence and Abuse (HERA) intervention.

The adaptation of a previous (HERA) intervention was implemented in primary health care
settings in Palestine, informed by stakeholder meetings, interviews with clinic managers and health care providers (HCP), facility-level readiness data, and findings of a previous pilot study. The training component of the intervention, delivered by the Palestinian Counseling Centre, included a train-the-trainer session, two clinic-based training sessions, and reinforcement sessions for front-line healthcare providers in four clinics.

Healthcare providers were trained to ask about DV, give immediate support, and offer a referral to a nurse case manager. The care pathway beyond the case manager was either referral to a primary-care based psychologist or social worker or to a gender-based violence focal point external to the clinic that coordinated referrals to appropriate external services (e.g. police, safe house, psychologist, social worker).

For the evaluation, the researchers employed a thematic analysis of post-intervention semi-structured interviews with HCP and trainers, and observations of training sessions and field notes. Provider Intervention Measure (PIM) data on changes in HCP attitudes and practice were analysed with descriptive statistics. Identification and referral rates for women disclosing DV 12 months before and 12 months after the intervention were obtained from clinic registries. The research team also developed a theory of change to triangulate the qualitative and quantitative data.

Results showed that the training proved acceptable to HCPs and there was evidence of positive change in attitudes and readiness to engage with women patients experiencing DV. Compared to the year before the intervention, there was a reduction in the number of patients disclosing DV during the intervention and of referrals in three of the four clinics. This reduction may be explained by the impact of the Covid 19 pandemic on clinic priorities, lack of time, persisting HCP fear about engaging with DV, and HCP rotation between clinics.

The delivery of the training component of the HERA intervention within the Palestinian primary
healthcare system proved partly feasible and was acceptable to HCPs, but contextual factors limited HCP implementation of the training in practice.

To download the article: Evaluation of a domestic violence training and support intervention in Palestinian primary care clinics in the west bank: a mixed method study

For further information, please contact Nagham at naghamjoudeh@gmail.com