Archives

Trends in outcomes used to measure the effectiveness of domestic and sexual violence and abuse services: a scoping review

In the UK, domestic and sexual violence and abuse (DSVA) is prevalent, and a range of support services and interventions are available to those who have experienced or perpetrated it. Currently, there is no consensus on how the effectiveness and impact of these services should be measured, nor is it clear what outcomes and outcome measures are currently being used by service providers and researchers.

In 2022, VISION researchers, led by Dr Sophie Carlisle, co-designed and conducted a scoping review with an advisory group of representatives from six UK-based DSVA organisations, to summarise, map and identify trends in outcome measures used in evaluations and studies of DSVA services and interventions in the UK.

They searched eight databases, four grey literature databases, put out a call for evidence and searched relevant DSVA websites and identified a total of 80 studies describing 87 interventions and services that were relevant to the review.

A total of 426 outcome measures were extracted, of these there were 282 unique outcome measures. The most commonly used outcome, reported in 11 studies, was the cessation of abuse, as measured by the Severity of Abuse Grid. Over time, both the number of studies and the variety of outcome measures has increased.

This research highlights inconsistencies in measurements of effectiveness in evaluations of DSVA services and research. As this area matures, there is an increased need for a core of common, reliable metrics.

For further information please see: Trends in outcomes used to measure the effectiveness of UK-based support interventions and services targeted at adults with experience of domestic and sexual violence and abuse: a scoping review | BMJ Open

Photo from licensed Adobe Stock library

Referral outcomes for victim-survivors of sexual violence accessing specialist services

Sexual violence and abuse (SVA) is highly prevalent globally, has devastating and wide-ranging effects on victim-survivors, and demands the provision of accessible specialist support services.

In the UK, Rape Crisis England & Wales (RCEW), a voluntary third sector organization, is the main provider of specialist SVA services. Understanding the profile of victim-survivors who are referred to RCEW and their referral outcomes is important for the effective allocation of services.

Using administrative data collected by three Rape Crisis Centres in England between April 2016 and March 2020, VISION researchers Annie Bunce, Niels Blom and Estela Capelas Barbosa, used multinomial regression analysis to examine the determinants of victim-survivors’ referral outcomes, controlling for a wide range of potentially confounding variables.

They discovered that support needs, more so than the type of abuse experienced, predicted whether victim-survivors were engaged with services. Particularly, the presence of mental health, substance misuse and social, emotional, and behavioral needs were important for referral outcomes. The referral source also influenced referral outcomes, and there were some differences according to demo-graphic characteristics and socioeconomic factors.

This research was co-produced with stakeholders from RCEW, who informed interpretation of these findings.

For further information please see: Determinants of Referral Outcomes for Victim–Survivors Accessing Specialist Sexual Violence and Abuse Support Services (tandfonline.com)

Or contact Annie at annie.bunce@city.ac.uk  

Photo from licensed Adobe Stock library

Prevalence of sexual violence victimisation amongst mental health service users

Researchers from King’s College London, Anjuli Kaul, Laura Connell-Jones, Sharli Anne Paphitis and Sian Oram (VISION researcher), have published a systematic review and meta-analyses in Social Psychiatry and Psychiatric Epidemiology which provides up-to-date estimates on the prevalence and risk of sexual violence victimisation amongst mental health service users.

This review pooled data from 26 studies encompassing a total of 197,194 participants. Sexual violence included any sexual acts, comments or advances (or attempts at said behaviours) made towards a person without their consent. Mental health service users included any person who had been in contact with a psychiatric inpatient, outpatient, community, perinatal, liaison, addiction, veteran psychiatric inpatient, or forensic mental health service.

The researchers searched 3 electronic databases (Medline, Embase, and PsychINFO) for peer-reviewed publications from their dates of inception until 18th July 2022. There were no restrictions on the geographic location of the included studies.

Key findings

The review found that studies consistently showed a high prevalence of past year and adult lifetime (since the age of 16) sexual violence victimisation in psychiatric service users, with higher rates found in women than men. Additionally, both male and female psychiatric service users were found to have an increased risk of experiencing sexual violence compared to non-psychiatric service users. This was the case regardless of whether the study measured past year or adult lifetime sexual violence or sampled a population of inpatients, outpatients or both.

The meta-analyses revealed high levels of heterogeneity within the data, which was likely partly due to the varied instruments used across studies to measure mental health and sexual violence. Additionally, there was not enough data available to calculate the pooled odds ratio of sexual violence victimisation for male or female psychiatric service users, nor was it possible to adjust odds ratios for known confounders such as age, ethnicity, income level or substance abuse.

The findings emphasise the need for healthcare practitioners to effectively recognise and respond to sexual violence in mental health services, and the need for a comprehensive and consistent measurement framework for sexual violence to enable reliable and comparable prevalence data to be collected.

 For further information please see: Prevalence and risk of sexual violence victimization among mental health service users: a systematic review and meta-analyses | Social Psychiatry and Psychiatric Epidemiology (springer.com)

Or contact Anjuli at anjuli.1.kaul@kcl.ac.uk  

Photo by Priscilla Du Preez 🇨🇦 on Unsplash

VISION/VASC Webinar Series: IPV and the LGBTQI+ communities

This event is in the past.

We are pleased to announce the VISION and Violence & Society Centre (VASC) Webinar Series.

The purpose of the 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.

Our first webinar is Tuesday, 20 February 2024, 1300 – 1350. We welcome Dr Steven Maxwell, Research Associate in the School of Social & Environmental Sustainability and Associate in the School of Health and Wellbeing, at the University of Glasgow.

Steven will present his research on intimate partner violence within the LGBTQI+ communities. He is a former mental health nurse and completed his PhD in Global Public Health at University College London in 2021. Steven’s PhD explored HIV pre-exposure prophylaxis uptake/adherence among men who have sex with men who engaged in sexualised drug use. His current interest is researching health inequities/social justices across minority and deprived populations, particularly sexual & mental health, and related substance use.   

To register for the event in order to receive the Teams invitation and / or if interested in presenting at a future Series, please contact: VISION_Management_Team@city.ac.uk

The VISION/VASC Webinar Series is sponsored by the UK Prevention and Research Partnership consortium, Violence, Health and Society (MR-V049879) and the Violence and Society Centre at City, University of London.

VISION Adolescent Domestic Abuse conference

This event is in the past.

If registered, please enter through the main entrance in the University Building, across from Northampton Square, a green space with a gazebo. There is also a silver sculpture in front of University Building.

Only those that registered will be able to enter the conference room.

To register please see: VISION and VASC Adolescent Domestic Abuse conference

The UK Prevention Research Partnership Violence, Health & Society (VISION) consortium and the Violence and Society Centre at City, University of London, are pleased to announce the Adolescent Domestic Abuse conference.

Thursday 18th April 2024, 10:00 – 17:00 followed by a reception 
Oliver Thompson Lecture Theatre (Tait Bldg), City, University of London, EC1B 0HB 

Adolescent domestic abuse, which includes physical, emotional, and/or sexual abuse that occurs between young people who are, or were, dating, is often overlooked in research, policy and practice. The current definition of domestic abuse leaves those aged under 16 in teenage relationships falling into the gap between child protection procedures and adult-focused domestic abuse policy. 

The conference brings together academics, practitioners, and policy makers to share existing research, policy and practice.

Registration is required and free. This is an in person conference only and catering will be provided. If you cannot attend but would like the slides, please contact the email listed below.

The programme: 

  • 9:30 – 10:00 Registration & refreshments 
  • 10:00 – 10:20 Welcome & setting the scene, Dr Ruth Weir, Violence and Society Centre, City, University of London and Katy Barrow-Grint, Assistant Chief Constable, Thames Valley Police
  • 10:20 – 10:40 Introductory Speaker, Louisa Rolfe OBE, Metropolitan Police and National Police Chief Council lead for Domestic Abuse
  • 10:40 – 11:00 Rapid evidence review on domestic abuse in teenage relationships, Flavia Lamarre, and Dr Ruth Weir, City, University of London
  • 11:00 – 11:30 Learning from the lived experience, SafeLives Changemakers
  • 11:30 – 12:00 Researching abuse within teenage relationships: A critique of a decade’s work and what we could do better, Professor Christine Barter, Co-Director of the Connect Centre for International Research on Interpersonal Violence and Harm, University of Central Lancashire 
  • 12:00 – 13:00 Lunch
  • 13:00 – 14:20 Panel 1: Teenage relationships and abuse: What the research says, chaired by Professor Sally McManus, Director of the Violence and Society Centre and Deputy Director of the VISION research project
  • Panel 1: Step up, Speak Out: Amplifying young people’s voices in understanding and responding to adolescent domestic abuse, Janelle Rabe, Centre for Research into Violence and Abuse, Durham University
  • Panel 1: ‘In practice it can be so much harder’: Young people’s approaches and experiences of supporting friends experiencing domestic abuse, Jen Daw and Sally Steadman South, SafeLives
  • Panel 1: Healthy relationships: children and young people attitudes and influences, Hannah Williams and Sarah Davidge, Women’s Aid
  • Panel 1: Intimate partner femicide against young women, Dr Shilan Caman, Karolinska Institutet, Sweden
  • 14:20 – 14:35 Break
  • 14:35 – 15:35 Panel 2: Sexual violence in teenage relationships, chaired by Katy Barrow-Grint, Thames Valley Police
  • Panel 2: “Always the rule that you can’t say no”: Adolescent women’s experiences of sexual violence in dating relationships – Dr Kirsty McGregor, Loughborough University 
  • Panel 2: Empowering Youth: Addressing Online Pornography and Adolescent Domestic Abuse – Insights from the CONSENT Project – Berta Vall, Elena Lloberas and Jaume Grané, Blanquerna, Barcelona, Spain and The European Network for Work with Perpetrators of Domestic Violence, Berlin, Germany
  • Panel 2: Image-Based Sexual Abuse as a Facet of Domestic Abuse in Young People’s Relationships – Dr Alishya Dhir, Durham University
  • 15:35 – 15:50 Break
  • 15:50 – 16:50 Panel 3: Specialist services and local government, chaired by Dr Olumide Adisa, University of Suffolk
  • Panel 3: The role and value of Early Intervention Workers in supporting children and young people aged 11–18 in a domestic abuse service context – Elaha Walizadeh and Leonor Capelier, Refuge 
  • Panel 3: Prevention, Identification, Intervention and Protection: Learning on teenage domestic abuse from a multi-agency model in the London Borough of Islington – Aisling Barker, Islington Borough Council
  • Panel 3: Tackling adolescent domestic abuse in Lambeth – Rose Parker, Erika Pavely, Ariana Markowitz, and Siofra Peeren, Lambeth Health Inequalities Research and Evaluation Network 
  • 16:50 – 17:00 Closing remarks and next steps
  • 17.00 – onwards Drinks reception, Conference attendees are invited to a drinks reception in the Oliver Thompson foyer

The abstracts

The abstracts and information on the poster presentations and stands are below for downloading.

ADA-abstracts-allDownload

For further information and any questions, please contact VISION at VISION_Management_Team@city.ac.uk

Photo by Tim Mossholder on Unsplash

Making change happen in primary care: the story of IRIS

VISION Director and Professor of Primary Care at the University of Bristol Medical School, Gene Feder, was a keynote speaker at the webinar: Making change happen in primary care – The IRIS story, on 28 November 2023.

With his co-presenter, Medina Johnson, CEO of IRIS, they shared the story of the concept and ambition that led to the beginning of the social enterprise established in 2017 to promote and improve the healthcare response to domestic violence and abuse (DVA).

DVA is a violation of human rights that damages the health of women and families. The health care sector, including primary care, has been slow to respond to the needs of patients affected by DVA, not least because of uncertainty about the effectiveness of training clinicians in identification and engagement with survivors of abuse.

To address that uncertainty, Gene and Medina conducted a cluster-randomised trial in Hackney and Bristol, finding that both identification and referral to specialist DVA services substantially increased in the intervention practices.

In the webinar they mapped the (not always smooth) trajectory from trial results to a nationally available programme commissioned by Integrated Care Boards (ICBs) and local authorities in over 50 areas to date, including getting into guidelines/policy, further implementation research, negotiating with commissioners, and setting up a social enterprise (IRISi) to drive the scaling up of the intervention.

For further information please watch the webinar video below.

For any questions or comments, please contact IRISi at info@irisi.org

Causal discovery for studying sexual abuse and psychotic phenomena

 Dr Giusi Moffa

Sexual abuse and bullying are associated with poor mental health in adulthood. Elucidating putative causal relationships between affective and psychotic symptoms may inform the development of therapies. Causal diagrams can help gain insights, but how?

Given a causal diagram, usually represented as a directed acyclic graph (DAG), and observational data from the variables on the graphs, many analytical methods (especially adjustment techniques) allow us to estimate the effect that intervening on a variable is expected to have on another.

In real-world problems, we rarely have a complete picture of an underlying structural mechanism regulating the relationship among different variables. Causal discovery is a technique leveraging statistics and machine learning tools to uncover plausible causal relationships from data, with little to no prior knowledge of them. While learning causal structures from purely observational data relies on unrealistic assumptions (especially causal sufficiency and faithfulness), a causal discovery exercise may help us identify the most promising scenarios to prioritise when designing interventional studies.

In a recent article, now available open access in Psychological Medicine, Dr Giusi Moffa, Statistician affiliated with the University of Basel, Switzerland and colleagues used state-of-the-art sampling methods for inference of directed acyclic graphs (DAGs) on data from the English Adult Psychiatric Morbidity Surveys, to investigate sexual abuse and psychotic phenomena.

The analysis sought to model the interplay among 20 variables, including being a victim of bullying or sexual abuse and a range of psychotic (e.g. paranoia, hallucinations and depression) and affective symptoms (e.g. worry and mood instability) while accounting for the sex of the participant. To respect temporality, we imposed some prior constraints on the DAG structure: childhood sexual abuse and bullying referred to events that were temporally antecedent to the assessment of the psychological variables, and hence they only admit incoming edges from sex and each other.

Contrary to expectations, the procedure favoured models placing paranoia early in the cascade of relationships, close to the abuse variables and generally upstream of affective symptoms. A possible implication is that paranoia follows from early abuse involving bullying or sexual exploitation as a direct consequence. Overall, the results were consistent with sexual abuse and bullying driving a range of affective symptoms via worry. As such, worry may be a salient target for intervention in psychosis.

Check out the paper for a more thorough discussion of the findings (joint work with Jack Kuipers, Elizabeth Kuipers, Paul Bebbington and VISION member Sally McManus).

This is a repost of a blog available on LinkedIn: https://www.linkedin.com/pulse/causal-discovery-studying-sexual-abuse-psychotic-phenomena-moffa

Paper available open access: https://www.cambridge.org/core/journals/psychological-medicine/article/sexual-abuse-and-psychotic-phenomena-a-directed-acyclic-graph-analysis-of-affective-symptoms-using-english-national-psychiatric-survey-data-erratum/CF603075EBBD5D75E60F327CE01C4050

For further information about the approach: giusi.moffa@unibas.ch