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Upcoming seminar: An overview of VISION systematic reviews on violence 

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:

  1. Insecure migration status increases risk of multiple forms of violence
  2. Measuring the effectiveness of UK support services and interventions for domestic and sexual violence and abuse

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

  1. Decouple immigration enforcement from violence prosecution and victim support
  2. Expand protections for survivors of domestic violence
  3. Strengthen protections for victims of work-related exploitation and improve employer regulations
  4. Address state violence in detention and border contexts
  5. 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:

  1. 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.
  2. 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:

  1. Outcome measures assessing the effectiveness of support interventions and services are varied and inconsistent.
  2. Where consistent measures have been used, meta-analyses demonstrate potential benefits of UK-based advocacy and outreach services, psychological support interventions, and perpetrator programmes.
  3. Studies and evaluations assessing the effectiveness of support interventions and services are often methodologically flawed.
  4. Conflicting demands and lack of sufficient funding make robust testing and evaluation difficult in the third sector, reflecting a circular challenge.
  5. 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

Perpetrators of domestic abuse against older adults: A rapid evidence assessment

Despite increased research on issues related to aging and older age, abuse of older adults (defined as 60 or over in this study) is a neglected area of academic study. Most of the available evidence is currently found within the elder abuse field; although there is no agreed definition of elder abuse, most incorporate abuse by perpetrators outside of the family (such as carers, people in positions of trust and in some cases strangers) meaning evidence on intimate partner and family member perpetrators is subsumed within these studies. Most studies on domestic abuse have paid limited attention to older age, and in many cases restrict the focus to intimate partner violence among young adults.

PhD student, Merili Pullerits at the Violence and Society Centre at City St George’s University of London, collaborated with colleagues Hannah Bows (Durham University), who led the study, and Natalie Quinn-Walker (University of Wolverhampton), to examine the existing, published research on the demographic and health characteristics, and the offending behaviours and histories of perpetrators of domestic violence and abuse against adults aged 60 and over. 

Using a systematic methodology, searches were conducted in five databases: MEDLINE Complete, APA PsychInfo, CINAHL Complete, SociINDEX with Full Text, Criminal Justice Abstracts with Full Text, and Web of Science (Core Collection), resulting in 75 papers being included in the review.

Their rapid review found that much of the available evidence comes from the elder abuse field, with only a fifth of the included studies taking a specific domestic abuse perspective. Because elder abuse studies often group together all abuse types across varied relationship contexts, such studies make  becomes difficult to extract findings on domestic abuse, potentially hiding important differences. Additionally, the review found that non-intimate partners, that is (adult) children or other family members, tend to be the most frequently reported perpetrator group, although this varied according to the design and methodology of the studies. Most perpetrators tend to be male, and, where information is available, poor health, and drug and alcohol problems are often reported.

The research team concluded that more evidence is required on perpetrators of domestic violence and abuse using a broader range of data sources and research methods.

Recommendation

Evidence on those that use domestic violence and abuse on older people should be situated within the conceptual lens of domestic abuse. Policy and practice should urgently review whether existing risk assessment tools and perpetrator programmes are suitable given that a substantial proportion of domestic abuse against older adults is perpetrated by younger sons, daughters or other family members.

To download: Perpetrators of domestic abuse against older adults – a rapid evidence assessment

To cite: Hannah Bows, Merili Pullerits, Natalie Quinn-Walker, Perpetrators of domestic abuse against older adults – a rapid evidence assessment, Aggression and Violent Behavior, Volume 82, 2025, 102056, ISSN 1359-1789, https://doi.org/10.1016/j.avb.2025.102056.

For further information, please contact Hannah at hannah.bows@durham.ac.uk

Funding: This study was funded by a Home Office (Domestic Abuse Perpetrators) grant.

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Challenges for evidence syntheses on homicide in a global context

Data and evidence on violence are a few of the many core elements necessary for prevention. They inform decision-making by policy makers, provide corroboration for claims-makers, and exist as a means of empowerment for advocates and activists. However, evidence required for prevention is currently fragmented across different systems of knowledge production, creating challenges in the form of missing data.

Viewed through the sociology of quantification and knowledge production, VISION Co-Investigator Dr Elizabeth Cook, provides methodological and ethical reflections on conducting a global systematic review of sex/gender-disaggregated homicide data. In doing so, she highlights epistemological and ontological differences that risk becoming obscured in global, comparative work on violence. 

The systematic review she draws on in her critique, Conflating the map with the territory: Challenges for evidence syntheses on homicide in a global context, consisted of a four-step search strategy: electronic database searches, hand searches of statistics, ministry, and police websites, citation tracking, and email survey of statistics offices.

Studies were included if they reported prevalence data on homicide which was sex/gender-disaggregated (by victim/offender relationship, sexual aspects, and/or motivation) by both women and men. From 194 WHO-recognised countries, data were available for just under half (n = 84). However, there were pronounced differences between countries and regions regarding the availability of data.

Evidence syntheses are just one way of trying to make sense of this vast body of evidence in a transnational context. Viewed through sociological work on quantification and epistemic communities, Lizzie has provided reflections on a global systematic review to establish the prevalence of sex/gender disaggregated homicide by country, region, and globally. 

Recommendation

To avoid conflating the ‘map with the territory’ as others argue, moving towards critical knowledge synthesis as a way to build in contestation and to decenter assumptions of objectivity in the global systematic review of sex/gender-disaggregated homicide data.

To download: Conflating the map with the territory: Challenges for evidence syntheses on homicide in a global context

To cite: Cook, E. A. (2025). Conflating the map with the territory: Challenges for evidence syntheses on homicide in a global context. International Sociology, 0(0). https://doi.org/10.1177/02685809251336694

For further information, please contact Lizzie at elizabeth.cook@citystgeorges.ac.uk

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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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Multiple adverse childhood experiences and mental and physical health outcomes in adulthood: New systematic review protocol assessing causality

Research suggests that adverse childhood experiences can have a lasting influence on children’s development that result in poorer health outcomes in adulthood. Like other exposure-outcome relationships, however, there is uncertainty about the extent to which the relationship between adverse childhood experiences and health is causal or attributable to other factors.

The aim of this systematic review is to better understand the nature and extent of the evidence available to infer a causal relationship between adverse childhood experiences and health outcomes in adulthood.

A comprehensive search for articles will be conducted in four databases (Medline, CINAHL, PsycInfo and Web of Science) and Google Scholar. The team, led by Dr Lisa Jones of Liverpool John Moores University, and includes VISION researchers Professor Mark Bellis and Professor Sally McManus, will review studies published since 2014:

  • of adults aged 16 years or over with exposure to adverse childhood experiences before age 16 years from general population samples;
  • that report measures across multiple categories of childhood adversity, including both direct and indirect types; and
  • report outcomes related to disease morbidity and mortality.

To download the protocol: Interpreting evidence on the association between multiple adverse childhood experiences and mental and physical health outcomes in adulthood: protocol for a systematic review assessing causality

To cite: Jones L, Bellis MA, Butler N, et al. Interpreting evidence on the association between multiple adverse childhood experiences and mental and physical health outcomes in adulthood: protocol for a systematic review assessing causality. BMJ Open 2025;15:e091865.  doi: 10.1136/bmjopen-2024-091865

For further information, please contact Lisa at l.jones1@ljmu.ac.uk

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Systematic review: Effectiveness of UK-based adult domestic and sexual violence support interventions and services

Recommendations

  • Further high-quality research into the effectiveness of domestic and sexual violence and abuse (DVSA) interventions and evaluations 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, practitioners and service providers, commissioners, policy makers and researchers will increase consistency in reported outcomes and create the cohesion necessary to develop a robust evidence base to aid understanding of how effective various support services are.

In the United Kingdom, there are a range of support services and interventions for people who have experienced domestic and sexual violence and abuse (DSVA), including refuges, advocacy such as Independent Domestic Violence Advisors (IDVAs), referral, outreach, and helplines. These are often provided by the Voluntary and Community Sector (VCS), although may also be located in the public or private sector. Due to the lack of consensus on outcomes used to assess effectiveness, evidence syntheses in this field have been limited.

Dr Sophie Carlisle led a team of VISION researchers, Dr Annie Bunce, Prof Sally McManus, Dr Estela Capelas Barbosa, Prof Gene Feder, and Dr Natalia V Lewis, and Prof Matthew Prina from Kings College London. They used findings from their scoping review to identify the common reported outcomes, to direct and inform an evidence synthesis on the effectiveness of UK-based interventions and services for DSVA.

The team conducted a systematic review and, where possible, meta-analysis. They searched relevant peer reviewed and grey literature sources. The following were included: randomised controlled trials, non-randomised comparative studies, pre-post studies, and service evaluations of support interventions or services for adults who had experienced or perpetrated DSVA. The intervention typology and selection of outcomes was determined based on co-production with stakeholders from specialist DSVA organisations. The quality of the studies was assessed independently by two reviewers. Where meta-analysis was not possible, the researchers synthesized studies with vote counting based on the direction of effect.

The review demonstrates that there appear to be benefits of UK-based advocacy and outreach services, psychological support interventions, and perpetrator programmes. However, risk of bias and methodological heterogeneity means that there is uncertainty regarding the estimated effects.

A co-produced core-outcome set is needed to develop a more robust evidence base and facilitate future research in this field. Research practices such as publishing of study protocols, following reporting guidelines and, for research where randomisation is not feasible, considering and accounting for potential confounding factors, would greatly improve the quality of research.

To download the paper: Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: a systematic review and meta-analysis – PMC

To cite: Carlisle S, Bunce A, Prina M, McManus S, Barbosa E, Feder G, Lewis NV. Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: a systematic review and meta-analysis. BMC Public Health. 2025 Mar 14;25(1):1003. doi: 10.1186/s12889-025-21891-5. PMID: 40087589; PMCID: PMC11908015.

For further information, please contact Sophie at sophie.carlisle4@nhs.net

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The impact and risk factors of adolescent domestic abuse: A rapid systematic review

As a phenomenon, abusive behavior between adolescents in intimate relationships remains relatively invisible, due in part to the persistent yet unfounded assumption that domestic abuse is something that occurs between adults. There is an emerging body of evidence indicating that both victimization and perpetration in intimate partner relationships can and do occur well before adulthood.

This review seeks to improve understandings of intimate partner abuse between adolescents, focusing in particular on younger adolescents below the age of 16 and the impacts and risk and protective factors.

VISION researchers Dr Ruth Weir, Dr Olumide Adisa and Dr Niels Blom, with their collaborators, conducted a rapid systematic review by searching three electronic databases (PsycInfo, Embase, and Social Sciences Citation Index). The team utilized pre-existing systematic reviews to identify relevant primary studies. Findings of the included studies were described and summarized using narrative synthesis.

Seventy-nine studies were identified for inclusion. Synthesis of the findings of these studies identified five categories of risk and protective factors, including bullying and parental intimate partner violence, social and cultural factors, school and neighborhood environment and health and wellbeing. However, the review also identified a gap of qualitative research and a lack of attention to how ADA intersects with cultural factors, gender differences, criminalization, and poor mental health. Many of the studies report on school-based settings, limiting understanding of the role of neighborhood factors in prevention, protection and recovery. Participatory research on help-seeking behaviors of adolescents is rare.

The review synthesized risk and protective factors associated with ADA, especially those occurring between younger adolescents. It highlighted the complex interplay and overlap between using and experiencing violence and abuse and the need for systematic research to inform the development of advocacy, interventions and prevention that is right for young people.

Highlights from the VISION ADA rapid review: Gaps, limitations & considerations for future research

  • Little recent academic interest on ADA in the UK
  • Focus in existing global literature on physical or sexual violence but less so on coercive control or emotional / psychological abuse
  • Lack of systematic examination of long-term consequences of ADA on wellbeing
  • Lack of intersectional analysis (ethnicity, sexual orientation, socioeconomic status, etc)
  • Little exploration of adolescents’ help-seeking behaviours and attitudes to different kinds of possible support
  • Research design limitations

To download the paper: Adolescent Domestic Abuse and Its Consequences: A Rapid Systematic Review | Journal of Family Violence

To cite: Weir, R., Adisa, O., Blom, N. et al. Adolescent Domestic Abuse and Its Consequences: A Rapid Systematic Review. J Fam Viol (2025). https://doi.org/10.1007/s10896-025-00813-4

For more information on this rapid review, please contact Ruth at ruth.weir@city.ac.uk

To view and / or download the list of systematic reviews included in this paper:

SRs included in Weir ADA journal articleDownload

Further ADA research across the VISION consortium:

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Systems analysis of service coordination in domestic abuse, primary care and child mental health services

The impact of intimate partner violence (IPV) on parental and child mental health is well documented, as is the associated increased use of healthcare services by survivors of IPV. UK policy emphasises the importance of partnership working between health services and domestic abuse agencies, along with clear referral pathways for victims of violence and abuse and co-ordinated local responses. However, in general, current policy and guidance is focused on the response to adult victims with more limited advice as to how this should be operationalised for working with children.

With first author Dr Claire Powell (University College of London), VISION researchers Dr Olumide Adisa and Professor Gene Feder and others explored how services work together to support parents and children experiencing both parental IPV and parental or child mental health problems by drawing on the perspectives of professionals working in primary care, children and young people’s mental health services (CYPMHS), and domestic abuse services.

The team conducted a qualitative study, interviewing professionals in geographically contrasting local authority areas in England. They carried out framework analysis using a systems approach and mapping techniques to understand the service interrelationships and boundary judgements of professionals.

Results showed that

  • The relationships between domestic abuse services, CYPMHS, and primary care were complex, involving funders and commissioners, local authority strategic groups, and wider services such as schools and children’s centres.
  • Participants consistently identified a gap in the relationship between statutory CYPMHS and domestic abuse services.
  • There were mental health service gaps were for children living with ongoing or intermittent IPV and for children and parents with needs falling below or between service thresholds.
  • There was a gap in services for users of abusive behaviour to prevent future IPV.
  • Staff perspectives revealed differing views on treating the effects of trauma, and the co-ordination and sequencing of care.

Improving the response to children and adults experiencing mental health problems in the wake of IPV requires a systems perspective to understand the barriers to service co-ordination. The findings indicate a particular need to address the gap between CYPMHS and domestic abuse services.

To download the paper: Domestic abuse, primary care and child mental health services: A systems analysis of service coordination from professionals’ perspectives – ScienceDirect

To cite the paper:  Claire Powell, Olumide Adisa, Lauren Herlitz, Shivi Bains, Sigrún Eyrúnardóttir Clark, Jessica Deighton, Shabeer Syed, Ruth Gilbert, Gene Feder, Emma Howarth, Domestic abuse, primary care and child mental health services: A systems analysis of service coordination from professionals’ perspectives, Children and Youth Services Review, Volume 169, 2025, 108076, ISSN 0190-7409, https://doi.org/10.1016/j.childyouth.2024.108076

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