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Training GPs remotely during COVID-19: Lessons learned

    There may have been a rise in domestic abuse during the COVID-19 pandemic. At the same time general practice adopted remote working, which extended to training and education being delivered online.

    IRIS (Identification and Referral to Improve Safety) is an example of an evidence-based UK healthcare training support and referral programme, focusing on DVA, which transitioned to remote delivery during the pandemic.

    To understand the adaptations and impact of remote DVA training in IRIS-trained general practices a group of researchers – including VISION members Estela Barbosa and Gene Feder – explored the perspectives of those delivering and receiving training. 

    It was found that remote DVA training in UK general practice widened access to learners. However, it may have reduced learner engagement compared with face-to-face training. DVA training is integral to the partnership between general practice and specialist DVA services, and reduced engagement risks weakening this partnership.

    The researchers recommend a hybrid DVA training model for general practice, including remote information delivery alongside a structured face-to-face element. This has broader relevance for other specialist services providing training and education in primary care.

    For further information please see: Adapting domestic abuse training to remote delivery during the COVID-19 pandemic: perspectives from general practice and support services | British Journal of General Practice (bjgp.org)

    Or contact Estela Barbosa Capelas at estela.barbosa@city.ac.uk

    Disclosing domestic violence on Reddit during the pandemic

      Domestic violence (DV) is a huge social issue and during the COVID-19 pandemic, DV and intimate partner violence (IPV) increased. Frequently imposed quarantine increased contact between perpetrators and victims, potentially leading to underlying increases in the occurrence of violence at home.

      Social media sites such as Reddit represent an alternative outlet for disclosing experiences of violence where healthcare access has been limited. This study analysed seven violence-related subreddits to investigate different violence patterns from January 2018 to February 2022, developing a new perspective and methodology for violence research. Specifically, we collected violence-related texts from Reddit using keyword searching and identified six major types of violence with supervised machine learning classifiers: DV, IPV, physical violence, sexual violence, emotional violence, and nonspecific violence or others. Among IPV-related posts, the number with COVID-related keywords was highest in the middle-pandemic phase.

      The findings highlight the importance of the role of social media as a platform for disclosing and describing experiences of violence and support the role of social media site monitoring as a means of informative surveillance for help-providing authorities and violence research groups.

      For further information please see: Characterizing the Differences in Descriptions of Violence on Reddit During the COVID-19 Pandemic – Lifang Li, Lilly Neubauer, Robert Stewart, Angus Roberts, 2023 (sagepub.com)

      Or contact Lifang at lifang.li@kcl.ac.uk or Angus at angus.roberts@kcl.ac.uk

      Photo by Philipp Katzenberger on Unsplash

      Unlocking violence information from clinical text

        Blog by Dr Lifang Li, Research Associate with UKPRP VISION, Kings College London

        Clinical Record Interactive Search (CRIS)

        In 2008, the Clinical Record Interactive Search (CRIS) system was launched. CRIS removes personal identifiers from the health records of the South London and Maudsley NHS Trust, making them available for use in mental health research. The platform operates under a governance framework that prioritises patient anonymity and places patients at the centre of its operations. The use of exceptionally large volumes of records with unprecedented levels of detail has the potential to revolutionise mental health research. 

        The CRIS Violence application

        The CRIS violence application is computer software that finds clinical text that refers to interpersonal violence, including the presence of violence, patient status (i.e. as perpetrator, witness or victim of violence) and violence type (domestic, physical and/or sexual) using Natural Language Processing (NLP). NLP uses pattern matching and statistical techniques to automatically process natural human language. It was developed by Riley Botelle, Professor Robert Stewart and their colleagues to the identification and classification of experiences of violence in narrative records, described in their 2022 paper “Can natural language processing models extract and classify instances of interpersonal violence in mental healthcare electronic records: an applied evaluative study”. Recently, after a thorough validation process, the CRIS team has started to run the violence application routinely, alongside many other NLP applications (e.g., to find suicidality, agitation, medications, anxiety) that are available for CRIS. Structured output from these, now including various violence-related variables, is saved back into the CRIS database, from where authorised health researchers can access it.  

        How does it serve the researchers and clinicians?

        By accurately identifying the presence of violence, different types of violence, and patient status, the application is enabling researchers to examine how experiences of violence are correlated with various mental health problems, outcomes and treatment trajectories, and how these relate to patients’ characteristics (such and age, gender, and ethnic group), and account for health inequalities.

        Future work

        Given the possibility that psychological abuse and economic abuse may also occur in patients and are recorded in the health record by clinicians, our work as part of the VISION consortium involves updating the current violence application to identify mentions of these, allowing us to extend the violence research possible using CRIS.

        Illustration: Nina Rys / Shutterstock.com