Making the links between domestic violence and child protection: Developing evidence-based training for general practice clinicians

Objectives: Children’s exposure to domestic violence is a challenge to child protection. We need mechanisms for linking them in policy and practice in healthcare settings. The RESPONDS (Researching Education to Strengthen... [ view full abstract ]

Objectives: Children’s exposure to domestic violence is a challenge to child protection. We need mechanisms for linking them in policy and practice in healthcare settings. The RESPONDS (Researching Education to Strengthen Primary care ON Domestic violence and Safeguarding) study aimed to establish an evidence base for development of training on both domestic violence and child protection for primary care clinicians, and a pilot training intervention.
Methods: The study involved four methods to develop the evidence base for the training intervention: 1) a systematic review of training interventions for improving professional responses to children affected by domestic violence; 2) a content mapping of 22 current training programmes in England; 3) interviews with 42 primary care practitioners,12 practice nurses and 15 practice managers regarding responses to domestic violence in families; 4) a two-stage consensus process with 28 multi-professional stakeholders.
Results: The review identified 21 studies showing positive improvements from training with experiential and post-training sessions. However, content mapping found current training had limited mention of domestic violence. Interviews indicated that primary care professionals do not connect child protection and domestic violence in ways that create safety for children and adults, lack institutional knowledge, interagency trust and self-confidence. There was uncertainty and confusion surrounding recording domestic violence cases in families’ medical records. The findings informed development of the RESPONDS training pilot, designed to encourage clinicians to overcome barriers and engage more extensively with patients experiencing domestic violence, while also responding directly to the needs of children.
Conclusion: An evidence-based RESPONDS training pilot was developed for primary care to provide effective and safe responses for all family members experiencing or perpetrating domestic violence and their children: delivered by local social workers and domestic violence advocates, integrating child protection and domestic violence knowledge and skills, to build confidence and competence, involving interactive and experiential elements.