Training healthcare providers to respond to intimate partner violence against women

This new review assessed the effectiveness of training programmes that seek to improve healthcare providers’ identification of and response to intimate partner violence (IPV) against women, compared to no intervention, wait list, placebo or training as usual.

The review authors included 19 studies involving 1662 participants: 12 studies compared IPV training with no training, and seven compared IPV training with training as usual or a sub-component of the intervention (or both). Three-quarters of all studies were conducted in the USA, with single studies from Australia, Iran, Mexico, Turkey and the Netherlands. Studies varied greatly in terms of content and delivery method. Most studies received some university or government support to complete the research.

Results

IPV training compared to no intervention, wait list or placebo

Within 12 months post-intervention, IPV training:

  • may improve HCPs’ attitudes towards IPV survivors (standardised mean difference (SMD) 0.71, 95% CI 0.39 to 1.03; 8 studies, 641 participants; low-certainty evidence);
  • may have a large effect on HCPs’ self-perceived readiness to respond to IPV survivors, although the evidence was uncertain (SMD 2.44, 95% CI 1.51 to 3.37; 6 studies, 487 participants; very low-certainty evidence);
  • may have a large effect on HCPs’ knowledge of IPV, although the evidence is uncertain (SMD 6.56, 95% CI 2.49 to 10.63; 3 studies, 239 participants; very low-certainty evidence);
  • may make little to no difference to HCPs’ referral practices of women to support agencies (although this is based on very low certainty evidence from one study of 49 clinics);
  • has an uncertain effect on HCPs’ response behaviours (based on very low-certainty evidence from two studies); and
  • may improve identification of IPV at six months post-training (one study, 54 participants).

No study assessed the impact of training HCPs on the mental health of women survivors.

IPV training compared to training as usual or a sub-component of the intervention or both

In general, there were no differences between the groups in terms of HCPs’ attitudes, safety planning, and referral to services or mental health outcomes; and inconsistent evidence about provider readiness to respond, their actual response, and changes in IPV knowledge.

No adverse IPV-related events were reported in any of the studies included in the review.

The evidence is current to June 2020.

Conclusions

The review authors concluded that the evidence broadly supports IPV training for HCPs. However, they also note that the overall certainty of the evidence is low to very low, with confidence in the findings reduced by substantial heterogeneity across studies and unclear risk of bias around randomisation and blinding of participants. The sustained effect of training on these outcomes beyond 12 months is undetermined. Better quality research is needed to assess the impact of content and different modes of delivering training on providers’ capacity to respond effectively to survivors of IPV.

 Read the full review here on the Cochrane Library.