Feder et al (2011, UK)25 2 urban primary care trusts | 24 practices System-based intervention: IRIS program | 24 practices No IRIS program |
Interactive multidisciplinary DV training Template in the EMRs linked to common diagnosis in DV patients DV cards Simplified referral to DV advocate
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No. of referrals of women in the EMRs to DV agencies Identification of DV patients in EMRs Referral of women registered in practices in study Measurement of clinician preparation, knowledge, and self-reported practices with regard to DV
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No. of referrals to DV agencies recorded in EMRs in the intervention practices was 21 times larger than that recorded in the control practices (adjusted intervention rate ratio = 22:1) DV disclosures in intervention practices were 641 vs 236 in control practices (adjusted intervention rate ratio = 3:1) The program was cost-effective Advocacy was recognized as essential No adverse events reported
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Lo Fo Wong et al (2006, Netherlands)26 Family practices | 38 FG discussions about DV and DV training | 17 No DV training |
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| Full training produced significant improvement in IPV detection (rate ratio = 4.54).
Comparison of the FG-only intervention with the control group resulted in a rate ratio of 2.20 Comparison of the full-training and FG-only groups resulted in a rate ratio of 2.19 Comparison of the full-training group with both untrained groups for awareness of partner abuse in case of non-obvious signs resulted in an OR of 5.92
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Coonrod et al (2000, US)27 Residents (multiple programs) | 53 Brief video and role-playing about DV | 49 No DV education |
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Self-reported diagnosis of a case of DV between the intervention and the follow-up 9–12 mo after the intervention Knowledge change was assessed via 5 true-false questions, administered before and after the intervention
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Intervention residents were 35% more likely than control residents to diagnose DV (RR = 1.35; 95% CI 0.96 to 1.90) but the result was not significant Significant improvement in knowledge was noted among intervention residents (P = .002)
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Thompson et al (2000, US)28 Multidisciplinary teams from 5 primary care clinics | 91 System-based intervention based on behaviour change model | 88 No system-based intervention for DV |
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Providers’ KAB Provider ratings of intervention components at 8–9 mo DV case finding at visits for injury, depression, chronic pelvic pain, or physical examination Assessment of management plans for victims
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Improved provider KAB outcomes up to 21 mo after program initiation and improved process of care (asking) outcomes at 9 mo Overall DV case finding increased by 30% (OR = 1.3; not statistically significant) Documented asking about DV was increased by 14.3% with a 3.9-fold relative increase at 9 mo in intervention clinics compared with control clinics Recorded quality of DV patient assistance did not change
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Haist et al (2007, US)29 Internal medicine residents | 14 Interactive DV workshop (2 h) using SPs | 13 Chronic pain workshop |
DV workshop discussion about DV background, signs of abuse, methods of screening for DV, elements of a safety plan, and state law requiring reporting
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Insinuated SPs with DV case scenarios were not identified more frequently by DV workshop residents than by chronic pain workshop residents: 16 of 25 (64%) vs 13 of 23 (56%) (P = .86, OR = 1.12, 95% CI 0.35 to 3.59) Residents in the intervention group recorded ≥ 75% higher scores on the checklist than residents in the control group did (P = .036, OR = 5.90, 95% CI 1.12 to 31.2) There was no significant difference in the rate of identification of DV in SPs programmed with DV scenarios by residents completing DV workshops compared with those completing workshops on chronic pain (64% vs 56%, P = .86, OR = 1.12, 95% CI 0.35 to 3.59)
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Harris et al (2002, US)30 Practising physicians in Kansas | 50 Online CME | 49 No online CME |
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There was a mean increase (17.8%) in the self-efficacy domain score for the intervention group versus a decrease (0.6%) in the control group (P < .001) Significant changes in 5 other domain scores No evaluation of physicians’ actual behaviour Long-term changes in knowledge and attitudes were not assessed
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Brienza et al (2005, US)31 University-based internal medicine residents | 22 residents DV training workshop | 22 residents DV training workshop and women’s shelter experience |
All residents participated in a 90-min IPV workshop that included didactic learning, videos, and role-playing Intervention residents received shelter experience (visiting a local women’s safe shelter, and attending a weekly meeting of IPV survivors)
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Intervention residents had a significantly greater improvement in the knowledge subscale (P = .04) No significant differences between intervention and control groups for change in the skill, attitude, and resource awareness composite subscales (P = .3, P = .9, and P = .8, respectively) Intervention residents self-reported more screening for IPV in women with “red-flag” presentations but this did not achieve statistical significance
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Campbell et al (2001, US)32 12 hospital EDs in Pennsylvania and California | 330 System-based intervention | 319 No system-based intervention |
2-d training and planning program Multidisciplinary team training approach (physician, nurse, social worker, administrator, and local DV advocate)
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Change in ED culture about IPV Change in ED personnel knowledge of IPV and attitudes toward victims of DV Rate of identification of victims of DV and prevalence of IPV Patient satisfaction
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The intervention EDs had significantly higher summary scores on all components of the culture criteria (P = .04) The intervention hospitals scored significantly higher than the control hospitals on a staff knowledge and attitude measure (P = .019) There was no significant difference in the rates of identifying victims of DV (P = .52) Patient satisfaction: intervention hospitals scored significantly higher (P < .001) after the intervention
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Short et al (2006, US)33 Community physicians in different specialties | 44 Asynchronous online IPV teaching program (4 h of CME) | 37 No online IPV teaching program |
Multimedia, interactive clinical cases Audio, video, and text-based materials
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Online IPV CME program produced a substantial improvement in 8 of 10 KAB outcomes during the study period Opinion scale related to alcohol or drugs and IPV did not significantly change (P = .445) Self-reported IPV management practices (behaviour) following the program were not assessed
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