Interventions to Improve Responses of Helping Professionals to Intimate Partner Violence: A Systematic Review

Background/Purpose: Various professionals in health care, criminal justice, social service, and religious settings come into contact with battered women. While these professionals’ readiness and competence in identifying and intervening with battered women are critical in ensuring the women’s safety and improving their well-being, professional responses to battered women have not been always consistent and proactive. Despite the increased number of studies of the interventions targeting helping professionals and recent evidence of effectiveness, previous studies of the effectiveness of interventions for helping professionals heavily rely on interventions in the health care settings, ignoring other professionals and organizations that have contact with battered women. Therefore, the purpose of the study is to systematically review the available evidence on effectiveness of interventions to improve the response of various helping professionals and organizations who come into contact with female victims of intimate partner violence. The study also aims to address practice implications regarding the need for evaluation studies in specific practice settings as well as improving the design quality of intervention studies whose target is strengthening the performance of the helping professionals.

Methods: The study implements four steps of study selection process: 1) database selection; 2) keyword search; 3) a title/abstract review; and 4) a full-text review.  PubMed, PsyINFO, CINAHL, Criminal Justice Abstract, ATLA Religion Database, Sociological Abstracts, and Social Service Abstracts were searched from the database start dates to September 2012. A total of 1,477 citations were retrieved during the search. Both authors reviewed all titles and abstracts using established inclusion criteria, and a total of 111 articles matched the inclusion criteria for a full text review. Both authors reviewed these articles independently and selected 52 articles that met the inclusion criteria for review. Both authors independently reviewed these 52 studies using a set of parameters specific to each design developed by the US Preventive Services Task Force.

Results: Approximately 85% of the reviewed studies were conducted in health care settings, with most interventions targeting improvement of health care professionals’ screening, assessment, and identification of intimate partner violence. Lack of intervention studies focusing on organizational capacity-building and/or collaborative response to intimate partner violence was noteworthy. Although most of the studies reported positive effects on at least one outcome measure, only 7 studies were rated as good quality, most of which used a randomized controlled design. Very little high-quality evidence exists to evaluate the effectiveness of interventions for behavioral mediators (i.e., knowledge, attitudes, self-efficacy).

Conclusions and Implications: This review pinpoints the pressing need for more rigorous studies using randomized controlled designs, especially in non-health care settings such as the social service and religious sectors. Similar to the health care settings, non-health care settings should develop preventive policies such as internal regulations and guidelines to promote intervention, prevention and subsequent evaluation efforts regarding intimate partner violence.  Future interventions need to focus on increasing organizational capacity to respond to intimate partner violence in order to create system-wide changes in organizational responses to intimate partner violence.