Applications of Theories of Change to Address Behaviors Among Those Who Have Engaged in Intimate Partner Violence: A Scoping Review

Background: Understanding mechanisms of behavior change is important to optimize interventions. Health behavior interventions designed based on theories that describe pathways of behavioral change tend to have more efficacious outcomes. Notably, the efficacy of interventions that address IPV perpetration is mixed. Many programs that aim to address adult IPV perpetration apply explanatory theories (i.e., how IPV occurs) to intervention design. However, little is known about how interventions that address IPV perpetration apply theories of change (i.e., specific pathways of behavior change in the context of IPV). Hence, the review aims to provide a landscape of how interventions designed to mitigate adult IPV perpetration apply theories of change (TOC) to intervention design, delivery, and outcome evaluation methods.

Method: We applied the scoping review guidance developed by the Joanna Briggs Institute (Peters et al., 2017) as a methodological framework. The review included studies examining outcomes of interventions specifically designed to mitigate IPV perpetration among adults (≥18 years). All included studies described how a TOC was applied in their intervention and/or methodology. All included studies captured the outcome of program participation but were not limited to experimental or quasi-experimental designs to capture various outcome operationalizations. All publications were in English, but not limited to the US, as IPV is a global phenomenon. There were no limitations on the year of publication or publication type. A wide-net search strategy was implemented across APA PsychNet, CINAHL, Medline PubMed, Social Science Citation Index, and Web of Science. Each syntax was developed and narrowed using an iterative approach. Backward and forward searches were also conducted using other published reviews examining IPV perpetration. Each study was reviewed by at least two authors. Data from the included studies were extracted and synthesized.

Results: A total of 7786 unique studies were identified. After full-text review, 61 studies and 36 unique interventions were included. Approximately 42% of the interventions applied multiple TOCs to intervention design. Others (38%) used one TOC, and some (20%) developed their own; hence, not all studies named a specific theory but described their change mechanisms. While the studies described how TOCs influenced program design, only a few (21%) measured the constructs within TOCs, limiting the ability to test whether behavioral changes were due to specific mechanisms of change related to their TOCs. Lastly, a typology of TOC-based interventions emerged as an organizing framework from examining the intervention design and variation in facilitator attributes independent of IPV perpetration characteristics. Interventions were 1.) clinical/therapeutic, 2.) non-clinical, 3.) community (public health-oriented), or 4.) legal system-oriented.

Conclusions and Implications: Future studies should investigate the "black box" of interventions, i.e., how specific intervention components impact (and do not impact) outcomes to optimize efficiency and efficacy. There are also important implications. The typology of TOC-based interventions could help communities identify interventions that best fit their population, their ideological beliefs about IPV, and available resources. Furthermore, our typology of TOC-based interventions maps onto existing typologies describing IPV risk factors (e.g., Capaldi et al., 2012), indicating a critically important match between explanatory theories and TOCs.