Search

Background We evaluated whether faecal immunochemical testing (FIT) can rule out colorectal cancer (CRC) among patients presenting with ‘high-risk’ symptoms requiring definitive investigation. Methods Three thousand five hundred and ninety-six symptomatic patients referred to the standard urgent CRC pathway were recruited in a multi-centre observational study. They completed FIT in addition to standard investigations. CRC miss rate (percentage of CRC cases with low quantitative faecal haemoglobin [f-Hb] measurement) and specificity (percentage of patients without cancer with low f-Hb) were calculated. We also provided an updated literature review. Results Ninety patients had CRC. At f-Hb Discussion FIT alone as a triage tool would miss an estimated 1 in 8 cases in our study (1 in 14 from meta-analysis), while many people without CRC could avoid investigations. FIT can focus secondary care diagnostic capacity on patients most at risk of CRC, but more work on safety netting is required before incorporating FIT triage into the urgent diagnostic pathway.

This is a reflexive account of the messiness experienced by a Persian-Australian doctoral researcher interviewing social work and human service practitioners and people seeking asylum in Germany. This data collection was part of a cross-national comparative study of the impacts of policy on the experiences and perceptions of people seeking asylum and social work and human service practitioners in Bavaria and Western Australia. Through interview stories and the work of others, this article offers a first person account of the complexities, ambiguities and dilemmas that can occur before, during and after data collection, how these were navigated through the use of Finlay's (2012) five lenses for the reflexive interviewer, and some of the lessons learnt.

Family violence may be experienced at any stage of the lifespan; however, these experiences are often understood differently based on the age of the victim and who perpetrates the abuse. The significance of age is evident in the three categories of child abuse, domestic and family violence (DFV), and elder abuse. Each of these categories has its own definition which determines who is considered a victim or a perpetrator, and the behaviors counted as violent and abusive. These definitions influence how practitioners view victim-survivors’ experiences of violence, and the subsequent available responses. This article reports the findings of a scoping review of international literature published between 2011 and 2021, which explored how family violence is categorized and defined. The review was conducted as part of a larger study exploring how violence against women in intimate and family contexts is conceptualized and experienced, as well as the available responses. Forty-eight articles were included in the final review, and five categories of violence in family and intimate contexts were identified. These were child abuse, DFV, elder abuse, adolescent-to-parent violence, and sibling abuse. Comparison of definitions across categories found similarities in terms of the relationship between victim and perpetrator, behavior, intention, and harm caused to the victim. Review findings suggest that definitions of various forms of family violence do not differ greatly. Further research is needed to determine whether responses to family violence across the lifespan can and should be streamlined.

This article explores the findings of a qualitative study comparing social work and human service practice with people who have sought asylum in Germany and Australia. Globally social workers are c...

IntroductionIn the UK, the National Cancer Plan (2000) requires every cancer patient’s care to be reviewed by a multidisciplinary team (MDT). Since the introduction of these guidelines, MDTs have faced escalating demands with increasing numbers and complexity of cases. The COVID-19 pandemic has presented MDTs with the challenge of running MDT meetings virtually rather than face-to-face.This study aims to explore how the change from face-to-face to virtual MDT meetings during the COVID-19 pandemic may have impacted the effectiveness of decision-making in cancer MDT meetings and to make recommendations to improve future cancer MDT working based on the findings.Methods and analysisA mixed-methods study with three parallel phases:Semistructured remote qualitative interviews with ≤40 cancer MDT members.A national cross-sectional online survey of cancer MDT members in England, using a validated questionnaire with both multiple-choice and free-text questions.Live observations of ≥6 virtual/hybrid cancer MDT meetings at four NHS Trusts.Participants will be recruited from Cancer Alliances in England. Data collection tools have been developed in consultation with stakeholders, based on a conceptual framework devised from decision-making models and MDT guidelines. Quantitative data will be summarised descriptively, and χ2tests run to explore associations. Qualitative data will be analysed using applied thematic analysis. Using a convergent design, mixed-methods data will be triangulated guided by the conceptual framework.The study has been approved by NHS Research Ethics Committee (London—Hampstead) (22/HRA/0177). The results will be shared through peer-reviewed journals and academic conferences. A report summarising key findings will be used to develop a resource pack for MDTs to translate learnings from this study into improved effectiveness of virtual MDT meetings.The study has been registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/D2NHW).

PurposePrevious studies have pointed the need for more research, which explores how peer provision brings about change associated with recovery. This study aims to test Leamy’s framework, which consists of five recovery processes: connectedness, hope, identity, meaning and empowerment (also known as the CHIME framework) within the peer provision context.Design/methodology/approachThis mixed-methods study was completed in two stages. A total of 13 face-to-face interviews were conducted with peers and the transcripts were analysed thematically. A short online questionnaire was completed by 12 peers and analysed with both descriptive statistics and thematic analysis.FindingsThe participants spoke about the value of peer providers (PPs) in building connectedness, fostering hope and optimism, growing identity, enhancing meaning and empowerment (CHIME). However, their connectedness was hindered by external circumstances and the intrapersonal capacities of their PP.Practical implicationsThe CHIME framework was useful in highlighting stages in which peers moved through their recovery and its corresponding PP involvement. PPs were also found to promote motivation, which was a key driver in their peers’ recoveries. Further research is needed to test frameworks that account for wider systemic issues and the role PPs play in enhancing motivation.Originality/valueThis study has identified the usefulness of the CHIME framework in describing peer provision. It contributes to our understanding of how peer provision can promote recovery in persons with mental health challenges. It lays the groundwork for future research into examining the role of peer provision in recovery and its distinctiveness from other forms of mental health support.

Background Developing robust evidence is a challenge for researchers working with disadvantaged or vulnerable populations. For example, research shows that young people who have transitioned from out-of-home care (OOHC) to independent adulthood often experience poor long-term outcomes. However, evidence for the aetiology of those outcomes is weak due to methodological limitations such as small sample sizes and a lack of longitudinal data. This paper details the protocol for Navigating Through Life, a study that utilises novel research methods to better understand the pathways and outcomes of young people as they leave OOHC in Western Australia (WA). Methods Navigating Through Life is a longitudinal, mixed methods, population-based study. A prospective longitudinal study of young people aged 15–25 years will follow participants’ experiences and outcomes over a two-year period. Quantitative and qualitative data is being collected from participants five times over 2 years, using standardised outcome measures and individual interviews. Outcome measures focus on key dimensions of young people’s lives (e.g., social inclusion, well-being, resilience, self-determination). Interviews examine important influences and the variable contexts into which young people have transitioned from care. In addition, retrospective population-level data for young people transitioning from OOHC will be obtained from linked Western Australian government administrative records. Using a multitude of data sources, analysis will map pathways and outcomes of young people with care experience, and comparisons will be made with other population groups within WA. Discussion Navigating Through Life exemplifies a novel utilisation of multiple data sources to research outcomes for vulnerable and difficult to reach populations, and offers insights for other complex mixed-methods longitudinal studies. Results will provide new and more comprehensive data about specific pathways that may be influential to a range of post-care outcomes. Findings will extend evidence to inform better service-delivery models that improve outcomes and reduce disparities for vulnerable young people.

This article reports on mixed methods research into intimate partner violence (IPV) and women’s mental health. Using an online national survey and life history interviews, quantitative and qualitative data analysis demonstrates how IPV negatively impacts women’s sense of self, with other multiple losses in relation to income, work, housing, and social participation further undermining recovery into the long term. The feminist concept of sexual politics is used to critically examine current responses to mental health problems after IPV, and a feminist-informed response is outlined that addresses the gender inequalities underpinning IPV and the psychological distress it produces. Refereed/Peer-reviewed

This exploratory study aimed to understand the complexities and particularities of social service practices with men who use intimate partner violence in rural areas. Ten rural service providers in...

With a record number of people reported to be forcibly displaced worldwide and an increasingly anti-asylum policy environment in Global North host nations, it is critical to examine social work and human services with people seeking asylum and people with refugee status. This scoping review sought to identify and review the existing qualitative research on such practice from the perspectives of social work and human service practitioners, people seeking asylum and people with refugee status and clients in Global North host nations. The review presents the key findings and trends emerging from twenty publications and identifies areas for future research to further develop knowledge of this field of practice as there is a dearth of research on this topic. Through thematic analysis of very different publications, it was found that Global North host nations have varying forms of restrictive policy and dominant anti-asylum discourses. This and other factors result in many potential areas for improvement of social work and human services. The findings include recommendations for more inclusive and compassionate policy, person-centred and strength-based practice approaches, and further qualitative research with people seeking asylum.

Preventing and reducing domestic violence is a national and international social priority. Civil law protection orders (POs) have been the primary legal response to domestic violence internationally for a number of decades. However, evidence of their effectiveness is mixed due to variations in application within and across countries and variable quality of the research with most studies at high risk of bias. The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of POs in reducing violation rates of domestic violence, compare violation rates reported by victims and police reports, and identify factors that influence violation and reoffense. Two electronic databases were searched; two independent researchers screened abstracts. Data were collected and assessed methodologically, using the Kmet Checklist Appraisal Tool and National Health and Medical Research Council Hierarchy of Evidence. Twenty-five studies that evaluated the effectiveness of POs in reducing recidivism in domestic violence met the eligibility criteria. Meta-analyses of weighted means of violation in the studies were conducted. Violation rates were found to be higher for victim reports compared with police reports. Violation rates were reduced when POs used in combination with arrests. PO violation rates were lower among perpetrators without histories of arrest for committing violence, perpetrators not engaging in stalking, and where couples have had medium to high incomes. There is no consensus among the studies about what the most appropriate methodology is to measure PO effectiveness. Future research should establish a more unified approach to evaluating the effectiveness and violations of POs.

Economic abuse as a form of men’s violence against women has only been recently recognized as a form of violence in its own right. It is known to further exacerbate the detrimental long-term impacts of domestic and family violence on women and children. There is evidence to suggest the effectiveness of financial literacy programs in mitigating some of these impacts and improving women’s financial well-being in the longer term; however, there are very few domestic violence–informed, empirically evaluated programs internationally. This article reports the findings of a specialist domestic violence financial literacy curriculum, which was developed and piloted in Western Australia using pre–post measures and focus groups. These findings suggest that such financial literacy programs delivered in refuge settings have effective short-term outcomes among women. Lessons learned from the pilot and the implications for future implementation and scaling up of programs and research are also discussed.

Discretionary judgment is a necessary and desirable attribute of child protection practice and decision-making. Increasingly, approaches towards accountability in child protection services act to constrain the use of practitioner discretionary judgement through ever increasing layers of standardisation and technical-rational approaches to practice. This situation is at odds with the need for professionals to adaptively respond to practice environments that are characterised by uncertainty and complexity. At the same time, there are known weakness and problems that are reported in the decision-making literature, begging questions about how to best support and evaluate for effective and accountable discretion and decision-making across a whole system. In this paper discretion is conceptualised as a structural and epistemic phenomena that is constrained and restricted under the weight of standardisation. A five-part conceptual framework for a systems approach to policy evaluation is presented, and it is argued that this framework would support the capacity for effective discretionary judgement and decision-making to emerge as a property of the system overall. This paper is a theoretical and conceptual argument for a systemic policy evaluation framework that is supportive of discretionary judgment and decision-making in child protection systems shifting the emphasis away from technical-rational compliance.

Purpose In recent years, the employment of peer providers (PPs) has grown with the wider acceptance of lived experience expertise in recovery-oriented service provision. Although its effectiveness, theoretical foundations and factors influencing outcomes have been studied, a framework accounting for the dynamics of the PP–peer relationship has yet to be formulated. The purpose of this paper is to employ a qualitative approach to explore the journeys undertaken by PPs with their peers and form it into a cohesive framework of understanding. Design/methodology/approach In-depth interviews were conducted with PPs who were employed specifically to use their lived experience in supporting someone through mental distress. These interviews were recorded, transcribed and coded using a framework approach. To enhance rigour, this framework was verified with the latter author and three other participants recruited after data analysis. Findings A stepped model of peer provision practice was crafted to capture the non-linearity of recovery, as well as the PP–peer relationship. This model is founded upon trust in the milieu of shared experience and involves: creating a safe place – a stage of building trust and rapport to a point where a PP is given permission to enter into their peer’s headspace; a working partnership – stage of setting and working towards goals collaboratively; and stepping out – a stage marked by the termination of the PP–peer relationship. Originality/value This paper proposes a tangible framework underpinning the dynamics of peer provision practice, which furthers our understanding and complements current practice models in peer provision services.

BackgroundNational targets for timely diagnosis and management of a potential cancer are driven in part by the perceived risk of disease progression during avoidable delays. However, it is unclear to what extent time-to-treatment impacts prognosis for patients with non-small cell lung cancer, with previous reviews reporting mixed or apparently paradoxical associations. This systematic review focuses on potential confounders in order to identify particular patient groups which may benefit most from timely delivery of care.MethodsMedline, EMBASE and Cochrane databases were searched for publications between January 2012 and October 2020, correlating timeliness in secondary care pathways to patient outcomes. The protocol is registered with PROSPERO (the International Prospective Register of Systematic Reviews; ID 99239). Prespecified factors (demographics, performance status, histology, stage and treatment) are examined through narrative synthesis.ResultsThirty-seven articles were included. All but two were observational. Timely care was generally associated with a worse prognosis in those with advanced stage disease (6/8 studies) but with better outcomes for patients with early-stage disease treated surgically (9/12 studies). In one study, patients with squamous cell carcinoma referred for stereotactic ablative radiotherapy benefited more from timely care, compared with patients with adenocarcinoma. One randomised controlled trial supported timeliness as being advantageous in those with stage I–IIIA disease.ConclusionThere are limitations to the available evidence, but observed trends suggest timeliness to be of particular importance in surgical candidates. In more advanced disease, survival trends are likely outweighed by symptom burden, performance status or clinical urgency dictating timeliness of treatment.

PurposeOver the past decade, the push for recovery-oriented services has birthed a growth in the recruitment of peer providers in mental health services: Persons who live with and manage their mental health challenges and are employed to support persons currently using mental health services. The aim of this paper is to compare the responses of government and non-government organisations to the implementation of peer provision.Design/methodology/approachEmploying a qualitative study design, 15 people who supervised peer providers or who were strategically involved in peer provision were recruited using snowball sampling. Participants completed an in-depth interview that explored how peer provision services operated at their organisation and factors that shaped the way peer provision operates. The interviews were transcribed and analysed using Moore's Strategic Triangle. Synthesised member checking and researcher triangulation ensued to establish trustworthiness.FindingsThe way in which peer provision operated sat along a continuum ranging from adoption (where practices are shaped by the recovery ethos) to co-option (where recovery work may be undertaken, but not shaped by the recovery ethos). Political and legal mandates that affected the operational capacities of each organisation shaped the way peer provision services operated.Research limitations/implicationsThe findings of the study highlight the need to reconsider where peer provision services fit in the mental health system. Research investigating the value of peer provision services may attract the support of funders, service users and policy makers alike.Originality/valueIn employing Moore's strategic triangle to evaluate the alignment of policy (theauthorising environment) with theoperational capacityand practice of peer provision services (thetask environment), this study found that organisational response to peer provision is largely influenced by political and legal mandates externally. The successful implementation of peer provision is mediated by effective supervision of peer providers.

Objectives: To evaluate whether quantitative measurement of faecal haemoglobin (f-Hb) using faecal immunochemical testing (FIT) can be used to rule out colorectal cancer (CRC) for patients who present to primary care with high risk symptoms defined by national guidelines for urgent referral for suspected cancer (NICE NG12). Design: Prospective cohort study carried out between April 2017 and March 2019. Setting: 59 GP practices in London and 24 hospitals in England. Participants: Symptomatic patients in England referred to the urgent CRC pathway who provided a faecal sample for FIT in addition to standard investigations for cancer. Main outcome measures: CRC was confirmed by established clinical and histopathology procedures. f-Hb (microgr per gram of stool) was measured in a central laboratory blinded to cancer outcome. We calculated sensitivity (percentage of patients with CRC who have f-Hb exceeding specified cut-offs); false-positive rate [FPR] (percentage of patients without CRC whose f-Hb exceeds the same cut-offs); and positive predictive value [PPV] (percentage of all patients with f-Hb above the cut-offs who have CRC). Results: 4676 patients were recruited of whom 3596 patients were included (had a valid FIT test and a known definitive diagnosis). Among the 3596, median age was 67 years, 53% were female and 78% had colonoscopy. 90 patients were diagnosed with CRC, 7 with other cancers, and 3499 with no cancer found. f-Hb did not correlate with age, sex or ethnicity. Using f-Hb greater than or equal to 4 microgr/g (lowest limit of detection), sensitivity, FPR and PPV were 87.8%, 27.0% and 7.7% respectively. Using f-Hb greater than or equal to 10 microgr/g, the corresponding measures were 83.3%, 19.9% and 9.7%. 15 patients with CRC had f-Hb below 10 microgr/g. If FIT had been used at thresholds of 10 microg/gr or 4 microgr/g, 1 in 6 or 1 in 8 patients with cancer respectively would have been missed. If the absence of anaemia or abdominal pain is used alongside f-Hb 10 microgr/g, only 1 in 18 cancers would be missed but 56% of people without CRC could potentially avoid further investigations including colonoscopies. Conclusions: In our study, if FIT alone had been used to determine urgent referral for patients with high risk symptoms for definitive cancer investigation, some patients with bowel cancer would not have been diagnosed. If used in conjunction with clinical features, particularly in the absence of anaemia, the efficacy of FIT is significantly improved. With appropriate safety netting, FIT could be used to focus secondary care diagnostic capacity on patients most at risk of CRC.

Domestic and family violence is a key area of concern for all professionals who work with families, with recent years seeing an expansion in the availability of intervention programs for men who perpetrate violence against women and children. This paper considers current approaches to the regulation of professional practice in this area, providing information about the changing context in which interventions are offered. The purpose of the paper is to encourage ongoing discussion about the setting of men's behaviour change program standards of practice in Australasia and to identify some key issues that require consideration.

The predominant perception of intimate partner violence (IPV) as constituting physical violence can still dominate, particularly in research and media reports, despite research documenting multiple forms of IPV including sexual violence occurring between intimate partners and various forms of psychological and emotional abuse. One frequently hidden or “invisible” form of abuse perpetrated within intimate partner relationships is economic abuse, also referred to as financial abuse in much of the literature. While the links between gendered economic insecurity and economic abuse are emerging, there remains a lack of consistency about definitions within the United States and globally, as there is no agreed upon index with which to measure economic abuse. As such, the purpose of this article is to review and analyze the global literature focused on either economic or financial abuse to determine how it is defined and what measures are used to capture its prevalence and impact. The 46 peer-reviewed articles that met all inclusion criteria for analysis came from a range of countries across six continents. Our review found that there is growing clarity and consistency of terminologies being used in these articles and found some consistency in the use of validated measures. Since this research is in its “infancy,” we need to have stronger collaborative efforts to use similar measures and terminology. Part of that collaborative effort is to consider how language and cultural differences may play a part in our understanding of economic abuse.

This chapter examines how the sexual politics of domestic violence gives rise to stigma and shame, eroding women's confidence and trust in others. The analysis presented here therefore makes a new contribution to knowledge about how intimate partner violence interrupts and changes women's social relationships and affiliations in ways that have lasting effects on the capacity to exercise citizenship. In common with findings in relation to employment, housing, and mental health, this chapter shows that women do not regain the levels of social engagement they had prior to intimate partner violence, and that the nature of social participation is also changed by intimate partner violence in ways that are not wholly negative. It explores how intimate partner violence affects women's participatory citizenship and the interconnections with its impact on the three other key life domains. This chapter also examines how women rebuild the social relationships and connections in their lives.

This chapter argues that sexual politics is present in all aspects of our lives, including gendered violence, the state, and citizenship. It adds that sexual politics opens up new possibilities for understanding the persistent effects of domestic violence by shifting attention to the politics of gender relations. This shift away from the binary category of gender as men/women to the active and relational dynamics of sexual politics undercuts assumptions that gendered violence is natural or inevitable, or that violence is only caused by individuals. Sexual politics has material and discursive effects and offers an understanding of how the gendered dynamics of domestic violence and its long-term consequences have remained largely hidden from view. This chapter argues that the persistence of violence against women is implicated in the sexual politics of citizenship and the state. Hence, the challenge of violence against women is recognised as an issue for the state, citizenship, and society.

This chapter is devoted to questions about why intimate partner violence is understood in terms of its psychological impact on individual women. It suggests alternative ways that the serious psychological and emotional impact of intimate partner violence might be understood and addressed so that policy and practice may be more beneficial. The notion of coercive control has become an important explanatory concept, exposing how intimate partner violence is almost always experienced as repeated, patterned violence, intimidation, isolation, and fear. This chapter shows how gendered discourses, practices, and power relations that are embedded in domestic violence erode women's sense of themselves as persons, and hence their capabilities to exercise their citizenship.

The challenge of violence against women should be recognised as an issue for the state, citizenship, and the whole community. This book examines how responses by the state sanction violence against women and shape a woman's citizenship long after she has escaped from a violent partner. Drawing from a long-term study of women's lives in Australia, including before and after a relationship with a violent partner, it investigates the effects of intimate partner violence on aspects of everyday life including housing, employment, mental health, and social participation. The book contributes to theoretical explanations of violence against women by reframing it through the lens of sexual politics. Finally, it offers critical insights for the development of social policy and practice.

This chapter returns to the topics broached in the previous chapters and considers the progress made so far. It shows how there have been achievements in many countries in terms of housing, law reform, policy development, and the provision of support services for women leaving intimate partner violence. But, while these developments are important and could go some way towards improving the safety of women and their children, this chapter argues that not all state responses are sufficiently informed about the nature of the gender inequalities that enable violence, nor of the specific impact of intimate partner violence. It points to areas where state responses to intimate partner violence must improve in order to build women's capabilities to exercise full citizenship. After all, male-dominated sexual politics continues to locate intimate partner violence as an issue of the private sphere while, at the same time, claiming that gender equality has been won anyway and is therefore irrelevant.

This chapter is focused on the challenges of researching gendered violence. Here, the chapter presents the empirical foundation and design of a large-scale national study conducted across Australia; which included a major survey, in-depth interviews, and constructed life histories. This chapter also considers some of the challenges faced when conducting and participating in gendered violence research in the context of the politics of ignorance and sexual politics. Given the risks that can flow from participating in and conducting research into gendered violence, it was particularly vital that the study was tightly conceptualised and methodologically sound, so that the benefits of participation by contributing to the development of new knowledge clearly outweighed any risks. The research study outlined here aimed to reveal the breadth and interconnected nature of the impact of intimate partner violence on women's citizenship as part of challenging wilful ignorance about violence and its relationship to gender inequality. As such, this research was an inherently political project that involved balancing a number of key considerations.

This chapter draws together theoretical perspectives in developing an argument about gendered violence and women's citizenship. It suggests that the state's role in securing, enabling, and maintaining the rights of citizens plays an important part in how violence is perpetrated and challenged. The apparent failure of the state to protect women as citizens from persistent violence is examined, with particular attention to the sexual politics of power and violence and the interconnections of material conditions, discourses, and subjectivities in the everyday life of the citizen. The chapter proposes that the persistence of domestic violence is implicated in the sexual politics of citizenship. In addition, the discursive impact of a politics of ignorance serves to deny or obscure how women's inequality, materially and discursively, is produced and reproduced in everyday life.

This chapter is about how living the connected effects of violence situates the argument that domestic violence reverberates across women's lives and erodes their citizenship. A data analysis here reveals the effects of intimate partner violence on the material, emotional, and social aspects of women's lives and how such violence disrupts and restricts their combined capabilities to participate in everyday life, very often for lengthy periods. The chapter offers insights into how women's experiences are shaped by a range of factors, such as state legislation and policy, the resilience or hostility of their own families and communities, and the availability of opportunities to gain and maintain employment. It reveals that women who have experienced violence rarely regain their place on their original life course. The quality of their housing, employment, mental health, and social participation is generally diminished.

This chapter shows that feminists themselves have struggled with the obstacles created by the fitful and damaging politics of ignorance that help to sustain gender inequality. Whether unequal gender relations are merely natural, or whether men's identity depends on maintaining their dominant position as patriarch of the family by necessary force, or whether somehow women's psychology or childhood socialisation leads them to attract abusive men into their lives, or whether women need to learn how to manage their violent partner for the sake of the marriage, the children or their relationship with god are all questions that feminists have needed to work through. And, the chapter argues, this work must continue. The discursive effects of a politics of ignorance about violence against women have an impact on women as much as on men, and on our social and political understanding of violence as much as on social institutions and the state.

Intimate partner violence (IPV) is an extreme example of gender inequality that compromises women’s citizenship. This article discusses the effects of IPV on women’s housing circumstances based on the findings of a large national Australian survey. The analysis found that IPV erodes women’s citizenship, which includes their access to safe and affordable housing, connections to “home,” and participation in community life. Drawing on notions of gendered citizenship, this article provides new understandings about how women negotiate housing as a key dimension of citizenship in the context of IPV. Refereed/Peer-reviewed

PurposeThe purpose of this paper is to assess the applicability of relational contract theory in situations where government departments contract with non‐government welfare organisations to deliver human service programmes. Its limits are highlighted by an assessment of programmes for domestically violent men that epitomise “management of incomplete contracts” central to the theory.Design/methodology/approachThe paper is based on an evaluation of contracted‐out programmes for perpetrators of domestic violence in Australia that set out to compare and contrast distinct models of service delivery by documenting programme logic, service delivery effectiveness and effects on programme participants. It reflects on the difficulties of monitoring such programmes and considers the implications of this for contracting theory and for human service practice.FindingsIn contrast to critiques of contracting‐out in a neo‐liberal environment that emphasise how accountability and reporting requirements limit the autonomy of contracted agencies, this paper highlights considerable variation in how programmes were managed and delivered despite standardised service delivery contracts developed by the government department funding the programmes. This leads to a consideration of “incomplete contracts” where service delivery outcomes are hard to measure or there is limited knowledge of the contracted agencies by the contracting government department.Originality/valueThe paper highlights a situation in which the recommendations of relational contracting theory can exacerbate the difficulties of quality assurance rather than minimise them. It then argues a need for workforce development in the government departments and the contracted agencies, to enable a nuanced monitoring of the programmes' service delivery and promotion of quality assurance processes.

The growing significance of domestic violence programs run by the state and contracted nongovernment agencies in Australia over the past decade has not been matched by a commensurate growth in evaluation of those programs. A number of evaluations have been conducted, but only a few have been long-term and large-scale, due to funding and other constraints. The promotion of evidence-based practice and policy encourages practitioners and scholars to aim for comprehensive and systematic review of initiatives, but achieving that is no mean feat since both the service delivery and governance of these programs are often complex and multi-stranded.In this article we reflect on theoretical and practical issues of evaluation by reporting on the experience of undertaking an evaluation of domestic violence perpetrator and victim support programs delivered for an Australian state government by contracted community service agencies. The experience was not as we had expected on the basis of social policy debates. In this situation, there were difficulties in generating sufficiently robust data on offenders in group programs that delayed and limited the scope of a quasi-experimental assessment of intervention, although that strand continues to date. At the same time, however, this strengthened the importance of evaluating service delivery and governance issues within a ‘realist evaluation’ paradigm. Since contemporary domestic violence programs often typically combine coordinated support for women and children and behaviour change intervention with offenders, evaluation needs multi-stranded approaches that may draw on paradigms more commonly thought of as being in tension.

Homelessness is often conceptualised as an urban problem. However, significant numbers of people experiencing homelessness live in regional, rural and remote areas, where distances can be considerable and there are fewer housing options and services available to assist them. Drawing on the perspectives of service providers, this paper discusses contested understandings of home and homelessness as well as housing and service provision in two remote Western Australian mining towns. The key findings were that normative policy definitions of homelessness that focused on 'living in a house' as a 'home' were not always culturally relevant for local Aboriginal communities, and there was limited access to adequate housing options in both communities. Furthermore, 'top down' funding and decisions often occurred without community consultation, which fragmented service delivery, limited 'grassroots' participation and constrained opportunities for locally relevant service responses. These findings highlight Westernised and urban assumptions underpinning the policy domain in which housing and homelessness responses are determined, emphasising the limits of current conceptualisations for Aboriginal people and service providers working in remote areas Refereed/Peer-reviewed

In this article we report on the research findings from our exploratory study examining connections between Australian responses to two important social issues: domestic violence and employment. Although international literature particularly from North America, comprehensively addresses the connections between domestic violence and employment, there is a paucity of Australian research on this topic. Intrigued by this as both practitioners and researchers, we sought to discover whether the problems, solutions and conclusions addressed internationally were relevant to an Australian context. The result was a unique contribution to Australian knowledge and practice where we demonstrate the applicability of some aspects of North American approaches to Australia and document innovative local practices in the field. In this article we argue for a more comprehensive approach in responses to the connections between domestic violence and employment as an alternative pathway out of poverty for women affected by domestic violence.