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Purpose We undertake a critical analysis of UK longitudinal and repeated cross-sectional population surveys which ask about experiences of intimate partner violence and abuse (IPVA). Method Seven relevant UK representative population-based surveys which ask about IPVA among adults and/or young people (16-17 years old) were identified. We critically engage with the questionnaires to analyse the strengths and limitations of existing UK data on IPVA. Results Several limitations in UK surveys are identified. Many questions still show a bias, partly historical, towards collecting more data about physical abuse. Few surveys ask about financial abuse, abuse post-separation or through child contact, or through technologies, though improvements are under way. Surveys still seek to count incidents of abuse, instead of enquiring about the impact of abusive behaviours on victims. Ethnicity and other demographic variables are not always adequately captured (or accessible to data users), making it difficult to explore aspects of inequality. Potentially useful comparisons within the UK are difficult to undertake given the increasingly divergent questionnaires used in different UK nations. Conclusions We discuss how future iterations of existing surveys or new surveys can improve with regards to how questions about IPVA are asked. Given that surveys across geographical contexts often suffer similar weaknesses, our findings will be relevant for IPVA survey methodology beyond the UK context., Author(s): Valeria Skafida [sup.1] , Gene Feder [sup.2] , Christine Barter [sup.3] Author Affiliations: (1) grid.4305.2, 0000 0004 1936 7988, Social Policy, School of Social and Political Science, University of [...]

Purpose: Young people (YP) are at greater risk of experiencing intimate partner violence and abuse (IPVA), with high prevalence rates at 18–25 years and potentially severe short and long-term health and social impacts. YP often view adult support services as not for them and more research is needed to understand effective responses to IPVA among different groups. Methods: Semi-structured interviews alongside Life History Calendars were undertaken to explore 18 young peoples' (18–25 years) experiences of community and service level responses to their IPVA between 2019–2020. Thematic analysis and case studies were carried out. Results: Participant accounts commonly described what did or did not help within: education; primary care physicians and maternity services; third sector or non-government support organisations; and counselling and support workers. YP wanted clearer information on identifying abuse from a younger age in schools and better access and signposting to specialist services. They benefited the most from equal power dynamics in relationships with professionals where they were supported to make their own decisions. Conclusions: Professionals in all sectors (including schools) need IPVA trauma-informed training that encourages equal power dynamics, with a clear understanding of and access to referral pathways, to be able to respond to the needs of YP experiencing IPVA. [ABSTRACT FROM AUTHOR]

Domestic violence (DV) is a global prevalent health problem leading to adverse health consequences, yet health systems are often unprepared to address it. This article presents a comparative synthesis of the health system's pre-conditions necessary to enable integration of DV in health services in Brazil, Nepal, Sri Lanka and occupied Palestinian Territories (oPT). A cross-country, comparative analysis was conducted using a health systems readiness framework. Data collection involved multiple data sources, including qualitative interviews with various stakeholders; focus-group discussions with women; structured facility observations; and a survey with providers. Our findings highlight deficiencies in policy and practice that need to be addressed for an effective DV response. Common readiness gaps include unclear and limited guidance on DV, unsupportive leadership coupled with limited training and resources. Most providers felt unprepared, lacked guidance and felt unsupported and unprotected by managers and their health system. While in Brazil most providers felt they should respond to DV cases, many in Sri Lanka preferred not to. Such organizational and service delivery challenges, in turn, also affected how health providers responded to DV cases leaving them not confident, uncertain about their knowledge and unsure about their role. Furthermore, providers' personal beliefs and values on DV and gender norms also impacted their motivation and ability to respond, prompting some to become 'activists' while others were reluctant to intervene and prone to blame women. Our synthesis also pointed to a gap in women's use of health services for DV as they had low trust in providers. Our conceptual framework demonstrates the importance of having clear policies and highlights the need to engage leadership across every level of the system to reframe challenges and strengthen routine practices. Future research should also determine the ways in which women's understanding and needs related to DV help-seeking are addressed. [ABSTRACT FROM AUTHOR]

Background: People with severe and multiple disadvantage (SMD) who experience combinations of homelessness, substance misuse, violence, abuse, and poor mental health have high health needs and poor access to primary care. Aim: To improve access to general practice for people with SMD by facilitating collaborative service improvement meetings between healthcare staff, people with lived experience of SMD, and those who support them; participants were then interviewed about this work. Design and setting: The Bridging Gaps group is a collaboration between healthcare staff, researchers, women with lived experience of SMD, and a charity that supports them in a UK city. A project was co-produced by the Bridging Gaps group to improve access to general practice for people with SMD, which was further developed with three inner-city general practices. Method: Nine service improvement meetings were facilitated at three general practices, and six of these were formally observed. Nine practice staff and four women with lived experience of SMD were interviewed. Three women with lived experience of SMD and one staff member who supports them participated in a focus group. Data were analysed inductively and deductively using thematic analysis. Results: By providing time and funding opportunities to motivated general practice staff and involving participants with lived experience of SMD, service changes were made in an effort to improve access for people with SMD. These included prioritising patients on an inclusion patient list with more flexible access, providing continuity for patients via a care coordinator and micro-team of clinicians, and developing an information-sharing document. The process and outcomes improved connections within and between general practices, support organisations, and people with SMD. Conclusion: The co-designed strategies described in this study could be adapted locally and evaluated in other areas. Investing in this focused way of working may improve accessibility to health care, health equity, and staff wellbeing. [ABSTRACT FROM AUTHOR]