General practitioners will be trained to spot and respond to domestic violence and abuse in men, women, and children—not just female victims. This matters because current primary care programmes like IRIS focus almost entirely on women experiencing abuse. Men who are victims, men who perpetrate abuse, and children exposed to it are largely missed. The evidence base for what works for these groups is weak, and no integrated programme exists that addresses all family members in one GP setting. If successful, this research could fundamentally change how the NHS responds to domestic violence. Workstream 1 will develop and test IRIS+, an enhanced training and advocacy programme that extends support to male victims and exposed children. Workstream 2 will test a primary-care-linked perpetrator programme aimed at stopping abuse at its source. Both workstreams include cost-effectiveness analysis, so funders will know whether these interventions deliver value for money. The potential impact is a safer, more equitable response to domestic violence across the entire family—reducing harm to victims and holding perpetrators accountable, all from the GP surgery.
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REPROVIDE aim: To increase the safety and well-being of victims of domestic violence and abuse (DVA) and their children Workstream 1 Aim: To improve identification and referral from general practice of female and male patients experiencing or perpetrating DVA and their children. Objectives Study 1: assess the evidence for interventions for men experiencing DVA Study 2: develop integrated training, support, referral and advocacy intervention (IRIS+); including specification of outcome data for men and children exposed to DVA Study 3: evaluate acceptability and utility of IRIS+ intervention to clinicians Study 4: determine effectiveness and cost-effectiveness of IRIS+ vs. current IRIS programme Study 5: understand the perceptions and experiences of IRIS+ trainers and practitioners and the perceived impact of IRIS+ on patients Workstream 2 Aim: To improve outcomes for partners or ex-partners and children of perpetrators of DVA through a primary-care linked domestic violence perpetrator programme (DDVP) Objectives Study 6: Synthesize evidence to identify the DVPP with the greatest likelihood of effectiveness and inform our choice of outcome measures for the trial Study 7: Determine the acceptability and feasibility of the DVPP and trial design Study 8: Determine effectiveness and cost effectiveness of the DVPP Study 9: To understand the perceptions and experiences of participants experiences of the intervention and its context Background and rationale Domestic violence and abuse (DVA) is a major public health and clinical challenge to health services. Previous research has demonstrated that training and support programmes can improve the response of clinicians to women patients experiencing abuse. Training around the needs of men experiencing or perpetrating DVA and exposed children has been piloted, but the DVA advocacy response to male victims needs further development. Primary care-based training for an effective and safe response to all family members experiencing or perpetrating DVA needs to be integrated into one programme and rigorously evaluated. There remains uncertainty about teffectiveness of interventions for patients who disclose perpetration,d espite the ubiquity of perpetrator programmes in the UK, Europe and north America. Research plan Workstream I Study 1: Systematic review of interventions in all settings for male victims of DVA and mapping study of UK programmes Method: systematic review of (a) studies relating to interventions for male victims of DVA (b) reports in grey literature in any UK-based setting; analysis: (a) Narrative review of quantitative studies; qualitative meta-analysis of qualitative studies. (b) mapping and thematic analysis Study 2: Development and data specification of IRIS+ Method: two stage Delphi consensus method with action learning and wider stakeholder group to configure IRIS+; specification of data collection for trial Study 3: Feasibility study of IRIS+ Method: delivery of IRIS+ in four general practices and measurement of clinician attendance, referral and PIMS questionnaire; analysis: feasibility will be judged by attendance, referral and change in PIMS score Study 4: Trial of IRIS+ Method: Cluster randomised trial of 48 general practices randomised to IRIS vs IRIS+. Primary outcomes: number of men having contact with specialist DVA services and number of children identified as exposed to DVA Analysis: Poisson regression model; for cost-effectiveness -Markov model extrapolating from exposure to advocacy to safety and wellbeing outcomes for men, women and children. Study 5: Nested qualitative study of programme implementation Method: focused ethnography; analysis: thematic Workstream II Study 6: Evidence synthesis and intervention development Method: realist review synthesising previous systematic reviews and new studies with views of PPI groups; modified two-stage Delphi to inform adaption of DDVP and choice of outcome measures and
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