Ethical Considerations in Conducting Family Violence Research

There is a lack of procedure in the UK guiding social researchers faced with ethical questions. In particular, investigators concerned with family violence and its effects on children face some of the most complex ethical dilemmas in social research and there is a need for greater transparency of ethical procedures. This paper summarizes some key ethical principles guiding social research focused on children, and the decisions that researchers face when conducting studies in the area of child maltreatment or domestic violence. A case example of a study conducted in Dublin, Ireland is used to illustrate difficulties surrounding decisions of informed consent, confidentiality and disclosure, distress and danger, and questioning children directly about their experiences of family violence. The advice of the ethics committee and the solutions agreed by the research team are shared. While the study was subject to a review by an independent ethics committee, in the absence of nationally-recognized or agreed guidelines, good ethical practice is largely dependent upon the moral judgments of the research team. It is hoped that by providing one such case example, others might be encouraged to report on their own ethical protocols and procedures

The relative contribution of family conflict to children’s health and development

Conflict is an inherent part of human relationships and is ubiquitous within families. These disputes are not in themselves harmful to children. Rather, it is the strategies used to resolve conflict that have a bearing on children’s health and development, notably whether family members employ aggressive or violent tactics. The study examines evidence from a sample of 161 children, selected to be representative of children living in Dublin, Ireland. It explores children’s responses to different methods of conflict resolution in two family relationships and seeks to expand the understanding of how social problems, such as child maltreatment and domestic violence, occur within normative family processes. The study shows that the use of psychological and minor physical aggression to resolve conflict in the parental relationship and the parent-child relationship is typical. It occurs in 90 per cent of families over a twelve-month period. Severe physical force or violence between family members is less common. The study finds that while there is considerable variation in children’s responses to conflict resolution strategies, children who experience aggression in both the inter-parental and parent-child relationship are at elevated risk for behavioural and emotional problems. The frequency and severity of the aggression explains some of the variance in child well-being but not all. The study lends support to Bronfrenbrenner’s (1979) ecological theory by demonstrating empirically how the individual, family, neighbourhood, and potentially societal, contexts moderate the transmission of poor conflict resolution strategies to children's health and development. The findings suggest that while the child's age and gender play a small role, family and neighbourhood contexts are strongly implicated in outcomes for children exposed to risky conflict resolution tactics in the home. In particular, parental mental health problems, low socio-economic status and poor peer relationships increase children’s vulnerability to the effects of aggressive conflict tactics. The relevance of the evidence for policy and practice are drawn out. A distinction can be drawn between responses to pathological behaviour by parents and normative, yet harmful, conflict resolution strategies. Public health approaches to promote reasoning within families as well as prevention and early intervention strategies that support all families, not just economically disadvantaged parents known to child protection and domestic violence agencies, are required. In addition, greater sensitivity to children's gender and stage of development and more attention to policies that reduce stress on families and violence within communities are advocated.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Building Effective Responses: An Independent Review of Violence against Women, Domestic Abuse and Sexual Violence Services in Wales

Independent researchers from the Connect Centre for International Research on Interpersonal Violence based in the School of Social Work at the University of Central Lancashire were commissioned by the Welsh Government in 2013 to conduct research into violence against women, domestic abuse and sexual violence services in Wales. The research aimed to inform the forthcoming Ending Violence Against Women and Domestic Abuse (Wales) Bill, implementation of the legislation and future policy more generally, as well as informing future funding decisions. The remit of the review covers: Domestic abuse, including that experienced in Lesbian, Gay, Bisexual and Transgender (LGBT) relationships and elder abuse. Violence against women, including female genital mutilation (FGM), forced marriage and honour-based violence. Sexual violence including rape, sexual assault and harassment Sexual exploitation including prostitution and trafficking1 for sexual purposes. Services for women and men who are victims or perpetrators of violence against women, domestic abuse or sexual violence. The review does not encompass criminal justice services or housing services and, with the exception of prevention work, services for children and young people in Wales were also excluded from this study

The impact of three evidence-based programmes delivered in public systems in Birmingham, UK

The Birmingham Brighter Futures strategy was informed by epidemiological data on child well-being and evidence on “what works,” and included the implementation and evaluation of three evidence-based programmes in regular children’s services systems, as well as an integrated prospective cost-effectiveness analysis (reported elsewhere). A randomised controlled trial (RCT) of the Incredible Years BASIC parenting programme involved 161 children aged three and four at risk of a social-emotional or behavioural disorder. An RCT of the universal PATHS social-emotional learning curriculum involved children aged four–six years in 56 primary schools. An RCT of the Level 4 Group Triple-P parenting programme involved parents of 146 children aged four–nine years with potential social-emotional or behavioural disorders. All three studies used validated standardised measures. Both parenting programme trials used parentcompleted measures of child and parenting behaviour. The school-based trial used teacher reports of children’s behaviour, emotions, and social competence. Incredible Years yielded reductions in negative parenting behaviours among parents, reductions in child behaviour problems, and improvements in children’s relationships. In the PATHS trial, modest improvements in emotional health and behavioural development after one year disappeared by the end of year two. There were no effects for Triple-P. Much can be learned from the strengths and limitations of the Birmingham experience

Incredible Years parenting programme: cost-effectiveness and implementation

Purpose – There is growing interest in the economic evaluation of public health prevention initiatives and increasing government awareness of the societal costs of conduct disorder in early childhood. The purpose of this paper is to investigate the cost-effectiveness of the Incredible Years (IY) BASIC parenting programme compared with a six-month waiting list control. Design/methodology/approach – Cost-effectiveness analysis alongside a pragmatic randomised controlled trial of a group-parenting programme. The primary outcome measure was the Strengths and Difficulties Questionnaire (SDQ), a measure of child behaviour. Findings – The IY programme was found to have a high probability of being cost-effective, shifting an additional 23 per cent of children from above the clinical concern to below the cut-off on the SDQ compared to the control group, at a cost ranging from £1612-£2418 per child, depending on the number of children in the group. Originality/value – The positive findings of this study have led to ongoing implementation of the IY programme and is therefore an example of commitment to evidence-based service provision and investment in prevention initiatives

The Effectiveness of the KiVa Bullying Prevention Program in Wales, UK: Results from a Pragmatic Cluster Randomized Controlled Trial

AbstractThe study evaluated the implementation fidelity and effectiveness of KiVa, an evidence-based program that aims to prevent and address bullying in schools, with a particular emphasis on changing the role of bystanders. The study was a two-arm waitlist control cluster randomized controlled trial in which 22 primary schools (clusters) (N = 3214 students aged 7–11) were allocated using a 1:1 ratio to intervention (KiVa; 11 clusters, n = 1588 students) and a waitlist control (usual school provision; 11 clusters, n = 1892 children)). The trial statistician (but not schools or researchers) remained blind to allocation status. The outcomes were as follows: student-reported victimization (primary outcome) and bullying perpetration; teacher-reported child behavior and emotional well-being; and school absenteeism (administrative records). Implementation fidelity was measured using teacher-completed online records (for class lessons) and independent researcher observations (for school-wide elements). Outcome analyses involved 11 intervention schools (n = 1578 children) and 10 control schools (n = 1636 children). There was no statistically significant effect on the primary outcome of child-reported victimization (adjusted intervention/control OR 0.76; 95% CI 0.55 to 1.06; p = 0.11) or on the secondary outcomes. The impact on victimization was not moderated by child gender, age, or victimization status at baseline. Lesson adherence was good but exposure (lesson length) was lower than the recommended amount, and there was considerable variability in the implementation of whole school elements. The trial found insufficient evidence to conclude that KiVa had an effect on the primary outcome. A larger trial of KiVa in the UK is warranted, however, with attention to issues regarding implementation fidelity. Trial registration: Current Controlled Trials ISRCTN23999021 Date 10-6-13</jats:p

Predictors of Mother and Infant Emergency Department Attendance and Admission: A Prospective Observational Study

Objective To explore the predictors of emergency department attendance and admission for mothers and their infants. Methods Self-reported emergency department (ED) attendance and admission, sociodemographic, mental health, and other measures were recorded at baseline and at 12 months at 4 sites in England between May 2017 and March 2020. Results Infants’ gestational age (OR 0.73, 95% CI 0.61 to 0.88, p = 0.001), mothers’ mental health (OR 2.40, 95% CI 1.30 to 4.41, p = 0.005) and mothers’ attendance at ED (OR 2.34, 95% CI 1.13 to 4.84, p = 0.022) predicted infant ED attendance. Frequency of attendance was predicted by ED site (IRR 0.46, 95% CI 0.29 to 0.73, p = 0.001) and mothers’ age (IRR 0.96, 95% CI 0.92 to 1.00, p = 0.028). Infant hospital admissions were predominantly for respiratory (40%) and other infectious diseases (21%) and were predicted by previous health problems (OR 3.25, 95% CI 1.76 to 6.01, p < 0.001). Mothers’ ED attendance was predicted by mixed or multiple ethnic origin (OR 9.62, 95% CI 2.19 to 42.27, p = 0.003), having a male infant (OR 2.08, 95% CI 1.03 to 4.20, p = 0.042), and previous hospitalisation (OR 4.15, 95% CI 1.81 to 9.56, p = 0.001). Hospital admission was largely for reproductive health issues (61%) with frequency predicted by having attended the ED at least once (IRR 3.39, 95% CI 1.66 to 6.93, p = 0.001), and being anxious or depressed (IRR 3.10, 95% CI 1.14 to 8.45, p = 0.027). Conclusions for Practice Improving the reproductive and mental health of mothers may help to avoid poor maternal and infant health outcomes and reduce emergency service utilisation and hospitalisation

Barriers and facilitators in the delivery of a proportionate universal parenting program model (E-SEE Steps) in community family services

Background A proportionate universal (PU) approach to early years’ service provision has been advocated to improve children’s health and development and to reduce health inequality, by ensuring that services provide timely and high-quality parenting support commensurate with need. Process-oriented research is critical to examine the factors that contribute to, or hinder, the effective delivery/implementation of such a model in community-based family services. This study aimed to assess the delivery, acceptability and feasibility of a new PU parenting intervention model (called E-SEE Steps), using the Incredible Years® (IY) parent program, when delivered by trained health/family service staff in three “steps”—one universal step (the IY Babies Book), and two targeted steps (group-based IY Infant and Toddler programs). Methods An embedded mixed-methods process evaluation within a pragmatic parallel two-arm, assessor blinded, randomized controlled trial was conducted in community services in four local authorities in England. The process evaluation used qualitative data gathered via interviews and focus groups with intervention arm parents who were offered the targeted steps (n = 29), practitioners (n = 50), service managers (n = 7) and IY program mentors (n = 3). This was supplemented by quantitative data collected using group leader pre-training (n = 50) and post-delivery (n = 39) questionnaires, and research notes of service design decisions. Results The E-SEE Steps model was acceptable to most parents, particularly when it was accompanied by engagement strategies that supported attendance, such as providing childcare. Practitioners also highlighted the positive development opportunities provided by the IY training and supervision. However, participant views did not support the provision of the IY Babies book as a standalone universal component, and there were barriers to eligible parents—particularly those with low mood—taking up the targeted programs. Service providers struggled to align the PU model with their commissioned service contracts and with their staff capacity to engage appropriate parents, including tackling common barriers to attendance. Conclusions Despite general enthusiasm and support for delivering high-quality parenting programs in community services in the England, several barriers exist to successfully delivering IY in a proportionate universal model within current services/systems