Anna Dowrick

University of Oxford

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Gene Feder

University of Bristol

Chris Griffiths

Queen Mary University of London

Estela Capelas Barbosa

University of Bristol

Cecilia Vindrola‐Padros

University College London

Medina Johnson

University of Bristol

Georgina Singleton

University College London

Eszter Szilassy

University of Bristol

Elizabeth Emsley

University of Bristol

Tanvi Rai

University of Oxford

Alex Hardip Sohal

Universidad de Londres

Cooperative Institutions

University College London

University of Oxford

Queen Mary University of London

University of Bristol

Primary Health Care

University of Manchester

Universidad de Londres

National Institute for Health Research

Manchester Academic Health Science Centre

City, University of London

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Additional file 1: of Improving the healthcare response to domestic violence and abuse in primary care: protocol for a mixed method evaluation of the implementation of a complex intervention

Figshare (2018)

Alex Hardip Sohal Gene Feder Estela Capelas Barbosa Lee Beresford Anna Dowrick

IRIS publicity materials supplied. (ZIP 1802 kb)

10.6084/m9.figshare.6933350

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Citations (0)

Feasibility of a reconfigured domestic violence and abuse training and support intervention responding to affected women, men, children and young people through primary care

Research Square (Research Square) (2023)

Eszter Szilassy Caroline Coope Elizabeth Emsley Emma Williamson Estela Capelas Barbosa

Abstract Background Identification in UK general practice of women affected by domestic violence and abuse (DVA) is increasing, but men and children/young people (CYP) are rarely identified and referred for specialist support. To address this gap, we collaborated with IRISi (UK social enterprise) to strengthen elements of the IRIS+ intervention which included the identification of men, direct engagement with CYP, and improved guidance on responding to information received from other agencies. IRIS+ was an adaptation of the national IRIS (Identification and Referral to Improve Safety) model focused on the needs of female victim-survivorsof DVA. Without diminishing the responses to women, IRIS+ also responded to the needs of men experiencing or perpetrating DVA, and CYP living with DVA and/or experiencing it in their own relationships. Our study tested the feasibility of the adapted IRIS+ intervention in England and Wales between 2019-21. Methods We used mixed method analysis to triangulate data from various sources (pre/post intervention questionnaires with primary care clinicians; data extracted from medical records and DVA agencies; semi-structured interviews with clinicians, service providers and referred adults and children) to assess the feasibility and acceptability of the IRIS+ intervention. Results The rate of referral for women doubled (21.6/year/practice) from the rate (9.29/year/practice) in the original IRIS trial. The intervention also enabled identification and direct referral of CYP (15% of total referrals) and men (mostly survivors, 11% of total referrals). Despite an increase in self-reported clinician preparedness to respond to all patient groups, the intervention generated a low number of male perpetrator referrals (2% of all referrals). GPs were the principal patient referrers. Over two-thirds of referred women and CYP and almost half of all referred men were directly supported by the service. Many CYP also received IRIS+ support indirectly, via the referred parents. Men and CYP supported by IRIS+ reported improved physical and mental health, wellbeing, and confidence. Conclusions Although the study showed acceptability and feasibility, there remains uncertainty about the effectiveness, cost-effectiveness, and scalability of IRIS+. Building on the success of this feasibility study, the next step should be trialling the effectiveness of IRIS+ implementation to inform service implementation decisions.

Preparedness

Brief intervention

10.21203/rs.3.rs-2832326/v1

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Citations (1)

How should we do racially just research? Learning from a qualitative study on COVID-19 pandemic experiences in the UK

Deleted Journal (2024)

Tanvi Rai Anna Dowrick Kaveri Qureshi Heather M. Munro C. Wild

Racialised social inequalities were exposed and exacerbated during the COVID-19 pandemic. The methods health researchers employ in designing and conducting research can replicate the same inequalities, with important implications for the creation of new knowledge. In this paper, we retrospectively and critically analyse the thinking and methods we employed during two qualitative studies about the diverse experiences of people and families during the COVID-19 pandemic in the UK. Set within a wider literature on engaging with race and ethnicity in health research, we present an analysis based on reflexive accounts and testimonies from researchers, and close-up examinations of different stages of the research. By illustrating these ideological, practical and interactional components of research, including some uncomfortable reflections, we hope to encourage more open conversations among researchers and research funders. Through this process, we can strengthen efforts that dismantle unhelpful historical research orthodoxies and move towards re-formulating ways of research practice that are more explicitly anti-racist and inclusive.

Reflexivity

Pandemic

2019-20 coronavirus outbreak

10.55016/ojs/jcph.v1i2.77774

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Adapting domestic abuse training to remote delivery during the COVID-19 pandemic: a qualitative study of views from general practice and support services

British Journal of General Practice (2023)

Elizabeth Emsley Eszter Szilassy Anna Dowrick Sharon Dixon Anna De Simoni

Background Identifying and responding to patients affected by domestic violence and abuse (DVA) is vital in primary care. There may have been a rise in the reporting of DVA cases during the COVID-19 pandemic and associated lockdown measures. Concurrently general practice adopted remote working that extended to training and education. IRIS (Identification and Referral to Improve Safety) is an example of an evidence-based UK healthcare training support and referral programme, focusing on DVA. IRIS transitioned to remote delivery during the pandemic. Aim To understand the adaptations and impact of remote DVA training in IRIS-trained general practices by exploring perspectives of those delivering and receiving training. Design and setting Qualitative interviews and observation of remote training of general practice teams in England were undertaken. Method Semi-structured interviews were conducted with 21 participants (three practice managers, three reception and administrative staff, eight general practice clinicians, and seven specialist DVA staff), alongside observation of eight remote training sessions. Analysis was conducted using a framework approach. Results Remote DVA training in UK general practice widened access to learners. However, it may have reduced learner engagement compared with face-to-face training and may challenge safeguarding of remote learners who are domestic abuse survivors. DVA training is integral to the partnership between general practice and specialist DVA services, and reduced engagement risks weakening this partnership. Conclusion The authors recommend a hybrid DVA training model for general practice, including remote information delivery alongside a structured face-to-face element. This has broader relevance for other specialist services providing training and education in primary care.

Safeguarding

Pandemic

10.3399/bjgp.2022.0570

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Negotiating un/sanitary citizenship: the reception of UK government COVID-19 public health messaging by racialised people highly exposed to infection

Anthropology and Medicine (2024)

Anna Dowrick Kaveri Qureshi Tanvi Rai

Governments across the world differently invoked citizen responsibility for responding to the risk of COVID-19 infection. Approaches which focused on changing social practices served to reinforce distinctions between 'sanitary' and 'unsanitary' citizenship. This paper examines citizens' responses to public health policy messaging, exploring as a case study the reception of UK Government messaging about responsible behaviour during the first two years of the COVID-19 pandemic. We examine the public responses to such messaging from narrative interviews with 43 people who became ill with COVID-19. These interviews were with people who identified as members of the minoritised religious and racialised groups, who were most heavily burdened by the impact of COVID-19. Interviewees challenged assumptions that they were 'irresponsible' for having caught COVID-19, and instead directed attention towards the ways in which pandemic guidance was unworkable. Some actively critiqued government messaging, questioning the problematic racialisation of pandemic messaging and challenging individual responsibilisation for the management of the pandemic. Through this analysis we demonstrate the active role of citizens in enacting, and at times resisting, health policy.

2019-20 coronavirus outbreak

Pandemic

10.1080/13648470.2023.2274710

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Citations (3)

Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice

BJPsych Open (2020)

Norha Vera San Juan David Aceituno Nehla Djellouli Kirsi Sumray Nina Regenold

Background Substantial evidence has highlighted the importance of considering the mental health of healthcare workers during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of well-being and the evidence base behind such guidelines remain unclear. Aims The aims of the study are to assess the applicability of well-being guidelines in practice, identify unaddressed healthcare workers’ needs and provide recommendations for supporting front-line staff during the current and future pandemics. Method This paper discusses the findings of a qualitative study based on interviews with front-line healthcare workers in the UK ( n = 33), and examines them in relation to a rapid review of well-being guidelines developed in response to the COVID-19 pandemic ( n = 14). Results The guidelines placed greater emphasis on individual mental health and psychological support, whereas healthcare workers placed greater emphasis on structural conditions at work, responsibilities outside the hospital and the invaluable support of the community. The well-being support interventions proposed in the guidelines did not always respond to the lived experiences of staff, as some reported not being able to participate in these interventions because of understaffing, exhaustion or clashing schedules. Conclusions Healthcare workers expressed well-being needs that aligned with socio-ecological conceptualisations of well-being related to quality of life. This approach to well-being has been highlighted in literature on support of healthcare workers in previous health emergencies, but it has not been monitored during this pandemic. Well-being guidelines should explore the needs of healthcare workers, and contextual characteristics affecting the implementation of recommendations.

Pandemic

Front line

Well-Being

10.1192/bjo.2020.148

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Citations (115)

Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care

BMC Psychiatry (2014)

Karina Lovell Jonathan Lamb Linda Gask Peter Bower Waquas Waheed

Psychological therapy is effective for symptoms of mental distress, but many groups with high levels of mental distress face significant barriers in terms of access to care, as current interventions may not be sensitive to their needs or their understanding of mental health. There is a need to develop forms of psychological therapy that are acceptable to these groups, feasible to deliver in routine settings, and clinically and cost effective. We developed a culturally sensitive wellbeing intervention with individual, group and sign-posting elements, and tested its feasibility and acceptability for patients from ethnic minorities and older people in an exploratory randomised trial. We recruited 57 patients (57% of our target) from 4 disadvantaged localities in the NW of England. The results of the exploratory trial suggest that the group receiving the wellbeing interventions improved compared to the group receiving usual care. For elders, the largest effects were on CORE-OM and PHQ-9. For ethnic minority patients, the largest effect was on PHQ-9. Qualitative data suggested that patients found the intervention acceptable, both in terms of content and delivery. This exploratory trial provides some evidence of the efficacy and acceptability of a wellbeing intervention for older and ethnic minority groups experiencing anxiety and depression, although challenges in recruitment and engagement remain. Evidence from our exploratory study of wellbeing interventions should inform new substantive trial designs. Current controlled trials ISRCTN68572159

Disadvantaged

Exploratory research

Patient Health Questionnaire

10.1186/s12888-014-0217-8

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Citations (48)

Domestic violence: Safe and compassionate consultations

InnovAiT Education and inspiration for general practice (2018)

Anna Dowrick Alex Hardip Sohal Moira Kelly Chris Griffiths Gene Feder

Up to a third of women presenting to their GP have experienced domestic violence and abuse (DVA) in either a current or past relationship. It is associated with a wide range of commonly seen medical symptoms. Clinicians sometimes lack confidence in asking about abuse, due to concerns about time, patient safety, how to respond appropriately, and limited knowledge of support services. Addressing DVA can lead to significant improvements in patient health and well-being, as well as rewarding consultations for practitioners. Drawing on research with GPs and patients, this article offers advice about delivering safe and compassionate consultations about DVA.

Compassionate Use

10.1177/1755738018759133

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A manifesto for improving cancer detection: four key considerations when implementing innovations across the interface of primary and secondary care

The Lancet Oncology (2024)

Anna Dowrick Sue Ziébland Tanvi Rai Claire Friedemann Smith Brian D Nicholson

Manifesto

Unintended consequences

Interface (matter)

Cancer Detection

10.1016/s1470-2045(24)00102-5