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      Trends in outcomes used to measure the effectiveness of UK-based support interventions and services targeted at adults with experience of domestic and sexual violence and abuse: a scoping review

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          Abstract

          Objectives

          In the UK, a range of support services and interventions are available to people who have experienced or perpetrated domestic and sexual violence and abuse (DSVA). However, it is currently not clear which outcomes and outcome measures are used to assess their effectiveness. The objective of this review is to summarise, map and identify trends in outcome measures in evaluations of DSVA services and interventions in the UK.

          Design

          Scoping review.

          Data sources

          MEDLINE, EMBASE, PsycINFO, Social Policy and Practice, ASSIA, IBSS, Sociological abstracts and SSCI electronic databases were searched from inception until 21 June 2022. Grey literature sources were identified and searched.

          Eligibility

          We included randomised controlled trials, non-randomised comparative studies, pre–post studies and service evaluations, with at least one outcome relating to the effectiveness of the support intervention or service for people who have experienced and/or perpetrated DSVA. Outcomes had to be assessed at baseline and at least one more time point, or compared with a comparison group.

          Charting methods

          Outcome measures were extracted, iteratively thematically grouped into categories, domains and subdomains, and trends were explored.

          Results

          80 studies reporting 87 DSVA interventions or services were included. A total of 426 outcome measures were extracted, of which 200 were used more than once. The most commonly reported outcome subdomain was DSVA perpetration. Cessation of abuse according to the Severity of Abuse Grid was the most common individual outcome. Analysis of temporal trends showed that the number of studies and outcomes used has increased since the 1990s.

          Conclusions

          Our findings highlight inconsistencies between studies in outcome measurement. The increase in the number of studies and variety of measures suggests that as evaluation of DSVA services and interventions matures, there is an increased need for a core of common, reliable metrics to aid comparability.

          Protocol registration

          https://osf.io/frh2e.

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          Most cited references131

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          PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

          Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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            A brief measure for assessing generalized anxiety disorder: the GAD-7.

            Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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              The PHQ-9: validity of a brief depression severity measure.

              While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2024
                30 April 2024
                : 14
                : 4
                : e074452
                Affiliations
                [1 ] departmentHealth Service and Population Research , Ringgold_4616King's College London , London, UK
                [2 ] departmentViolence and Society Centre , Ringgold_4895City University of London , London, UK
                [3 ] departmentPopulation Health Sciences Institute , Ringgold_5994Newcastle University , Newcastle upon Tyne, UK
                [4 ] departmentPopulation Health Sciences, Bristol Medical School , Ringgold_1980University of Bristol , Bristol, UK
                [5 ] Ringgold_9701National Centre for Social Research , London, UK
                [6 ] departmentCentre for Academic Primary Care, Population Health Sciences, Bristol Medical School , University of Bristol , Bristol, UK
                Author notes
                [Correspondence to ] Dr Sophie Carlisle; sophie.r.carlisle@ 123456kcl.ac.uk
                Author information
                http://orcid.org/0000-0002-9784-9910
                http://orcid.org/0000-0002-7608-8702
                http://orcid.org/0000-0002-7890-3926
                http://orcid.org/0000-0002-4839-6548
                Article
                bmjopen-2023-074452
                10.1136/bmjopen-2023-074452
                11086554
                38688671
                0e6fc7f0-eedd-4f8e-a8d5-e4edb719bf30
                © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/.

                History
                : 11 April 2023
                : 19 March 2024
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100014013, UK Research and Innovation;
                Award ID: MR-VO49879/1
                Categories
                Public Health
                1506
                1724
                Original research
                Custom metadata
                unlocked

                Medicine
                systematic review,public health,mental health
                Medicine
                systematic review, public health, mental health

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