The PEACH Study:What Makes for Effective Prevention in Domestic

Abuse for Children and Young People?

Jane Ellis, Nicola Farrelly, Soo Downe, Sue Bailey, Sandra Hollinghurst and Nicky Stanley

Effectiveness

Questions of effectiveness linked to:• aims or intended outcomes of programmes

• underpinning theory

• evaluation methodology

• time frame

Systematic review: flow chart

Programme aims and intended outcomes

• Few explicitly seek behaviour change

• Most seek to 'raise awareness' – increase knowledge and understanding– implicit assumption K and U will change attitudes – support for victims through help-seeking

information

Peer reviewed literature: programme outcomes

• 9 controlled trials and 14 cohort studies• 8 had evidence of medium (5-12 months) and long-term

(over 12 months) outcomes• 3 reported behavioural change (all RCTs)• 2 reported changes in awareness, knowledge and help

seeking only (pre- and post)• 1 reported no change (control group)• 2 adverse effects (one RCT and one control)

Audiences• Small groups of students at higher risk at baseline

might have skewed data

• Boys increasingly identified as a key target for change

• ‘Fourth R’ programme that found gender to have a direct relationship on outcomes

• Little attention paid to addressing complexities for marginalised children and young people; lack of attention to LBGT young people repeatedly emphasised

• No controlled studies with children aged under 10

UK grey literature • Reviewed evaluations of 28 programmes

• Pre/post and process evaluations

• Those who received interventions generally enjoyed them and found them valuable

• Criticisms focused on a need for longer programmes

• Difficulties in engaging some boys who thought programmes were anti-men

Theoretical underpinning • Theories about causation and change

• Explicit statements of theory found in more recent studies in published and grey literature

• Social norms and feminist theory widely used

• An interpretation of behavioural change theory hypothesised

• Five programmes had theory of change models

• Philosophical mis-alignment is more problematic than lack of programme fidelity

Context• National policy: framing delivery of preventive

interventions as a statutory requirement = wider and more consistent implementation

• Also provides a strong message from Government that contributes to shifting social norms

• Transferring across cultures and populations difficult• Boys to Men - greater resources required• Safe Dates - attention to language and cultural context of

abuse

Local contexts• Readiness of setting/school was seen to be

important

• Support across all aspects of a school’s work,

parents, local community and relevant local

agencies (whole school approach)

• Advantages in involving young people in design

and delivery

• Issues re referral on after disclosure

Disclosure and access to support services

Qualitative literature reviewed and the young people’s consultation group argued for interventions to be linked to appropriate services for those who disclosed experiences of abuse in their own or their parents’ relationships

‘it makes people aware but then they need the help afterwards’ (Young People’s Consultation Group 1)

UK Media Campaign ‘This is Abuse’

• Target audience:• 13 -18 year old boys and girls with a slight C2DE bias• parents/carers (adults 35+)• partner agencies• latterly shift to focus on boys conduct

• Aims to challenge attitudes, mobilise communities and signpost help

• Multi platform: website, TV, ads in range of locations inc online and mobile, materials for partner organisations

• TV and online – greatest reach

Campaign outcomes• Longer term outcomes from the campaign not captured, such

measures are difficult to obtain

• Data from two waves in 2011 and 2012

• Increased help-seeking from partner agencies and use of ‘Need Help’ section on website

• 540,000 visits to website during 2011/12 with 2,500 comments made on discussion forums

• High proportion of comments (48% on rape prevention campaign) from victims of abuse

• Comments show adverts helped young people to understand what abusive behaviours were and that they had been raped

this website is so good and helpful! I never spoke to anyone

about my experience because i was worried no one would

understand but on here people who actually know what you

have been through can reply to you, it’s helped me so much and

now i am seeking the right help to get my life back to normal and

to deal with my feelings. I'm so relieved i found this website, I'm

now having councilling but i could have never done it without

getting advice from this website, i hope everyone else on this

website who has been hurt can now feel more confident and now

feel as though they aren't alone :) xxx

(Comment on campaign website’s discussion forum)

Media campaigns and schools work

• Increasingly important in shaping the climate within which school based interventions are received

• Function as a source for materials used in the delivery of schools programmes

Gaps identified to date

• Effectiveness in terms of outcomes (rather than process measures or intervening variables)

• Effectiveness for populations and specific sub-groups

• Agreed tool(s) for analysis of process and outcomes

• Literature on costs and cost effectiveness• Evaluation of media campaigns

Conclusions • North American evidence shows programmes can

change behaviour as well as knowledge and attitudes• Need for home-grown programmes in UK• Use whole population interventions to identify those at

risk with need for other services • Interventions need to take account of power

differentials particularly in relation to gender • Messages should be positively framed avoiding a

blaming approach that could provoke resistance from some boys

This project was funded by the National Institute for Health Research Public Health Research Programme

The views and opinions expressed are those of the authors and do not necessarily reflect those of the Public Health Research Programme, NIHR, NHS or the Department of Health

PEACH Project report coming soon…