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Designing and evaluating culture-sensitive and faith-based domestic violence interventions: International experiences

Background

Within the sector of domestic violence, the question of evaluation and effectiveness is central. Despite the existence of a wide array of interventions and programmes, how effectiveness is to be measured given difference designs, methodologies and approaches in the sector is an on-going debate. Moreover, specialists increasingly recognise the importance of accounting for cultural diversity and the need to address gaps in the domestic violence evidence of what works and for whom in different cultural contexts.

The current webinar aims to contribute to this effort by looking more closely at how interventions can be assessed cross-culturally, with a special focus on interventions that are designed to be sensitive to religious traditions, faith and spirituality. Are current methods adequate to capture the complex mechanisms by which faith-based domestic violence interventions impact on victims/survivors and perpetrators, congregations or communities? How should evaluation mechanisms be designed when programmes aim to be religio-culturally sensitive and what should be the standards for measuring effectiveness, if there should be a common standard in the first place? Currently, the randomised controlled trial (RCT) method is considered one of the most rigorous scientific approaches in the evaluation of domestic violence programmes. Are RCTs appropriate and adequate for capturing impact when it is recognised that impact can be defined differently cross-culturally, requiring different approaches to be measured?

The webinar will combine a series of presentations by researchers and practitioners from different disciplines and sectors who are experienced in the design, implementation and/or evaluation of domestic violence research and interventions working with diverse communities and in diverse cultural contexts. The aim is to reflect on and respond to the questions guiding the webinar to achieve knowledge exchange and to farther cross-sectoral and cross-disciplinary learning. The presentations will be followed by a discussion with the audience, who will be welcome to share their own experiences and response to the webinar questions and presentations.

Presentations

Designing and evaluating faith-based interventions in culture-sensitive ways: Insights from the international evidence and practical lessons from project dldl/ድልድል

Dr Romina Istratii, Project dldl/ድልድል & Mr Aklil Damtew/Ms Bantamlak Gelaw, EOC DICAC, Ethiopia

A common reference for the scholarship that looks at faith-based interventions involving clergy is the understanding that religious personnel, the discourses they use and their responses to communities can both contribute to the continuation of the problem of domestic violence and serve as a positive influence in efforts to address the problem. While the literature on domestic violence interventions involving clergy is extensive, crossing the disciplines of psychology, sociology, anthropology and the sectors of public health and international development, the evidence on evaluation and assessment methods is visibly limited. A systematic review of the evidence identified 12 relevant papers that discussed domestic violence interventions involving clergy across the world, some of which assessed effectiveness and/or impact. Most assessments of such programmes were qualitative, and there was a visible dearth of studies that managed to evaluate programme effectiveness using quantitative methodologies. The presentation will discuss some of the most relevant evidence on faith-based interventions to problematise and explore standards of effectiveness when programmes are designed and delivered in diverse cultural and religious contexts. The second part of the presentation will turn to look at the assessment approach followed by project dldl/ድልድል to assess the impact of a series of domestic violence workshops delivered with clergy in Ethiopia combining approaches used in the NGO sector with research rigorous methodologies and objectives.

Lessons learned from a domestic violence perpetrator programme

Professor Parveen Ali, Division of Nursing and Midwifery, Health Sciences School, The University of Sheffield

Domestic violence and abuse (DVA) has been identified as a pressing public health issue, but one with a very weak evidence base to inform intervention design and delivery. Emergency hospital admission rates linked to DVA are around five times higher in deprived communities than in the most affluent. Service commissioners and providers need to understand that effective interventions, if implemented well with good uptake in deprived areas and population groups, would have an important effect on reducing the related inequalities in physical and mental ill-health. Effective interventions would also have an important social and economic impact as the overall costs of DVA. There have been some attempt to evaluate perpetrator programmes for voluntary participants in the UK, but much more needs to be done to understand the mechanism through which such programme work especially when delivered to people from social-economically deprived areas. There is a need for more rigorous and theory-driven evaluations of community-based interventions for perpetrators to enable greater understanding of how such interventions operate to effect change, the optimal components of such interventions, and how they can be successfully implemented in practice. This presentation aims to explore how lessons learned from a domestic violence perpetrator programme evaluation helped shape design, development and delivery of the new County Wide perpetrator programme – Inspire to Change.

Testing the effectiveness of domestic violence interventions: Why randomised controlled trials are necessary but not sufficient

Professor Gene Feder, Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol

We need to know if interventions to prevent domestic violence or improve outcomes for survivors and their families do more harm than good. We also need to know if the resources for these interventions can be justified as there are always competing interventions (and priorities). The randomised controlled trial is a method of reducing bias in the measurement of the effects of interventions, whether these are community-based programmes, perpetrator groups or individual care for survivors. The results of trials can also be pooled in meta-analyses to give a more generalisable estimate of the effect and explore factors that may influence the effect (e.g. demographics or type of violence). With nested qualitative studies, trial findings can be placed into their specific institutional, cultural, and national contexts. Trials also pose epistemological and political challenges, including who determines the choice of outcome measures, what happens if important outcomes don’t have measures, and how to convince intervention advocates or service providers that their intervention needs testing (and that not all participants will get the intervention).

Arts-based and visual methods for designing and evaluating domestic violence interventions

A/Prof Erminia Colucci, Department of Psychology, Middlesex University London

Domestic violence is one of the strongest predictors of suicidal behaviour, yet both these (interlinked) major public health issues are highly stigmatised and challenging to explore in most societies. During this presentation, Erminia will provide examples and reflections on the use of arts-based and visual methods for designing and evaluating culture- and faith-sensitive domestic violence interventions. She will emphasise the need to expand our concept of ‘evaluation’ to include tools that allow for a meaningful in-depth exploration of impact and change at individual and community levels.

Presenters’ bios

Mr Aklil Damtew

Akli Damtew has been working as a lawyer and Project Coordinator for the EOC DICAC Development Commission for 10 years. He previously served for four years as the Legal Department Head at the North Shoa Diocese of Debre Birhan in Amhara region. Aklil holds a Bachelor Degree and LLB in Law and an MBA in Business Management. He also has a traditional church educational training and background. In the past year, he has served as the focal point for project dldl/ድልድል and the project’s pilot series of workshops to train clergy on domestic violence in North Shoa.

Dr Romina Istratii

Dr Romina Istratii is UKRI Future Leaders Fellow at the School of History, Religions and Philosophies at SOAS University of London. She is Principal Investigator of the UKRI-funded project “Bridging religious studies, gender & development and public health to address domestic violence: A novel approach for Ethiopia, Eritrea and the UK” and creator of project dldl/ድልድል. She is a critical international development thinker and practitioner from Eastern Europe with decade-long experience in developing cosmology-sensitive and people-centred methodologies and approaches for analysing and addressing issues with gender dimensions in religious societies of Africa. She is the author of the monograph Adapting Gender and Development to Local Religious Contexts: A Decolonial Approach to Domestic Violence in Ethiopia (Routledge, 2020).

Professor Parveen Ali

Professor Parveen Ali works as a Professor in Nursing at the University of Sheffield. She is a Registered Nurse, Registered Midwife (Pakistan) Registered Nurse Teacher, Senior Fellow of Higher Education Academy and a Fellow of Royal Society of Arts, Manufactures and Commerce and Fellow of Faculty of Public Health. Parveen is Editor-in-Chief of International Nursing Review (The Official Journal of International Council of Nurses). She is an editorial board member of Journal of Advanced Nursing and Journal of Interpersonal Violence and visiting professor at Dow University of Health Sciences, Karachi, Pakistan and Khyber Medical University, Peshawar, Pakistan. Parveen’s research focuses on gender-based violence, domestic abuse, inequalities in health related to gender and ethnicity, and health care professionals’ preparation. She also loves to contribute to the development of health care professionals nationally and internationally to ensure health care professionals are prepared to meet the needs of individuals, families, communities and health care systems in this changing world.

Professor Gene Feder

Gene qualified at Guy’s Hospital medical school, following a BSc in Biology and Philosophy from the University of Sussex. He trained as a GP and was a principal in Hackney for 21 years until moving to Bristol. His research started with the health and healthcare of Traveller Gypsies, followed by studies on the development and implementation of clinical guidelines, management of chronic respiratory and cardiovascular conditions in primary care and the health impact of domestic violence. Current research focuses on healthcare responses to domestic violence globally. Gene’s methodological expertise is in randomised controlled trials and systematic reviews, collaborating with epidemiologists and social scientists on cohort and qualitative studies respectively. He has chaired four NICE guideline development groups and led the WHO intimate partner violence guidelines.

A/Prof Erminia Colucci

Dr. Erminia Colucci is Associate Professor in Visual and Cultural Psychology in the Department of Psychology at Middlesex University London (UK) and a registered Clinical and Community Psychologist (Italy). Her main area of research and training is in Cultural and Global Mental Health (PhD in Cultural Psychiatry), and Applied Cross-Cultural Psychology and Visual Anthropology (MPhil in Ethnographic Documentary), with a focus on low-middle income countries and immigrant and refugee populations. Erminia is passionate about using arts-based and visual methods in her research, teaching and advocacy activities. Erminia is the founder of Movie-ment and Chair of the World Association of Cultural Psychiatry SIG on Arts, Mental Health and Human Rights.

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