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Sohal AH, Feder G, Barbosa E, Beresford L, Dowrick A, El-Shogri F, Howell A, Lewis N, Johnson M, Nightingale C, Boomla K, Morris S, Eldridge S, Griffiths C. BMC Public Health 2018; 18(1): e971.


Queen Mary University of London, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, England.


(Copyright © 2018, Holtzbrinck Springer Nature Publishing Group - BMC)






BACKGROUND: Domestic violence and abuse remains a major health concern. It is unknown whether the improved healthcare response to domestic violence and abuse demonstrated in a cluster randomised controlled trial of IRIS (Identification and Referral to Improve Safety), a complex intervention, including general practice based training, support and referral programme, can be achieved outside a trial setting.

AIM: To evaluate the impact over four years of a system wide implementation of IRIS, sequentially into multiple areas, outside the setting of a trial.

METHODS: An interrupted time series analysis of referrals received by domestic violence and abuse workers from 201 general practices, in five northeast London boroughs; alongside a mixed methods process evaluation and qualitative analysis. Segmented regression interrupted time series analysis to estimate impact of the IRIS intervention over a 53-month period. A secondary analysis compares the segmented regression analysis in each of the four implementation boroughs, with a fifth comparator borough.

DISCUSSION: This is the first interrupted time series analysis of an intervention to improve the health care response to domestic violence. The findings will characterise the impact of IRIS implementation outside a trial setting and its suitability for national implementation in the United Kingdom.

Language: en


Domestic violence abuse complex intervention implementation evaluation


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