Applying normalization process theory to understand implementation of a family violence screening and care model in maternal and child health nursing practice: a mixed method process evaluation of a randomised controlled trial

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• 作者：Leesa Hooker ; Rhonda Small ; Cathy Humphreys ; Kelsey Hegarty…
• 关键词：Normalization process theory ; Process evaluation ; Intimate partner violence ; Maternal and child health nursing ; Complex intervention
• 刊名：Implementation Science
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：10
• 期：1
• 全文大小：445 KB
• 参考文献：Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non partner sexual violence.
  1. Vos, T, Astbury, J, Piers, LS, Magnus, A, Heenan, M, Stanley, L (2006) Measuring the impact of intimate partner violence on the health of women in Victoria, Australia. Bull World Health Organ 84: pp. 739 CrossRef
  2. Richards, K (2011) Children’s exposure to domestic violence in Australia. Trends and issues in crime and criminal justice.
  3. Australian Bureau of Statistics. Personal Safety Survey, Australia. 2013.
  4. Walsh, D (2008) The hidden experience of violence during pregnancy: a study of 400 pregnant Australian women. Aust J Prim Health 14: pp. 97-105 CrossRef
  5. Department of Education and Early Childhood Development. Maternal and Child Health Service: Practice Guidelines. 2009.
  6. FamilyViolence: Department of Human Services, Victoria. [http://www.dhs.vic.gov.au/for-individuals/children,-families-and-young-people/family-violence].
  7. Feder, G, Ramsay, J, Dunne, D, Rose, M, Arsene, C, Norman, R (2009) How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of nine UK National Screening Committee critieria. Health Technol Assess 13: pp. 1-113 CrossRef
  8. Taft A, O’Doherty L, Hegarty K, Ramsay J, Davidson L, Feder G. Screening women for intimate partner violence in healthcare settings. Cochrane Database Syst Rev. 2013(4). Art. No. CD007007.
  9. McFarlane, J, Groff, J, O’Brien, J, Watson, K (2006) Secondary prevention of intimate partner violence: a randomized controlled trial. Nurs Res 55: pp. 52-61 CrossRef
  10. MacMillan, HL, Wathen, CN, Jamieson, E, Boyle, MH, Shannon, HS, Ford-Gilboe, M (2009) Screening for intimate partner violence in health care settings: a randomized trial. JAMA 302: pp. 493-501 CrossRef
  11. Tiwari, A, Leung, W, Leung, T, Humphreys, J, Parker, B, Ho, P (2005) A randomised controlled trial of empowerment training for Chinese abused pregnant women in Hong Kong. BJOG 112: pp. 1249-56 CrossRef
  Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines.
  12. Hooker, L, Ward, B, Verrinder, G (2012) Domestic violence screening in Maternal & Child Health nursing practice: a scoping review. Contemp Nurse 42: pp. 198-215 CrossRef
  13. Wathen, CN, MacMillan, HL (2012) Health care’s response to women exposed to partner violence. JAMA 308: pp. 712-3 CrossRef
  14. Department of Education and Early Childhood Development. Maternal and Child Health Service: Program Standards. 2009.
  15. Department of Human Services. Family Violence Risk Assessment and Risk Management Framework and Practice Guides 1- (version 2). 2012.
  16. Department of Education and Early Childhood Development. Maternal and Child Health Service: Key Ages and Stages Framework. 2009.
  17. Taft, A, Small, R, Hegarty, KL, Watson, LF, Gold, L, Lumley, JA (2011) Mothers-AdvocateS In the Community (MOSAIC)-non-professional mentor support to reduce intimate partner violence and depression in mothers: A cluster randomised trial in primary care. BMC Public Health 11: pp. 178 CrossRef
  18. Taft, AJ, Small, R, Humphreys, C, Hegarty, K, Walter, R, Adams, C (2012) Enhanced maternal and child health nurse care for women experiencing intimate partner/family violence: Protocol for MOVE, a cluster randomised trial of screening and referral in primary health care. BMC Public Health 12: pp. 811 CrossRef
  19. May, C, Finch, T (2009) Implementing, embedding,
• 刊物主题：Health Promotion and Disease Prevention; Health Administration; Health Informatics;
• 出版者：BioMed Central
• ISSN：1748-5908

文摘

Background In Victoria, Australia, Maternal and Child Health (MCH) services deliver primary health care to families with children 0- years, focusing on health promotion, parenting support and early intervention. Family violence (FV) has been identified as a major public health concern, with increased prevalence in the child-bearing years. Victorian Government policy recommends routine FV screening of all women attending MCH services. Using Normalization Process Theory (NPT), we aimed to understand the barriers and facilitators of implementing an enhanced screening model into MCH nurse clinical practice. Methods NPT informed the process evaluation of a pragmatic, cluster randomised controlled trial in eight MCH nurse teams in metropolitan Melbourne, Victoria, Australia. Using mixed methods (surveys and interviews), we explored the views of MCH nurses, MCH nurse team leaders, FV liaison workers and FV managers on implementation of the model. Quantitative data were analysed by comparing proportionate group differences and change within trial arm over time between interim and impact nurse surveys. Qualitative data were inductively coded, thematically analysed and mapped to NPT constructs (coherence, cognitive participation, collective action and reflexive monitoring) to enhance our understanding of the outcome evaluation. Results MCH nurse participation rates for interim and impact surveys were 79% (127/160) and 71% (114/160), respectively. Twenty-three key stakeholder interviews were completed. FV screening work was meaningful and valued by participants; however, the implementation coincided with a significant (government directed) change in clinical practice which impacted on full engagement with the model (coherence and cognitive participation). The use of MCH nurse-designed FV screening/management tools in focussed women’s health consultations and links with FV services enhanced the participants-work (collective action). Monitoring of FV work (reflexive monitoring) was limited. Conclusions The use of theory-based process evaluation helped identify both what inhibited and enhanced intervention effectiveness. Successful implementation of an enhanced FV screening model for MCH nurses occurred in the context of focussed women’s health consultations, with the use of a maternal health and wellbeing checklist and greater collaboration with FV services. Improving links with these services and the ongoing appraisal of nurse work would overcome the barriers identified in this study.