Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK.
Trials. 2023 Sep 28;24(1):617. doi: 10.1186/s13063-023-07612-6.
In contrast to evidence for interventions supporting victim/survivors of domestic violence and abuse (DVA), the effectiveness of perpetrator programmes for reduction of abuse is uncertain. This study aims to estimate the effectiveness and cost-effectiveness of a perpetrator programme for men.
Pragmatic two-group individually randomised controlled trial (RCT) with embedded process and economic evaluation. Five centres in southwest England and South Wales aim to recruit 316 (reduced from original target of 366) male domestic abuse perpetrators. These will be randomised 2:1 to a community-based domestic abuse perpetrator programme (DAPP) or usual care comparator with 12-month follow-up. Female partners/ex-partners will be invited to join the study. The intervention for men comprises 23 weekly sessions of a group programme delivered in voluntary sector domestic abuse services. The intervention for female partners/ex-partners is one-to-one support from a safety worker. Men allocated to usual care receive no intervention; however, they are free to access other services. Their partners/ex-partners will be signposted to support services. Data is collected at baseline, and 4, 8 and 12 months' follow-up. The primary outcome is men's self-reported abusive behaviour measured by the Abusive Behaviour Inventory (ABI-29) at 12 months. Secondary measures include physical and mental health status and resource use alongside the abuse measure ABI (ABI-R) for partners/ex-partners and criminal justice contact for men. A mixed methods process evaluation and qualitative study will explore mechanisms of effectiveness, judge fidelity to the intervention model using interviews and group observations. The economic evaluation, over a 1-year time horizon from three perspectives (health and social care, public sector and society), will employ a cost-consequences framework reporting costs alongside economic outcomes (Quality-Adjusted Life Years derived from EQ-5D-5L, SF-12 and CHU-9D, and ICECAP-A) as well as the primary and other secondary outcomes.
This trial will provide evidence of the (cost)effectiveness of a DAPP. The embedded process evaluation will further insights in the experiences and contexts of participants and their journey through a perpetrator programme, and the study will seek to address the omission in other studies of economic evaluations.
ISRCTN15804282, April 1, 2019.
与支持家庭暴力和虐待受害者/幸存者的干预措施相比，减少施虐者虐待行为的干预措施的有效性尚不确定。本研究旨在评估一种针对男性的施虐者方案的有效性和成本效益。
采用实用的 2 组个体随机对照试验（RCT），并嵌入了过程和经济评估。英格兰西南部和南威尔士的 5 个中心旨在招募 316 名（从最初的 366 名目标减少）男性家庭暴力施虐者。这些人将以 2:1 的比例随机分配到基于社区的家庭暴力施虐者方案（DAPP）或常规护理对照组，并进行 12 个月的随访。女性伴侣/前伴侣将被邀请参加研究。男性的干预措施包括在自愿部门的家庭暴力服务中进行 23 次每周小组课程。女性伴侣/前伴侣的干预措施是由安全工作者提供一对一的支持。分配到常规护理的男性不接受干预；但是，他们可以自由访问其他服务。他们的伴侣/前伴侣将被引导到支持服务。数据在基线时收集，并在 4、8 和 12 个月的随访时收集。主要结局是男性在 12 个月时通过虐待行为清单（ABI-29）自我报告的虐待行为。次要指标包括伴侣/前伴侣的身心健康状况和资源使用情况，以及针对男性的虐待行为测量（ABI-R）和刑事司法接触。一项混合方法的过程评估和定性研究将探索有效性的机制，通过访谈和小组观察来判断对干预模型的忠实程度。经济评估将在 1 年的时间范围内从三个角度（健康和社会护理、公共部门和社会）进行，采用成本效益框架，报告成本以及经济结果（EQ-5D-5L、SF-12 和 CHU-9D 得出的质量调整生命年，以及 ICECAP-A）以及主要和其他次要结果。
这项试验将提供 DAPP 的（成本）有效性证据。嵌入式过程评估将进一步深入了解参与者的经验和背景以及他们在施虐者方案中的经历，并且该研究将试图解决其他研究中经济评估的遗漏问题。
ISRCTN86713772，2019 年 4 月 1 日。
