Howarth Emma, Feder Gene, Barter Christine, Powell Claire
School of Psychology, University of Sussex, Brighton, United Kingdom.
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
Front Psychiatry. 2024 Mar 11;15:1296437. doi: 10.3389/fpsyt.2024.1296437. eCollection 2024.
There is appetite in the UK to better measure the impact of domestic violence and abuse (DVA) interventions on children. The spread of outcomes-based commissioning means outcome measurement is no longer just the territory of academic researchers but is now firmly within the purview of practitioners and policy makers. However, outcomes measured in trials only partially represent the views of those delivering and using services with respect to how success should be defined and captured. Even within trials there is huge inconsistency in the definition and measurement of important endpoints. This yields a body of evidence that is difficult to make sense of, defeating the ends for which it was produced - to improve the response to children and families who have experienced abuse. Development of Core Outcome Sets (COS) is seen as a solution to this problem, by establishing consensus across key stakeholder groups regarding a minimum standard for outcome measurement in trials, and increasingly in service delivery contexts. To date COS development has addressed outcomes relating to health conditions or interventions, with limited application to public health challenges. We reflect on our efforts to develop a COS to evaluate psychosocial interventions for children and families experiencing DVA. We highlight the value of COS development as a mechanism for improving evidence quality and the response to families experiencing abuse. Finally, we make recommendations to researchers and COS guideline developers to support this broader application of COS methodology.
英国有意愿更好地衡量家庭暴力和虐待(DVA)干预措施对儿童的影响。基于结果的委托方式的推广意味着结果测量不再只是学术研究人员的领域,现在已牢牢落入从业者和政策制定者的职权范围内。然而,试验中测量的结果仅部分代表了服务提供者和使用者对于如何定义和获取成功的看法。即使在试验中,重要终点的定义和测量也存在巨大的不一致性。这产生了一堆难以理解的证据,违背了其产生的目的——改善对遭受虐待的儿童和家庭的应对措施。核心结局集(COS)的开发被视为解决这一问题的方法,通过在关键利益相关者群体之间就试验中,以及越来越多地在服务提供环境中的结果测量的最低标准达成共识。迄今为止,COS的开发主要涉及与健康状况或干预措施相关的结果,在公共卫生挑战方面的应用有限。我们反思了我们为开发一个COS以评估针对遭受DVA的儿童和家庭的心理社会干预措施所做的努力。我们强调了COS开发作为提高证据质量和应对遭受虐待家庭的一种机制的价值。最后,我们向研究人员和COS指南开发者提出建议,以支持COS方法的更广泛应用。