Effects of an e-learning platform to improve primary care physicians’ response to domestic violence

Family Violence (FV) is a broad term that includes different types of violence and abuse that occur within the family, like domestic violence (DV) or Intimate Partner Violence (IPV), Child Abuse or neglect (CA), Elder Abuse (EA) and Female Genital Mutilation (FGM), inter alia. The most prevalent is DV or IPV, declared to be one of the most serious human rights violations, even prior to the aggravated situation brought about by the COVID-19 in 2020. Margaret Chan, 2013 WHO director, called it a global public health care issue of epidemic proportions, but COVID-19 has transformed it into a pandemic as well, earning it the dubious distinction of being the shadow pandemic. Governments’ responses to stop the spread of the infection have forced many families to stay at home, triggering or aggravating cases of IPV and abuse.

The prevalence of IPV around the world has been estimated at 30%, although this percentage varies depending on the region of the world or the country, ranging from 20% in the Western Pacific to 33% in the World Health Organisation (WHO) South-East Asia region. Unfortunately, the United Nations Population Fund (UNFPA) predicts that the impact of the pandemic will increase IPV by 20% during the pandemic.

Despite the epidemic proportions of this healthcare problem and its enormous and horrendous consequences at all levels (social well-being, physical and mental health), not only for the individual but also their families, IPV remains largely underdiagnosed. Although victims tend to use healthcare services more, and trust health care professionals (HCP) to disclose abuse, they do not do so unless professionals specifically ask for it. Nevertheless, one of the most common barriers that prevent HCP from enquiring is that they do not feel adequately trained to tackle it.

Although research on the effectiveness of IPV training for HCP suggests that they improve their knowledge, attitudes, self-perceived readiness to approach this problem, and actual response, this topic has not yet been formally included in the curricula.
The World Health Organization and the National Institute for Health have published guidelines for health services and recommendations to facilitate the development and implementation of effective training, underlining the need to improve HCP education.

The overall objectives of this thesis are to describe current training provisions on FV in the European Region (FAVICUE), and to investigate the effects of a digital education intervention in improving primary care physicians’ response to DV (E-DOVER).