Digital Education of Health Professionals on the Management of Domestic Violence: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

Ushashree Divakar, Nuraini Nazeha, Pawel Posadzki, Krister Jarbrink, Ram Bajpai, Andy Hau Yan Ho, James Campbell, Gene Feder, Josip Car, Ushashree Divakar, Nuraini Nazeha, Pawel Posadzki, Krister Jarbrink, Ram Bajpai, Andy Hau Yan Ho, James Campbell, Gene Feder, Josip Car

Abstract

Background: The World Health Organization states that 35% of women experience domestic violence at least once during their lifetimes. However, approximately 80% of health professionals have never received any training on management of this major public health concern.

Objective: The objective of this study was to evaluate the effectiveness of health professions digital education on domestic violence compared to that of traditional ways or no intervention.

Methods: Seven electronic databases were searched for randomized controlled trials from January 1990 to August 2017. The Cochrane Handbook guideline was followed, and studies reporting the use of digital education interventions to educate health professionals on domestic violence management were included.

Results: Six studies with 631 participants met our inclusion criteria. Meta-analysis of 5 studies showed that as compared to control conditions, digital education may improve knowledge (510 participants and 5 studies; standardized mean difference [SMD] 0.67, 95% CI 0.38-0.95; I2=59%; low certainty evidence), attitudes (339 participants and 3 studies; SMD 0.67, 95% CI 0.25-1.09; I2=68%; low certainty evidence), and self-efficacy (174 participants and 3 studies; SMD 0.47, 95% CI 0.16-0.77; I2=0%; moderate certainty evidence).

Conclusions: Evidence of the effectiveness of digital education on health professionals' understanding of domestic violence is promising. However, the certainty of the evidence is predominantly low and merits further research. Given the opportunity of scaled transformative digital education, both further research and implementation within an evaluative context should be prioritized.

Keywords: domestic violence; evidence-based; health workforce; systematic reviews.

Conflict of interest statement

Conflicts of Interest: None declared.

©Ushashree Divakar, Nuraini Nazeha, Pawel Posadzki, Krister Jarbrink, Ram Bajpai, Andy Hau Yan Ho, James Campbell, Gene Feder, Josip Car. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.05.2019.

Figures

Figure 1
Figure 1
Preferred Reported Items for Systematic Reviews and Meta-analyses chart summarizing the selection process. RCT: randomized controlled trial.
Figure 2
Figure 2
Forest plot comparing the experimental and control groups in terms of outcomes. IV: interval variable; random: random effect model; std: standardized.
Figure 3
Figure 3
Risk of bias summary.

References

    1. Krantz G. Violence against women: a global public health issue! J Epidemiol Community Health. 2002 Apr;56(4):242–3. doi: 10.1136/jech.56.4.242.
    1. Hewins E, DiBella D, Mawla J. Domestic Violence and the Role of the Healthcare Provider: The Value of Educating on Assessment and Intervention Strategies. 2013. [2019-05-11]. .
    1. World Health Organization . Responding to Intimate Partner Violence and Sexual Violence Against Women: WHO Clinical and Policy Guidelines 2013. Geneva, Switzerland: WHO Press; 2013. [2019-05-20]. .
    1. . 2018. Oct 05, [2019-05-11]. Guidance - Domestic abuse: how to get help .
    1. Kaur R, Garg S. Addressing domestic violence against women: an unfinished agenda. Indian J Community Med. 2008 Apr;33(2):73–6. doi: 10.4103/0970-0218.40871.
    1. World Health Organization. [2018-10-01]. Understanding and addressing violence against women. Intimate partner violence .
    1. Florida State University. 2014. [2019-05-09]. Conditions & Injuries Related to Domestic Violence-National Prevention Toolkit on Domestic Violence for Medical Professionals .
    1. Davis R. Domestic violence‐related deaths. Jnl Aggress Conflict Peace Res. 2010 Apr 14;2(2):44–52. doi: 10.5042/jacpr.2010.0141.
    1. Perona M, Benasayag R, Perelló A, Santos J, Zárate N, Zárate P, Mearin F. Prevalence of functional gastrointestinal disorders in women who report domestic violence to the police. Clin Gastroenterol Hepatol. 2005 May;3(5):436–41.
    1. Stene LE, Jacobsen GW, Dyb G, Tverdal A, Schei B. Intimate partner violence and cardiovascular risk in women: a population-based cohort study. Journal of women's health. 2013;22(3):250–8.
    1. Trevillion K, Oram S, Feder G, Howard LM. Experiences of domestic violence and mental disorders: a systematic review and meta-analysis. PLoS One. 2012;7(12):e51740. doi: 10.1371/journal.pone.0051740.
    1. Yut-Lin W, Othman S. Early detection and prevention of domestic violence using the Women Abuse Screening Tool (WAST) in primary health care clinics in Malaysia. Asia Pac J Public Health. 2008;20(2):102–16. doi: 10.1177/1010539507311899.
    1. Usta J, Antoun J, Ambuel B, Khawaja M. Involving the health care system in domestic violence: what women want. Ann Fam Med. 2012;10(3):213–20. doi: 10.1370/afm.1336.
    1. Sardinha L, Nájera Catalán HE. Attitudes towards domestic violence in 49 low-middle-income countries: A gendered analysis of prevalencecountry-level correlates. PLOS ONE. 2018;13(10):e0206101.
    1. Anyangwe SC, Mtonga C. Inequities in the global health workforce: the greatest impediment to health in sub-Saharan Africa. Int J Environ Res Public Health. 2007 Jun;4(2):93–100.
    1. Du Plat-Jones J. Domestic violence: the role of health professionals. Nurs Stand. 2006;21(14-16):44–8. doi: 10.7748/ns2006.12.21.14.44.c6392.
    1. Arcoraci V, Squadrito F, Altavilla D, Bitto A, Minutoli L, Penna O, Amato A, Bruno R, Tripodi VF, Alibrandi A, Ingrassia PL, Santalucia P, Fodale V. Medical simulation in pharmacology learning and retention: A comparison study with traditional teaching in undergraduate medical students. Pharmacol Res Perspect. 2019 Feb;7(1):e00449. doi: 10.1002/prp2.449.
    1. Congdon TW. A medical student's perspective on education about domestic violence. Acad Med. 1997 Jan;72(1 Suppl):S7–9.
    1. Zaher E, Keogh K, Ratnapalan S. Effect of domestic violence trainingystematic review of randomized controlled trials. Canadian Family Physician. 2014;60(7):618–624.
    1. Runyan CW, Gunther-Mohr C, Orton S, Umble K, Martin SL, Coyne-Beasley T. PREVENT: a program of the National Training Initiative on Injury and Violence Prevention. Am J Prev Med. 2005 Dec;29(5 Suppl 2):252–8. doi: 10.1016/j.amepre.2005.08.013.
    1. Zehry K, Halder N, Theodosiou L. E-Learning in medical education in the United Kingdom. Procedia - Social and Behavioral Sciences. 2011;15:3163–3167. doi: 10.1016/j.sbspro.2011.04.265.
    1. Shefet D, Dascal-Weichhendler H, Rubin O, Pessach N, Itzik D, Benita S, Ziv A. Domestic violence: a national simulation-based educational program to improve physicians' knowledge, skills and detection rates. Med Teach. 2007 Jun;29(5):e133–8. doi: 10.1080/01421590701452780.
    1. Sangrà A, Vlachopoulos D, Cabrera N. Building an inclusive definition of e-learning: An approach to the conceptual framework. IRRODL. 2012 Apr 13;13(2):145–159. doi: 10.19173/irrodl.v13i2.1161.
    1. Paul P, Toon E, Hadadgar A, Jirwe M, Lim KTK, Semwal M, Tudor Car L, Zary N, Lockwood C, Car J. PROSPERO CRD42016045571. 2016. [2019-05-16]. Online- and local area network (LAN)-based eLearning interventions for medical doctors' education .
    1. Ruiz JG, Mintzer MJ, Leipzig RM. The impact of E-learning in medical education. Acad Med. 2006 Mar;81(3):207–12.
    1. Wong WK, Ng PK. An Empirical Study on E-Learning versus Traditional Learning among Electronics Engineering Students. American Journal of Applied Sciences. 2016 Jun 01;13(6):836–844. doi: 10.3844/ajassp.2016.836.844.
    1. Car J, Carlstedt-Duke J, Tudor Car L, Posadzki P, Whiting P, Zary N, Atun R, Majeed A, Campbell J, Digital Health Education Collaboration Digital Education in Health Professions: The Need for Overarching Evidence Synthesis. J Med Internet Res. 2019 Dec 14;21(2):e12913. doi: 10.2196/12913.
    1. Kyaw BM, Saxena N, Posadzki P, Vseteckova J, Nikolaou CK, George PP, Divakar U, Masiello I, Kononowicz AA, Zary N, Tudor Car L. Virtual Reality for Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res. 2019 Jan 22;21(1):e12959. doi: 10.2196/12959.
    1. Dunleavy G, Nikolaou CK, Nifakos S, Atun R, Law GCY, Tudor Car L. Mobile Digital Education for Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res. 2019 Feb 12;21(2):e12937. doi: 10.2196/12937.
    1. Huang Z, Semwal M, Lee SY, Tee M, Ong W, Tan WS, Bajpai R, Tudor Car L. Digital Health Professions Education on Diabetes Management: Systematic Review by the Digital Health Education Collaboration. J Med Internet Res. 2019 Feb 21;21(2):e12997. doi: 10.2196/12997.
    1. George PP, Zhabenko O, Kyaw BM, Antoniou P, Posadzki P, Saxena N, Semwal M, Tudor Car L, Zary N, Lockwood C, Car J. Online Digital Education for Postregistration Training of Medical Doctors: Systematic Review by the Digital Health Education Collaboration. J Med Internet Res. 2019 Feb 25;21(2):e13269. doi: 10.2196/13269.
    1. Lall P, Rees R, Law GCY, Dunleavy G, Cotič Z, Car J. Influences on the Implementation of Mobile Learning for Medical and Nursing Education: Qualitative Systematic Review by the Digital Health Education Collaboration. J Med Internet Res. 2019 Feb 28;21(2):e12895. doi: 10.2196/12895.
    1. Tudor Car L, Kyaw BM, Dunleavy G, Smart NA, Semwal M, Rotgans JI, Low-Beer N, Campbell J. Digital Problem-Based Learning in Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res. 2019 Feb 28;21(2):e12945. doi: 10.2196/12945.
    1. Tudor Car L, Kyaw BM, Atun R. The role of eLearning in health management and leadership capacity building in health system: a systematic review. Hum Resour Health. 2018 Sep 03;16(44):1–9. doi: 10.1186/s12960-018-0305-9.
    1. Xu X, Posadzki PP, Lee GE, Car J, Smith HE. Digital Education for Health Professions in the Field of Dermatology: A Systematic Review by Digital Health Education Collaboration. Acta Derm Venereol. 2018 Oct 15;99(2):133–138. doi: 10.2340/00015555-3068.
    1. Wahabi HA, Esmaeil SA, Bahkali KH, Titi MA, Amer YS, Fayed AA, Jamal A, Zakaria N, Siddiqui AR, Semwal M, Tudor Car L, Posadzki P, Car J. Medical Doctors' Offline Computer-Assisted Digital Education: Systematic Review by the Digital Health Education Collaboration. J Med Internet Res. 2019 Mar 01;21(3):e12998. doi: 10.2196/12998.
    1. Semwal M, Whiting P, Bajpai R, Bajpai S, Kyaw BM, Tudor Car L. Digital Education for Health Professions on Smoking Cessation Management: Systematic Review by the Digital Health Education Collaboration. J Med Internet Res. 2019 Mar 04;21(3):e13000. doi: 10.2196/13000.
    1. Gentry SV, Gauthier A, L'Estrade Ehrstrom B, Wortley D, Lilienthal A, Tudor Car L, Dauwels-Okutsu S, Nikolaou CK, Zary N, Campbell J, Car J. Serious Gaming and Gamification Education in Health Professions: Systematic Review. J Med Internet Res. 2019 Mar 28;21(3):e12994. doi: 10.2196/12994.
    1. Kyaw BM, Posadzki P, Dunleavy G, Semwal M, Divakar U, Hervatis V, Tudor Car L. Offline Digital Education for Medical Students: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res. 2019 Mar 25;21(3):e13165. doi: 10.2196/13165.
    1. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta-analyses involving cross-over trials: methodological issues. Int J Epidemiol. 2002 Feb;31(1):140–9.
    1. Accreditation Council for Continuing Medical Education. [2019-05-10]. CME Content: Definition and Examples .
    1. Davis N, Davis D, Bloch R. Continuing medical education: AMEE Education Guide No 35. Med Teach. 2008;30(7):652–66. doi: 10.1080/01421590802108323.
    1. Short LM, Surprenant ZJ, Harris JM Jr. A community-based trial of an online intimate partner violence CME program. Am J Prev Med. 2006 Feb;30(2):181–5. doi: 10.1016/j.amepre.2005.10.012.
    1. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. 2011. [2019-05-10].
    1. Guyatt G, Oxman A, Akl EA, Kunz R, Vist G, Brozek J, Norris S, Falck-Ytter Y, Glasziou P, DeBeer H, Jaeschke R, Rind D, Meerpohl J, Dahm P, Schünemann HJ. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011 Apr;64(4):383–94. doi: 10.1016/j.jclinepi.2010.04.026.
    1. Danley D, Gansky Sa, Chow D, Gerbert B. Preparing dental students to recognize and respond to domestic violence. The Journal of the American Dental Association. 2004 Jan;135(1):67–73. doi: 10.14219/jada.archive.2004.0022.
    1. Harris JM Jr, Kutob RM, Surprenant ZJ, Maiuro RD, Delate TA. Can Internet-based education improve physician confidence in dealing with domestic violence? Fam Med. 2002 Apr;34(4):287–92.
    1. Hsieh NK, Herzig K, Gansky SA, Danley D, Gerbert B. Changing dentists' knowledge, attitudes and behavior regarding domestic violence through an interactive multimedia tutorial. J Am Dent Assoc. 2006 May;137(5):596–603.
    1. Shapiro MC, Anderson OR, Lal S. Assessment of a novel module for training dental students in child abuse recognition and reporting. J Dent Educ. 2014 Aug;78(8):1167–75.
    1. Smeekens AE, Broekhuijsen-van Henten DM, Sittig JS, Russel IM, ten Cate OT, Turner NM, van de Putte EM. Successful e-learning programme on the detection of child abuse in emergency departments: a randomised controlled trial. Arch Dis Child. 2011 Apr;96(4):330–4. doi: 10.1136/adc.2010.190801.
    1. Masic I. E-learning as new method of medical education. Acta Inform Med. 2008;16(2):102–17. doi: 10.5455/aim.2008.16.102-117.
    1. Neville FG. Oxford Textbook Of Violence Prevention: Epidemiology, Evidence, And Policy. Oxford University Press: Oxford Textbooks In Public Health; 2015. Preventing violence through changing social norms; pp. 239–244.
    1. World Health Organization World Health Organization. 2009. [2019-02-02]. Violence prevention the evidence: Changing cultural and social norms that support violence .
    1. World Health Organization . Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva, Switzerland: WHO; 2013. [2019-02-02]. .
    1. Feder G, Davies RA, Baird K, Dunne D, Eldridge S, Griffiths C, Gregory A, Howell A, Johnson M, Ramsay J, Rutterford C, Sharp D. Identification and Referral to Improve Safety (IRIS) of women experiencing domestic violence with a primary care training and support programme: a cluster randomised controlled trial. Lancet. 2011 Nov 19;378(9805):1788–95. doi: 10.1016/S0140-6736(11)61179-3.
    1. Passey D, Laferrière T, Ahmad MY-A, Bhowmik M, Gross D, Price J, Resta P, Shonfeld M. Educational Digital Technologies in Developing Countries Challenge Third Party Providers. Journal of Educational Technology & Society. 2016;19(3):121–133.
    1. Grant S, Mayo-Wilson E, Montgomery P, Macdonald G, Michie S, Hopewell S, Moher D, on behalf of the CONSORT-SPI Group CONSORT-SPI 2018 Explanation and Elaboration: guidance for reporting social and psychological intervention trials. Trials. 2018 Jul 31;19(1):406. doi: 10.1186/s13063-018-2735-z.

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