Pathways to Safety: A qualitative evaluation of an Australian domestic violence training program for primary care.

Abstract

BACKGROUND: General practitioners are among the most trusted professionals for disclosures of domestic violence (DV). However, primary care health professionals often perceive they lack the skills to appropriately respond. To address this need, the Pathways to Safety Training Program was delivered, aiming to increase readiness to respond to DV in primary care using a whole-of-practice approach. This qualitative study sought to evaluate the experiences and impact of the program on participants and program facilitators. METHODS: Twenty-five participants from primary care clinics and facilitators of the training program were interviewed about their experiences of the program and its impact on their practice. Interviews were audio-recorded, transcribed verbatim and thematically analysed. RESULTS: We generated five themes: The collaborative, whole-of-practice approach engaged and motivated learners; Skilled and sensitive facilitators created safe spaces; Training encouraged professional and personal connection; Training elevated the response to DV; and Participants identified opportunities to expand the program. A whole-of-practice approach led to opportunities for appreciation, interaction, and collaboration between colleagues. These opportunities were managed by skilled facilitators who were trained and supported to create safe spaces. This encouraged professional and personal connection which enhanced the spirit of collaboration post-training and provided the context for in-depth reflection on attitudes about DV. This, in conjunction with the practical skills learned during the training, led to an elevation of the response to DV within primary care. Participants identified opportunities to expand the program including follow-up training sessions to encourage accountability, more advanced training and an in-person delivery option. CONCLUSIONS: From a qualitative perspective, Pathways to Safety training program positively impacted the readiness of primary care to respond to DV. Two features of this training program are the whole-of-practice approach and co-facilitation by general practitioners and DV workers, which created opportunities for collaboration, reflection and conversation to improve the response to DV. We recommend the development and sustained funding of training programs which use this structure to enhance practice and service cohesion on sensitive clinical issues.