Title: A realist review of advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse
Funder: Department of Health and Social Care

Abstract: The new realist review will evaluate active features of advocacy for women experiencing partner abuse (1.3 million in England and Wales, 2015/16), to inform our linked Cochrane review, CD005043 (update due 2018). Advocacy has become more complex since the CD005043 review began in 2005. For the 2015 update we used author consensus to determine inclusion of advocacy packages, including psychological support. More objective appraisal of action and effect was impossible with current research knowledge. This weakened review findings, with heterogeneous approaches and uncertainty regarding active elements and related outcomes. A linked realist review (with service user feedback) will strengthen: the 2018 update’s usefulness; future logic models; NICE guidelines recommending NHS advocacy use. We envisage CD005043 branching into two related reviews that provide clearer evidence and thus are better positioned to inform practice. We anticipate 17 studies in the CD005043 review update; the realist review will also include studies of psychological support, thus possibly 20-25 studies. The government considers domestic violence (costing the nation £5.5 billion/year) a priority issue, pledging £100 million funding for 2017. Thus, our theoretically underpinned linked reviews with their practical recommendations will have potential for significant policy impact. Review authors include UK leaders in domestic violence policy.

Lay abstract: The new realist review will evaluate active features of advocacy for women experiencing partner abuse (1.3 million in England and Wales, 2015/16), to inform our linked Cochrane review, CD005043 (update due 2018). Advocacy has become more complex since the CD005043 review began in 2005. For the 2015 update we used author consensus to determine inclusion of advocacy packages, including psychological support. More objective appraisal of action and effect was impossible with current research knowledge. This weakened review findings, with heterogeneous approaches and uncertainty regarding active elements and related outcomes. A linked realist review (with service user feedback) will strengthen: the 2018 update’s usefulness; future logic models; NICE guidelines recommending NHS advocacy use. We envisage CD005043 branching into two related reviews that provide clearer evidence and thus are better positioned to inform practice. We anticipate 17 studies in the CD005043 review update; the realist review will also include studies of psychological support, thus possibly 20-25 studies. The government considers domestic violence (costing the nation £5.5 billion/year) a priority issue, pledging £100 million funding for 2017. Thus, our theoretically underpinned linked reviews with their practical recommendations will have potential for significant policy impact. Review authors include UK leaders in domestic violence policy.

Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: DISPUTED AETIOLOGY AND OTHER