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Primary healthcare response to family violence: a Delphi evaluation tool.

BACKGROUND
Family violence is identified as a significant yet preventable public health problem internationally and in Aotearoa, New Zealand. Despite this, responses to family violence within New Zealand primary healthcare settings are generally limited and ad hoc. Along with guidelines and resources, a systems approach is indicated to support a safe and effective response to those who experience violence in the home.


AIM
To modify an existing United States evaluation tool to guide implementation of family violence intervention programmes within New Zealand primary healthcare.


METHODS
Twenty-nine expert panelists, representing diverse family violence prevention and intervention organisations across New Zealand, participated in three rounds of a modified Delphi method to identify ideal primary healthcare family violence response programme indicators. In Round One, tool scope and context issues for New Zealand were identified; in Round Two, expert panelists identified ideal indicators and rated indicator importance, and in Round Three, expert panelists attended a one-day workshop to achieve consensus on tool categories, indicators, scoring and measurement notes. The developed tool was subsequently piloted at six volunteer primary healthcare sites for performance, clarity and usefulness.


RESULTS
The final tool encompasses 143 indicators organised within 10 categories. Pilot sites found the tool and evaluation experience useful in guiding programme development.


CONCLUSION
The evaluation tool represents a best practice standard enabling focused family violence intervention programme development and quality improvement within primary healthcare settings. A standardised evaluation tool may be useful in guiding programme development. Future evaluations will enable individual and national benchmarking activities, using category, overall and target scores to measure progress across settings and over time.