Identifying and responding to domestic abuse in cancer care: A mixed methods service evaluation of a training and support intervention

Purpose: This article reports on a service evaluation of a domestic abuse intervention for hospital-based cancer professionals in two sites. The core component was a training and monitoring process, which hospital-based domestic abuse coordinators led. This role was adapted from a generic hospital role to be cancer specific. Pre-training preparedness to identify and respond to domestic abuse, domestic abuse identifications, and changes ∼6 months post-training are presented.

Methods: We used an explanatory sequential design including a survey pre-training (Time 1), immediately post-training (Time 2) (with follow-up semi-structured interviews) and ∼6 months post-training (Time 3). Sites were asked to share domestic abuse identification numbers pre- and post-coordinator hire.

Results: Coordinators trained 1080 staff (17% of staff across two sites). Survey 1 (Time 1 & 2) response rate was 44.9% (n = 485) and survey 2 8.8% (n = 95) (Time 3). All confidence scores significantly increased from pre- (Time 1) to post-training (Time 2). Time 3 also saw significant gains. There were also highly significant decreases in the perception of most barriers to asking about and responding to domestic abuse post-training. We were unable to determine Site 2's identification rate but Site 1's increased. Qualitative findings shed light on key moderators between intervention components and outcomes, and additional components needed to change practice.

Conclusion: Our evaluation contributes further evidence of the benefit of hospital-based domestic abuse coordinator roles; contributes new evidence for the feasibility of adapting the role for a specific context; and illustrates the need for a domestic abuse response in the cancer setting.