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IPV as a public health issue
February 2018
Julie Taylor [PhD; RN; MSc; BSc (Hons); RNT;
FRCN]
Professor of Child Protection
Co-authors: Caroline Bradbury-Jones and
Maria Clark
Recurrence
• A third of those who have experienced IPV since
age 16 suffer over a long period of time.
• One in three experience more than one incident of
abuse often more than 20 times
• Most is undisclosed, but some more hidden than
others, eg forced marriage
What do we NOT mean by a public health
approach?
It does not mean “going soft” on violence and abuse
It does not make victims responsible for behaviour change or
prevention
It is not solely about primary prevention or health promotion
It doesn’t mean it is health’s job
It does not mean we can’t act until we have complete understanding
It does not work in opposition to ecological or developmental models
What is a public health approach to IPV? 

Taylor IPV2018_CCJP
A public health approach requires an
understanding of:
Classification, diagnosis, prevalence and incidence
Aetiological research – risk and protective factors, causal
mechanisms, and outcomes
Intervention and evaluation research – what works for whom
in what settings
Effectiveness of implementation and dissemination efforts


Focus on populations as entities

Requires knowledge of the prevalence (actual extent) of a
condition not just incidence (eg number of reported
cases).
Requires measurement of changes over time on the basis
of prevalence measures or proxy measures
Depends on epidemiology as a core discipline and good
data linkage systems
Taylor IPV2018_CCJP
Taylor IPV2018_CCJP
Taylor IPV2018_CCJP
1. Safer car
design
2. Better road
engineering
3. Improved driver
education
4. Drink driving, speeding
and seat belt laws and
enforcement
5. Public education
campaigns
Road Safety Strategy
A framework for promotion and prevention
Long term
outcomes
Prevention before
occurrence
Universal
‘Primary
Prevention’
Targeted
‘Secondary
Prevention’
Prevention of
recurrence
‘Tertiary Prevention’
Prevention of
impairment
IPV
Taylor IPV2018_CCJP
Possible Points of Intervention (A Public Health Approach)
Upstream
(primary protection)
Midstream
(secondary prevention)
Downstream
(tertiary intervention)
Poverty, housing
Lobbying
Community based
primary prevention
Risk reduction
programmes
Educational initiatives
Trauma recovery
programmes
Victim support
Adapted from Public Health Model of Diabetes Control (2001); and Tropical Disease Research Centre (2010)
Social
inequalities
Institutional
power
Neighbour-
hood Risk
indicators
Morbidity &
Injury
Mortality
Promising practices
• School based education programmes
• Early childhood and family-based approaches
• Community based education programmes
• Community action campaigns
• Social marketing/public education campaigns
• Social media
• Edutainment
• Legislative and policy reform
• Interventions to reduce alcohol and substance misuse
• Saturation approach
• Foster gender equality and women’s empowerment
• Integration of IPV prevention into a range of areas
• Improve safety of urban and rural physical environments
• Working with men and boys
Challenges in primary prevention
• The challenge of effective programme
design
• The challenge of acknowledging
gender in violence against women
prevention
• The challenge of evaluation
• The challenge of resources
Zika virus, swine flu…
Success is a non-event…..
@bulawayojulie
j.taylor.1@bham.ac.uk
Julie.Taylor99@nhs.net

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Taylor IPV2018_CCJP

  • 1. IPV as a public health issue February 2018 Julie Taylor [PhD; RN; MSc; BSc (Hons); RNT; FRCN] Professor of Child Protection Co-authors: Caroline Bradbury-Jones and Maria Clark
  • 2. Recurrence • A third of those who have experienced IPV since age 16 suffer over a long period of time. • One in three experience more than one incident of abuse often more than 20 times • Most is undisclosed, but some more hidden than others, eg forced marriage
  • 3. What do we NOT mean by a public health approach? It does not mean “going soft” on violence and abuse It does not make victims responsible for behaviour change or prevention It is not solely about primary prevention or health promotion It doesn’t mean it is health’s job It does not mean we can’t act until we have complete understanding It does not work in opposition to ecological or developmental models
  • 4. What is a public health approach to IPV? 

  • 6. A public health approach requires an understanding of: Classification, diagnosis, prevalence and incidence Aetiological research – risk and protective factors, causal mechanisms, and outcomes Intervention and evaluation research – what works for whom in what settings Effectiveness of implementation and dissemination efforts
  • 7. 
 Focus on populations as entities
 Requires knowledge of the prevalence (actual extent) of a condition not just incidence (eg number of reported cases). Requires measurement of changes over time on the basis of prevalence measures or proxy measures Depends on epidemiology as a core discipline and good data linkage systems
  • 11. 1. Safer car design 2. Better road engineering 3. Improved driver education 4. Drink driving, speeding and seat belt laws and enforcement 5. Public education campaigns Road Safety Strategy
  • 12. A framework for promotion and prevention Long term outcomes Prevention before occurrence Universal ‘Primary Prevention’ Targeted ‘Secondary Prevention’ Prevention of recurrence ‘Tertiary Prevention’ Prevention of impairment IPV
  • 14. Possible Points of Intervention (A Public Health Approach) Upstream (primary protection) Midstream (secondary prevention) Downstream (tertiary intervention) Poverty, housing Lobbying Community based primary prevention Risk reduction programmes Educational initiatives Trauma recovery programmes Victim support Adapted from Public Health Model of Diabetes Control (2001); and Tropical Disease Research Centre (2010) Social inequalities Institutional power Neighbour- hood Risk indicators Morbidity & Injury Mortality
  • 15. Promising practices • School based education programmes • Early childhood and family-based approaches • Community based education programmes • Community action campaigns • Social marketing/public education campaigns • Social media • Edutainment • Legislative and policy reform • Interventions to reduce alcohol and substance misuse • Saturation approach • Foster gender equality and women’s empowerment • Integration of IPV prevention into a range of areas • Improve safety of urban and rural physical environments • Working with men and boys
  • 16. Challenges in primary prevention • The challenge of effective programme design • The challenge of acknowledging gender in violence against women prevention • The challenge of evaluation • The challenge of resources
  • 17. Zika virus, swine flu… Success is a non-event…..