Preventing violence against women and girls - what works: effective investments summary

1. Introduction

This report^[2] looks at interventions used to prevent VAWG. It broadly considers gender based violence (GBV), while considering domestic abuse (DA), and sexual violence (SV) as specific, often overlapping, types of this form of violence.

The evidence summarised within this review is predominantly international; reflecting the wide geographical spread of available and robust evaluations on interventions to prevent VAWG. Scottish evidence has been presented where there is substantial and robust evidence to show that a particular intervention is effectiveor promising.

As this report focuses on pre-criminal justice and prevention-focused interventions, perpetrator programmes such as the Caledonian System and domestic violence perpetrator programmes (DVPPs) are out of scope. However the What Works to Reduce Reoffending (2015) report, which is due to be updated in 2021, will review the international evidence on the extent to which domestic abuse perpetrator programmes reduce reoffending.

Moreover, this report does not include the following interventions and approaches: legislative changes, interventions focused on reducing violence perpetration (rather than preventing it from happening), services to support and advocate for victims-survivors of various forms of VAWG, and interventions within the justice system aimed towards perpetrators, or victims-survivors (including civil protection orders). For the full out of scope list, refer to Annex E in the main report, accessible here.

This report aims to:

• Synthesise existing international evidence regarding the effectiveness of interventions designed to prevent VAWG and signpost to further evidence to help inform decision making
• Provide a clear indication of the effectiveness of an intervention based on a critical assessment of the available evidence base
• Provide information around barriers and facilitators to the successful implementation of interventions

It is important to note that this report does not purport to provide an exhaustive and definitive account of the evidence in this area.

Within this report, interventions are examined that seek specifically to prevent different types of VAWG as an outcome, and those that target key risk factors for violence perpetration and experiences^[3]. It is structured around three key questions^[4]:

1) What works to make environments safe?
2) What works to transform attitudes, beliefs and norms?
3) What works to prevent honour-based violence (HBV), including female genital mutilation (FGM)?^[5]

This report's focus on primary interventions reflects the increasing emphasis on preventive measures for reducing forms of VAWG such as domestic abuse (Cleaver et al., 2019). As Crooks et al. (2019) outline, primary prevention involves:

• universal approaches to reduce the likelihood of VAWG
• reducing risk factors associated with violence
• promoting protective factors to enhance women and girls' safety

While these tend by their nature to be broad based interventions, it is important to highlight that different interventions may impact particular groups of people and particular forms of abuse differently. The following sub sections note some of these differences, to be borne in mind while reading the report:

Victims-survivors characteristics

We know quite a bit about what works to prevent GBV for cisgender, heterosexual, white youth; however, there exist many gaps in our knowledge. These gaps are critical to address if we are to promote healthy relationships for all youths and ensure access to meaningful and effective prevention programs (Crooks et al., 2019:46).

This report therefore acknowledges that the experience of victims-survivors and the effectiveness of interventions may vary greatly dependent on their protected characteristics, identity, and access to resources.

Moreover, research by Femi-Ajoa et al. (2020) indicates additional barriers to disclosing domestic violence and abuse among women from ethnic minority populations include:

• immigration status
• community influences
• problems with language and interpretation
• unsupportive attitudes of staff within mainstream services

In this context, Femi-Ajoa et al. (2020:746) conclude that "there is an on-going need for staff from domestic violence services to be aware of the complexities within which women from ethnic minority populations experience domestic violence and abuse".

Key findings for service delivery and practice:

• Services and practitioners should seek to understand the specific difficulties people from ethnic minorities or religious communities, LGBTQ people, and people from other marginalised groups experience, and to be cognisant of the fact that their needs may differ from the majority of their clients.
• All client work should be trauma informed, and mindful that trauma may have been caused by others in the person's life or by negative experiences with other services or professionals.

Domestic abuse (DA)

Interventions to prevent DA must take the complex psychological, physical, emotional and financial dimensions of this form of VAWG into consideration. This includes the use of coercive and controlling behaviours to underpin and sustain domestic abuse (see Stark, 2007, 2009).

Facilitating early intervention may be a long-term and complex process as domestic abuse victims-survivors may wait considerable time before disclosure^[6] (Cleaver et al. 2019). Research suggests that in seeking formal and informal support, women experiencing DA delayed making contact with specialised services until a crisis occurred (e.g. assault by the perpetrator), or an individual ('an enabler') facilitated access (Evans and Feder 2014). As such, though abuse may have begun, early detection and intervention systems are needed (Cleaver et al., 2019).

Evans and Feder (2014) noted that the women they researched faced various barriers to accessing specialist services including, but not limited to:

• feelings of shame or denial
• lack of trust in others
• fear of repercussions such as the perpetrator finding out
• poor experiences of help seeking

According to Stark (2012), between 60 and 80 per cent of female victims-survivors of domestic abuse who had sought help had been subjected to coercive and controlling behaviours^[7]. Therefore, domestic abuse interventions must acknowledge and address how coercive control by the perpetrator acts as a barrier to victims-survivors reporting their experience or seeking help from the police or support services (see Scottish Women's Aid report, 2017).

Other barriers to reporting for women experiencing DA include, but are not limited to:

• lack of money
• health insurance (USA context)
• available time to contact support services
• lack of knowledge about resources

logistical barriers such as lack of child care or transportation

According to the WHO (2012a) report on intimate partner violence, international evidence highlighted a series of effective or promising approaches to preventing VAWG^[8], including DA^[9]. Although understood as particularly challenging to evaluate, this report advocates for "comprehensive, multi-sectoral, long-term collaboration between governments and civil society at all levels of the ecological framework" including:

• Use behaviour change communication to achieve social change (e.g. school-based prevention programmes)
• Engage men and boys^[10] to promote non-violence and gender equality
• Organise media and advocacy campaigns to raise awareness about existing legislation^[11]

The Scottish Crime and Justice Survey (SCJS) finds that most incidents of partner abuse do not come to the attention of the police^[12]. The SCJS 2017/18 report^[13]found that a fifth (19%) of those who experienced partner abuse in the 12 months prior to interview stated that the police came to know about the most recent incident.

Further breakdowns indicate similar rates of reporting of partner abuse for men (19%) and women (20%) in the 12 months prior to interview according to SCJS 2016/18 data.

Based on 2016/18 SCJS data, when asked the reasons for not reporting the most recent incident of partner abuse to the police, some common reasons given by female respondents were:

• those involved had dealt with the matter themselves (34%)
• the abuse was too trivial/not worth reporting (28%)
• the abuse was a private, personal or family matter (25%)
• it would have been inconvenient or too much trouble (17%)

It is also important to recognise the significant and detrimental impact of the COVID-19 on families experiencing domestic abuse (DA) in Scotland^[14], and internationally (WHO 2020). Evidence from Scotland suggests the isolation associated with the COVID-19 lockdown has magnified the impact and risk of domestic abuse for victims-survivors and children, and in some instances perpetrators of abuse have used violent and abusive behaviour apparently specific to lockdown^[15]. However, it is unclear whether/to what extent the nature of domestic abuse itself has changed. As such, it is not possible to draw conclusions on what the COVID-19 pandemic means for what works to prevent DA and other forms of VAWG. How the COVID-19 pandemic impacts the content and design of prevention-focused interventions should be monitored.

Key findings for service delivery and practice:

• Women typically face emotional barriers like shame and lack of trust, that cause them to delay seeking help.
• They may also face practical barriers ranging from difficulty getting time alone due to coercive control, to other issues like child care, transport, and money. Services should seek to understand the barriers their potential clients face, and find practical ways to meet client needs.
• To support comprehensive change, services and practitioners should seek to connect and collaborate across the sector with other agencies and government.

Sexual violence

DeGue et al.'s (2014) systematic review outlines the following criteria, which can contribute to effective primary prevention strategies for sexual violence perpetration, suggesting that interventions should be:

• comprehensive
• appropriately-timed
• involve varied teaching methods
• include a sufficient 'dose'
• foster positive relationships
• be relevant for particular sociocultural contexts
• have well-trained and equipped staff
• be theory and evidence driven

As noted above in relation to domestic abuse, there are barriers that victims-survivors face in receiving help and support and/or reporting sexual violence to the police^[16]. These can include cultural and socialattitudes, prior unsatisfactory experience with the justice system, concerns about the criminal justice process,and/or potential personal repercussions (see Prochuk 2018 for more detail).

Key findings for service delivery and practice:

• Sexual violence interventions should be theory-based and evidence driven.
• Staff need to be well trained and supported, including in programme fidelity, varied teaching methods, and socio-cultural context.