Preventing violence against women and girls - what works: evidence summary

Executive Summary

Research aims and overview

This report was undertaken to support strategic thinking regarding what works to prevent violence against women and girls (VAWG). This review presents a synthesis of available high-quality evidence on effective interventions for preventing VAWG; contributing to the work of Scottish Government’s Equally Safe strategy.

This report focuses on primary prevention interventions – those aimed at preventing violence before it occurs (WHO 2002). This review’s prevention and early intervention focus reflects the Scottish Government’s public health approach to violence prevention (ScotPHN 2019). This report is intended to inform policymakers and practitioners^[2] about the evidence base and effectiveness associated with different primary interventions to prevent VAWG.

The evidence summarised within this review is predominantly international^[3], 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 effective or 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. For the full out of scope list, refer to Annex E.

Key findings

Where is there evidence of effectiveness?

• There is strong evidence that interventions focused on modifying unsafe physical school environments are effective in preventing VAWG
• An example of this intervention is the Shifting Boundaries programme in the USA

Where is there evidence of promising or mixed effectiveness?

• There is strong evidence to suggest that bystander programmes that encourage prosocial behaviours among peers are promising in preventing VAWG
• Examples of bystander programmes include Mentors in Violence Prevention (MVP), the Green Dot and Bringing in the Bystander. However, each programme differs in approach
• There is evidence that school-based programmes which seek to prevent violence in dating and intimate partner relationships (through developing life skills, improving knowledge of abuse, and challenging social norms and gender stereotypes that increase the risk of violence) are promising
• Of these programmes, there is strong evidence that the Safe Dates programme is effective
• There is mixed evidence about the effectiveness of education as a sexual violence prevention strategy in higher education
• For example, there is limited robust evidence that looks at rape prevention programmes in both the short-term and longitudinally

Where is the evidence inconclusive?

• Due to a limited body of research it is not yet possible to draw reliable conclusions on the effectiveness of the following interventions:
• Awareness campaigns and edutainment
• Domestic abuse disclosure schemes
• Honour-based violence (HBV) interventions
• Interventions to prevent female genital mutilation (FGM)

Moderating factors: key findings

Across this report, the importance of accounting for the moderating factors, potential facilitators, and potential barriers for prevention interventions for VAWG have been highlighted where evidence is available. Accounting for these factors can encourage effective implementation of these evidence-based interventions.

According to the WHO (2019), the implementation of interventions to prevent VAWG must apply their guiding principles for effective programming. These ten principles^[4] are:

Core values

• Put women’s safety first and do no harm
• Promote gender equality and women’s human rights
• Leave no one behind

Generate and Disseminate Knowledge

• Develop a theory of change
• Promote evidence informed programming

Programme Design

• Use participatory approaches
• Promote coordination
• Implement combined interventions
• Address the prevention continuum
• Take a life-course approach

Conclusions

Importantly, this report acknowledges that the experience of potential victims-survivors and the effectiveness of prevention-focused interventions may vary greatly dependent on their protected characteristics, identity, and access to resources. Overall, there is limited evidence of what works for different populations.

Overall, much of the available high-quality evidence on the effectiveness of primary interventions to prevent VAWG has come from high income countries (such as the USA and Canada amongst others). In this context, it is important to account for cultural context in the application of interventions within a Scottish context, including the gendered analysis adopted in Scotland, where VAWG is defined as being a cause and consequence of systemic, deep-rooted women’s inequality (Annex B of the report outlines implementation fidelity and associated issues).

Some interventions have been identified as out of scope for this report (see Annex E). While these interventions have not been included within this report, this does not necessarily indicate that they do not work. Rather, they have been excluded due to limited available evidence (e.g. high-quality evaluations) or they are beyond the primary prevention focus of this report (e.g. topic out of scope).

Directions for future research

Based on the evidence presented within this report, the following areas for future research have been identified:

i. Further evaluations of interventions – both in Scotland and elsewhere – are necessary to understand ‘what works’. For example, for the interventions classified as ‘inconclusive’ additional evidence via high-quality longitudinal evaluations would be beneficial for understanding the impacts of these interventions on preventing VAWG. Embedding evaluation within the intervention programme approach will contribute to understanding the most effective approaches to preventing VAWG. Such evaluations should include both quantitative and qualitative approaches to better understand the impacts and effects of each intervention.

ii. More longitudinal research is required to understand the effects of primary prevention interventions for VAWG over time.

iii. While challenging, research that measures behavioural changes as a direct outcome would be welcome. As shown throughout this review, many evaluations of interventions to prevent VAWG focus on attitudinal change as an outcome. It is acknowledged that the relationship between attitudinal and behavioural change is unclear. As such, evidence on how attitudinal change impacts long term behavioural changes is often promising but sparse.

iv. Evidence around effective or promising primary prevention interventions is often from education settings with young people (e.g. secondary schools or higher education). Further research could look at alternative settings for primary prevention interventions.

v. Future research focused upon understanding interventions that may be effective for preventing HBV and FGM would be valuable. There is limited evidence available, particularly within the context of high-income countries. Likewise, while deemed out of scope for this report, there is limited available evidence on what works to prevent commercial sexual exploitation.

vi. Of the primary interventions presented within this report, those that focus on attitudinal and/or behavioural change to prevent VAWG (e.g. with younger people) may have an impact in preventing coercive and controlling behaviours as forms of domestic abuse, although whether interventions specifically targeted coercive and controlling behaviour was not always clear from the available literature. The evidence linked to this explicit outcome is limited and could be explored further.

vii. While there is emerging evidence about the exacerbated risk and impacts of domestic abuse for victim-survivors and families within the current context of the COVID-19 pandemic (WHO 2020), it is unclear whether/to what extent the nature of domestic abuse itself has changed^[5]. 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.