چکیده (انگلیسی):

Background:Despite primary health care being recognised as an ideal setting to effectively respond to those
experiencing family violence, responses are not widely integrated as part of routine health care. A lack of evidence
testing models and approaches for health sector integration, alongside challenges of transferability and
sustainability, means the best approach in responding to family violence is still unknown. The Primary Health Care
Family Violence Responsiveness Evaluation Tool was developed as a guide to implement a formal systems-led
response to family violence within New Zealand primary health care settings. Given the difficulties integrating
effective, sustainable responses to family violence, we share the experience of primary health care sites that
embarked on developing a response to family violence, presenting the enablers, barriers and resources required to
maintain, progress and sustain family violence response development.
Methods:In this qualitative descriptive study data were collected from two sources. Firstly semi-structured focus
group interviews were conducted during 24-month follow-up evaluation visits of primary health care sites to
capture the enablers, barriers and resources required to maintain, progress and sustain a response to family
violence. Secondly the outcomes of a group activity to identify response development barriers and implementation
strategies were recorded during a network meeting of primary health care professionals interested in family
violence prevention and intervention; findings were triangulated across the two data sources.
Results:Four sites, representing three PHOs and four general practices participated in the focus group interviews;
35 delegates from across New Zealand attended the network meeting representing a wider perspective on family
violence response development within primary health care. Enablers and barriers to developing a family violence
response were identified across four themes: ‘Getting started’, ‘Building effective relationships’, ‘Sourcing funding’
and‘Shaping a national approach to family violence’.
Conclusions:The strong commitment of key people dedicated to addressing family violence is essential for
response sustainability and would be strengthened by prioritising family violence response as a national health
target with dedicated resourcing. Further analysis of the health care system as a complex adaptive system may
provide insight into effective approaches to response development and health system integration.