The impact on children of exposure to domestic violence and the implications for a primary care response: a systematic review and secondary analysis of qualitative evidence

Children growing up with domestic violence and abuse (DVA), even if a child is not the direct target, can experience major physical and psychological health consequences, some of which persist to adulthood. Many of these childhood problems (challenging behaviours, post-traumatic stress disorder, depression and anxiety) will present to general practitioners. This study aims to bring together evidence about how being exposed DVA affects children’s health and well-being, and the needs that result, in order to make recommendations about how primary care might address these needs with support from other specialist services.

Exposure to DVA is common: 14% of children will be exposed at some point in their childhoods, and typically 3% in the past year. Much of the work that measures the impact of DVA on children is based on survey research, which neither captures the depth of experience or the voices of the children themselves. This means that strategies to help children recover may target issues that researchers feel are important, rather than those important to children. As part of a NIHR-funded review of programmes for children exposed to DVA (IMPROVE), we found several papers reporting how DVA affects children, from the viewpoint of children and non-abusing parents.

As part of a NIHR-funded qualitative study looking at the impact on friends and relatives of survivors, we generated rich information from other concerned third parties (non-parents) about the impact on children. In VOICES, we will draw together and derive some overarching messages from these sources in order to give a picture of: how children are affected by DVA; the areas of their lives that are most impacted; the most important health issues to be addressed from the perspective of children; and the needs that could potentially be addressed by doctors and other professionals working in primary care.

Research team: Alison Heawood¹ (co-PI), Alison Gregory (co-PI)¹, Lisa Arai¹, Gene Feder¹, Theresa Moore², Emma Howarth³, Harriet Macmillan⁴, Nicky Stanley⁵

1 Centre for Academic Primary Care, NIHR School for Primary Care Research, University of Bristol, England
2 NIHR CLAHRC West, University of Bristol, England
3 NIHR CLAHRC East of England, University of Cambridge, England
4 McMaster University, Canada
5 University of Central Lancashire, England

Funding body: NIHR School for Primary Care Research (UK)

Funding period: 2015-2017