Intimate Partner Violence (IPV) is recognised as a worldwide public health issue associated with increased morbidity and mortality, with significant health and social consequences of affected individuals5. IPV can include physical violence, sexual violence, psychological abuse and controlling behaviours by a current or past intimate partner. It is also one of the most common causes of harm to women worldwide6. Increased physical health problems such as injury, chronic pain, gastrointestinal, and gynaecological signs, as well as mental health issues such as depression and post-traumatic stress disorder are all identified as issues arising from IPV7. There is an ongoing need for resources and tools that women can access in ways it is safe for them to do so. Evidence-based safety strategies support women to protect themselves from both experiencing IPV and from the ongoing effects of IPV8. Therefore, the aim of this scoping review is to identify and describe the safety strategies identified in existing literature, to inform the development of a web-based safety decision tool for women experiencing IPV during COVID-19.
IPV has been described by the Executive Director of the United Nations Women as a “shadow pandemic” during COVID-191. Government authorities and non-government partners worldwide are reporting escalating IPV as countries grapple with the impacts of COVID-19. The coronavirus pandemic has influenced the lives of all people in New Zealand, with those vulnerable to family harm particularly impacted. Family violence is estimated to cost the New Zealand economy $4.1 billion to $7.0 billion dollars annually 9 . Before the coronavirus pandemic, 1 in 3 women in New Zealand experienced physical and/or sexual violence from an abusive partner in intimate relationships in their lifetime 10 . However, the current pandemic has amplified cases of IPV against women, with up to three times as many IPV cases compared to the same time last year 1 . This experience is echoed in New South Wales with 45% of IPV frontline workers reporting an escalation of IPV cases and 71% reporting increased complexity related to COVID-1911.
Māori are overrepresented in family violence statistics with 1 in 2 Māori women experiencing IPV in their lifetime compared with 1 in 3 non-Māori women10. Māori women are also three times as likely to be victims of homicide than non-Māori12. For Indigenous women, stigma and structural racism are common barriers to disclosing their experience of abuse to a formal service13. The social and structural entrapment experienced by women in abusive relationships, particularly for Māori women, is compounded by the impact of measures needed to contain COVID-1914. Therefore, any initiatives designed to support women experiencing IPV need to be responsive to the social and cultural needs of Māori.
The ongoing COVID-19 crisis brings emotional stress, economic strain, disruption of roles and responsibilities combined with restricted movement and social isolation. The stay-at-home policies have effectively reduced the spread of the disease leading to worldwide implementation to varying degrees15. IPV intensifies while women and their children are isolated from the people and resources that could help them16. Home is not a safe place for everyone, especially for those who may have to work from home or self-isolate at home with a partner who is agitated due to the social distancing restrictions during a pandemic. IPV victims during COVID-19 need alternative ways to stay safe as the usual channels of support may be compromised by the requirements surrounding social distancing1. Internationally there are reports of escalating IPV and a need for service innovations to support the types of help needed by victims of IPV at this time17.
In Aotearoa/New Zealand, an interactive, individualised web-based safety-decision aid (isafe) was developed in 2014 and tested in a randomised controlled trial. The isafe tool includes risk assessment and priority setting activities for safety decision making and the development of a personalised safety action plan for women experiencing IPV. isafe is currently being retooled for the COVID-19 context and will be deployed across Aotearoa/New Zealand. This review will identify current and emerging best practice related to safety strategies for women experiencing IPV during the COVID-19 pandemic to inform the safety plans within isafe. Dissemination of isafe nationwide has the potential to contribute to reducing IPV severity and improve health and wellbeing during the pandemic alerts, particularly for Māori women who have access to technology and the internet. isafe offers an alternative to formal help seeking and is potentially an economically sustainable resource. With effective community deployment, the tool may be a link for women to seek help from formal services, or for family advocates to incorporate within their assessment processes.
A scoping review was identified as the most appropriate method to identify extant COVID-19 related safety strategies within the literature. Scoping reviews are an increasingly popular method to review a broad range of health research evidence4. As a method to support knowledge synthesis, scoping reviews have been used to answer a range of health-related research questions and have potential to advance health care practice, policy and research18. In undertaking scoping reviews, researchers can critically examine the extent, range, and nature of the research activity in order to summarise and disseminate research findings and/or identify gaps in the existing literature4.
A preliminary search of MEDLINE, the Cochrane Database of Systematic Reviews and JBI Evidence Synthesis was conducted and no current scoping reviews on the topic were identified. Initial search of databases and google identified multiple resources that may fulfil the inclusion criteria. The objective of this scoping review is to identify the safety strategies in the literature that are specific to the COVID-19 context. An analysis of these safety strategies alongside discussions with community advocates about the application within Aotearoa New Zealand will inform the development of isafe to support women experiencing violence during COVID-19 and beyond.
Our scoping review seeks to answer, what safety strategies exist for women experiencing intimate partner violence during the COVID-19 pandemic?
The scoping review is designed to meet the following objectives:
Identify safety strategies designed to support women experiencing intimate partner violence during the COVID-19 pandemic.
Analyse appropriateness of strategies from policy, agency and service user perspectives.
Identify culturally informed safety strategies designed to support Indigenous Māori women.