SELECTING AND VALIDATING OUTCOME MEASURES FOR THE DOMESTIC VIOLENCE AND ABUSE CORE OUTCOME SET (DVA-COS)
By Jenna Harewell, Elizabeth Dunk Shivi Bains, Emma Howarth, Claire Powell, Lazaros Gonidis
Background - The domestic abuse core outcome set (DVA-COS) is an agreed set of five outcomes intended for use in evaluations of interventions or services for children and families with experience of domestic violence and abuse (DVA, hereafter referred to as domestic abuse). A COS is a minimum standard for measurement in intervention studies, the purpose of which is to overcome heterogeneity in outcome selection and measurement. The aim of a COS is to maximise the value of a body of evidence by facilitating comparison between and synthesis across studies, thus reducing research wastage. Since the development of the DVA-COS, work has been undertaken to identify, select, and validate outcome measurement instruments (OMIs) to measure the core outcomes. The Warwick– Edinburgh Mental Wellbeing Scale (WEMWBS) was previously identified as acceptable by stakeholders to capture two outcomes: child and caregiver emotional health and wellbeing. This work seeks to extend those findings by validating the measure for use with domestic abuse experienced populations. Aims Foundations, the national What Works Centre for Children & Families, commissioned two work packages to develop and integrate previous work to outline and validate OMIs for use to assess outcomes comprising the DVA-COS. Work package 1 seeks to identify three OMIs, and this report focuses on work package 2, which aimed to validate the Short WEMWBS (SWEMWBS) for use with children and young people (aged 11 to 18) who have experienced domestic abuse. The studies that make up this work package used mixed methods to examine the acceptability, content validity, structural validity, internal consistency, and measurement invariance for the scale in children and young people experiencing domestic abuse. We also report a validation study of the WEMWBS for adults with experience of domestic abuse. Methods The above aims were addressed across four individual studies: two planned and two supplementary. First, a qualitative ‘think aloud’ study assessed the acceptability of the SWEMWBS with children and young people who had experienced domestic abuse. The remaining three studies were quantitative analyses of secondary data on using the SWEMWBS and WEMWBS with children and young people and adult samples. • Study A: a qualitative think aloud study that involved interviews and a focus group to gather feedback from children and young people with domestic abuse experience on use of the SWEMWBS. • Study B: examined cross-sectional data collected by the OxWell Student Survey to validate the SWEMWBS with children and young people affected by domestic abuse. • Study C: examined anonymised longitudinal service data to validate the SWEMWBS with children and young people affected by domestic abuse. • Study D: validated the WEMWBS with adults who have experienced domestic abuse using cross-sectional data from the Adult Psychiatric Morbidity Survey (APMS). Key findings Our findings demonstrate the validity and acceptability of the SWEMWBS and WEMWBS in domestic abuse-experienced child and adult populations respectively. Study A indicated that the SWEMWBS is broadly acceptable for use with children and young people, while raising important considerations regarding respondents’ interpretation of the measure’s items as well as the emotional impact of the measure on this population. Studies B and C demonstrated robust psychometric validity2 of the SWEMWBS with children and young people affected by domestic abuse, and Study D showed robust psychometric validity of the WEMWBS with adult victims of domestic abuse. These are significant findings given the limited number of measures that have been evaluated for use with this population across practice and research contexts. Moreover, this represents an important step forward in the implementation of the DVA-COS, which we hope will help to unify outcome measurement in domestic abuse research and evaluation, as well as service monitoring. Recommendations We recommend that the SWEMWBS and WEMWBS be used to measure wellbeing in the context of evaluation studies (of any quantitative design) seeking to assess the impact of child-focused domestic abuse interventions. To enhance the acceptability of the measure to children and adults we suggest minor adaptations for use in the domestic abuse context. Finally, we recommend the development of guidelines for practitioners and researchers about how to use the tools in a ‘carefirst’ way and how to guard against the tools being used for screening or triaging, or rationing care, as well as guidance for commissioners on how to interpret and use evidence, generated by the completion of the SWEMWBS and WEMWBS, for the basis of decision making. This guidance needs to reflect the balance between the benefits of data-driven decision making and the risk of unduly narrowing the breadth of services or thwarting innovation in the sector. The OMI’s implementation (including the use of guidance) should be closely monitored and evaluated, to inform any associated refinements and to develop an in-depth understanding of the process and outcomes associated with embedding routine measurement in practice. Further work is also required to identify an alternative OMI or adapt the SWEMWBS for appropriate use with children under the age of. 11.
Foundations UK: 2025. 106p.
