Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: A systematic review and meta-analysis

Background: Domestic and sexual violence and abuse (DSVA) is prevalent and harmful. There are a range of support services and interventions available to those affected by it, but evidence of their effectiveness is uncertain. We synthesised evidence on the effectiveness of UK-based interventions and services for DSVA.

Methods: We conducted a systematic review and, where possible, meta-analysis. We searched MEDLINE, EMBASE, PsycINFO, Social Policy and Practice, ASSIA, IBSS, Sociological abstracts, SSCI and grey literature sources for publications published from inception to July 2023. We included randomised controlled trials, non-randomised comparative studies, pre-post studies, and service evaluations of support interventions or services for adults who had experienced or perpetrated DSVA. The intervention typology and selection of outcomes was determined based on co-production with stakeholders. The quality of the studies was assessed independently by two reviewers. Where meta-analysis was not possible, we synthesized studies with vote counting based on the direction of effect.

Results: Twenty-nine UK-based studies were included: 11 on advocacy, five on outreach, six on psychological interventions or services for victims-survivors, and six on perpetrator programmes. Meta-analyses showed benefits, with 58.7% (95% CI 53.6, 63.8) of advocacy and 46.2% (95% CI 39.1, 53.3) of outreach intervention and service participants reporting cessation of abuse at case closure. Vote counting was performed for psychological support interventions and perpetrator programmes, and showed positive effects on self-esteem and attitudes towards sexual offending. Most studies had a high risk of bias.

Conclusions: There appear to be benefits of UK-based advocacy and outreach services, psychological support interventions, and perpetrator programmes. However, risk of bias and methodological heterogeneity means that there is uncertainty regarding the estimated effects. There is need for more robust research, and a co-produced core-outcome set to facilitate future research in this field.